Sudden Decrease in Menstrual Flow: Is It Normal or a Sign of Pregnancy?

A sudden decrease in menstrual flow?

Hello Doctor: I have been taking Dailian for over three years, and my menstrual flow has been quite consistent.
I do not take the medication at a very precise time; I usually take it between 10:00 AM and 2:00 PM, and if I forget, I might take it in the afternoon or evening.
When I had about five pills left, I experienced what seemed like my period, but the flow was much lighter than usual, and the entire cycle was brown in color.
I continued to take the remaining pills as prescribed, but after finishing them, my menstrual flow has not increased.
Is this situation normal? Is there a possibility of pregnancy? Thank you for your response.

Chun Chun, 20~29 year old female. Ask Date: 2018/04/05

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
Oral contraceptives have the effect of suppressing endometrial hyperplasia (making it more difficult for a fertilized egg to implant).
As the source of menstrual flow decreases, the amount of menstrual bleeding naturally reduces, rather than blood being retained in the body.
Each type of combined oral contraceptive (COC) comes in different formulations, and it is important to take the contraceptive as directed.

If a dose is missed, it should be taken as soon as remembered, and the next pill should still be taken at the regular scheduled time.
If a missed dose of an effective pill exceeds 12 hours, in addition to taking the missed pill, it is advisable to use an additional barrier method of contraception for the next seven days.
If the missed dose exceeds 24 hours, it is recommended to stop taking the current contraceptive for seven days (including the days of missed pills) and then continue with the next cycle.

Combined oral contraceptives must be taken at the same time every day, and proper adherence can achieve a 99% effectiveness rate.
If a pill is missed and there is no expected withdrawal bleeding during the subsequent pill-taking period, pregnancy should be suspected.

Thank you! Wishing you peace and health.

Dr.
Zhang

Reply Date: 2018/04/05

More Info

When it comes to changes in menstrual flow, especially a sudden decrease in the amount of blood, it can raise questions about whether this is a normal variation or a potential sign of pregnancy. In your case, you have been taking the oral contraceptive pill, Dailian, for over three years, and you have noticed a significant change in your menstrual cycle.

First, it’s important to understand that hormonal contraceptives like Dailian work by regulating your menstrual cycle. They often lead to lighter periods, and some women may even experience missed periods altogether. The fact that you have been consistent with your medication, albeit with some variations in timing, suggests that your body is still under the influence of the hormones provided by the pill. However, missing doses or taking them at irregular times can sometimes lead to breakthrough bleeding or changes in menstrual flow.

The brown color of your menstrual blood is typically old blood that has taken longer to exit the uterus, which is not uncommon, especially when on hormonal contraceptives. It can also indicate a lighter flow, as the body may not be shedding the uterine lining as vigorously as it would during a normal cycle without hormonal influence.

Regarding the possibility of pregnancy, while hormonal contraceptives are highly effective, they are not 100% foolproof. If you have missed any doses or taken the pill inconsistently, there is a small chance that ovulation could occur, leading to potential pregnancy. If you suspect that you might be pregnant, the best course of action is to take a home pregnancy test. These tests are designed to detect the hormone hCG (human chorionic gonadotropin), which is produced shortly after a fertilized egg attaches to the uterine lining.

If the test is positive, or if you continue to experience unusual symptoms such as persistent light bleeding, abdominal pain, or any other concerning signs, it is crucial to consult with a healthcare provider. They can perform a blood test for pregnancy and provide further evaluation to rule out any other issues, such as ectopic pregnancy or hormonal imbalances.

In summary, while a sudden decrease in menstrual flow can be a normal response to hormonal contraceptives, it is essential to monitor your symptoms closely. If you have any doubts about the possibility of pregnancy or if your symptoms persist, seeking medical advice is always a prudent step. Your health and peace of mind are paramount, and a healthcare professional can provide personalized guidance based on your specific situation.

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