Is It Pregnancy or Hormonal Imbalance? Unusual Menstrual Changes

I am not sure if this is pregnancy or an endocrine disorder?

Hello, doctor.
I would like to ask about my girlfriend, who hasn't had her period for two months.
She took a pregnancy test, which came back negative.
We had unprotected intercourse on August 24, but I withdrew before ejaculation.
On September 1 and 2, she mentioned experiencing some bleeding that was brown in color, very light, and thin.
Then on September 2, there was a bit of pink blood when she wiped.
The bleeding stopped the next day, September 3, but today, September 4, the amount has increased again and is still brown, with some streaks of blood when wiping.
There has been no abdominal pain, which would indicate uterine contractions or spasms, and she hasn't experienced dizziness, nausea, excessive sleepiness, or general weakness.
Her temperature measured 35.8°C on September 3, and she has been experiencing diarrhea recently.
What could be the cause of this? Is it implantation bleeding or something abnormal with her body?

Niming, 20~29 year old female. Ask Date: 2017/09/04

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Your girlfriend has not had her period for two months, and she has taken a pregnancy test that came back negative.
On August 24, there was unprotected sexual intercourse, but ejaculation occurred before penetration.
On September 1 and 2, she reported experiencing light bleeding that was brown in color, and on September 2, there was a small amount of pink blood when wiping.
The bleeding stopped on September 3, but on September 4, the amount of brown blood increased, and there were streaks of blood when wiping.
There has been no abdominal pain, which would indicate uterine contractions or spasms, nor has she experienced dizziness, nausea, excessive sleepiness, or general weakness.
Her axillary temperature measured 35.8°C on September 3, and she has been experiencing diarrhea recently.
Given these symptoms, this is likely not implantation bleeding.

Reply Date: 2017/09/04

More Info

When it comes to unusual menstrual changes, especially in the context of a missed period and subsequent bleeding, there are several factors to consider. Your girlfriend's situation, where she has not had her period for two months but has tested negative for pregnancy, raises a few possibilities that could explain her symptoms.

Firstly, it is important to note that a missed period can be caused by a variety of factors, including hormonal imbalances, stress, significant weight changes, excessive exercise, or underlying medical conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders. Hormonal imbalances can disrupt the normal menstrual cycle, leading to missed periods or irregular bleeding.

The bleeding your girlfriend experienced on September 1st and 2nd, described as light and brownish, could potentially be implantation bleeding, which occurs when a fertilized egg attaches to the uterine lining. However, since she has tested negative for pregnancy, this is less likely. Brown blood typically indicates older blood that has taken longer to exit the body, which can occur at the beginning or end of a menstrual period.

The subsequent increase in bleeding on September 4th, along with the absence of abdominal pain or other concerning symptoms, suggests that this could be a form of irregular menstrual bleeding rather than a typical period. It is also worth noting that gastrointestinal issues, such as diarrhea, can sometimes be linked to hormonal changes or stress, which might further complicate the situation.

Given the complexity of menstrual health and the various factors that can influence it, it is advisable for your girlfriend to consult with a healthcare provider. A thorough evaluation, including a detailed medical history, physical examination, and possibly further testing (such as blood tests to check hormone levels), can help identify the underlying cause of her symptoms. This is particularly important if the irregularities persist or if she experiences any new symptoms.

In summary, while it is possible that your girlfriend's symptoms could be related to hormonal imbalances or stress, a definitive diagnosis can only be made by a healthcare professional. It is essential to approach this situation with care and seek medical advice to ensure her health and well-being.

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