Irregular Menstrual Flow: Possible Causes and Concerns

Menstruation has started, but there is no bleeding?

Hello Doctor: My girlfriend's last menstrual period started on February 28.
Her next estimated ovulation date is March 19, and her next menstrual period is expected around April 2.
Her cycle has been approximately 32 to 33 days over the past three months.
She often drinks cold beverages and has been staying up late, going to bed around 3 AM for the past four days.
On March 12, we had intercourse, and the condom broke, resulting in ejaculation inside.
We didn't notice it at the time.
On March 23, the condom broke again during intercourse, but we noticed immediately and switched to a new one.
By March 29, my girlfriend felt like her period was about to start and had some spotting.
On March 30, she mentioned that while using the restroom, she passed a dried clot of menstrual blood.
By March 31, she no longer had any bleeding.
I am worried about the possibility of pregnancy.
However, my girlfriend only has soreness in her left arm, which I suspect may be due to poor posture while lying in bed and using her phone.
She also experiences abdominal pain when drinking cold beverages, but it doesn't hurt when she avoids them.
Other than that, she hasn't reported any unusual symptoms.
I found several articles online where some individuals experienced a similar situation where their period only lasted 1 to 3 days and then stopped, thinking everything was fine, only to find out they were pregnant a month and a half later.
Doctor, what could this situation indicate? Thank you.

A Te, 20~29 year old female. Ask Date: 2018/04/01

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your description, there is a possibility of pregnancy, as the failure rate of correctly using condoms is still around 5%.
Generally, it is not recommended to rely solely on condoms for contraception.
Early pregnancy may not present specific symptoms, and subjective symptoms cannot be used to make a determination.
There are many reasons for bleeding outside of your menstrual period (such as lesions in the reproductive organs, pregnancy, hormonal imbalances, etc.).
It is advisable to consult a physician for a pregnancy test if your period is more than a week late or if you are uncertain.
Thank you! Wishing you safety and health.
Dr.
Zhang

Reply Date: 2018/04/01

More Info

Irregular menstrual flow can be concerning for many women, and understanding the potential causes is essential for addressing any underlying issues. Based on the information provided, several factors could contribute to your girlfriend's irregular menstrual cycle and the symptoms she is experiencing.

Firstly, it's important to note that menstrual cycles can vary significantly from month to month due to a variety of factors, including stress, lifestyle changes, and hormonal fluctuations. In your girlfriend's case, her recent lifestyle choices, such as consuming cold drinks and staying up late, could potentially impact her menstrual cycle. Stress and lack of sleep can disrupt the hormonal balance necessary for regular ovulation and menstruation.

The timeline you provided indicates that your girlfriend's last menstrual period started on February 28, with an expected ovulation around March 19 and a projected next period around April 2. However, the events that transpired, including the broken condoms during intercourse, raise concerns about the possibility of pregnancy. While it is possible for a woman to experience light bleeding or spotting in early pregnancy, it is also common for menstrual irregularities to occur due to other factors.

The fact that your girlfriend experienced what she described as a "dry" menstrual flow on March 30, followed by no further bleeding, could indicate several possibilities. It might be a sign of an early pregnancy, especially considering the unprotected intercourse that occurred. However, it could also be attributed to hormonal fluctuations or even a condition known as anovulation, where the ovaries do not release an egg during a cycle, leading to irregular bleeding.

Given the concerns about potential pregnancy, it would be prudent for your girlfriend to take a home pregnancy test if her period does not arrive as expected. Home pregnancy tests are generally reliable and can provide quick results. If the test is positive, it would be advisable for her to schedule an appointment with a healthcare provider for further evaluation and prenatal care.

Additionally, if your girlfriend continues to experience irregular menstrual cycles, abdominal pain, or any other concerning symptoms, it would be wise for her to consult with a healthcare professional. They can conduct a thorough evaluation, including a physical examination and possibly blood tests or imaging studies, to rule out any underlying conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or other hormonal imbalances.

In summary, while irregular menstrual flow can be caused by various factors, including lifestyle changes, stress, and hormonal fluctuations, the possibility of pregnancy should not be overlooked given the circumstances. Encouraging your girlfriend to take a pregnancy test and seek medical advice if her symptoms persist will help ensure her health and well-being. Regular check-ups and open communication about menstrual health are essential for maintaining reproductive health and addressing any concerns promptly.

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