Irregular Menstrual Cycles and Abnormal Bleeding Issues

Irregular menstrual periods and menstrual blood issues?

Hello, Doctor.
I gave birth on March 21, 2017, and I have been experiencing abdominal pain and lower back pain 3-4 days before my menstrual period.
My menstrual cycle is irregular, ranging from 30 to 45 days, and each period lasts 7-8 days.
In the first 1-5 days of my period, the blood flow is heavy, requiring me to change pads 3-4 times a day (the pads are wet, overflowing, and contain clots).
After that, for 6-8 days, the flow decreases to 1-2 pads a day (gradually becoming less and drier).

This time, I experienced abdominal pain and lower back pain 4 days before my period.
On June 17, the first day of my period, I only changed my pad once throughout the day (the blood flow was limited to the middle area of the pad, thick, and had an odor).
Today, June 19, I feel like my period is almost over, as there is only a small amount of blood on the pad, and when I wipe, there is only a little light pink blood.

Is this normal, Doctor? Should I see a doctor? If so, how should I explain my situation to the physician? Thank you for your help, Doctor.

Cai Si, 20~29 year old female. Ask Date: 2018/06/19

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On March 21, 2017, I experienced abdominal pain and lower back discomfort 3-4 days before my menstrual period.
My menstrual cycle has been irregular, ranging from 30 to 45 days, with each period lasting 7-8 days.
For the first 1-5 days of menstruation, I change my pad 3-4 times a day (the flow is heavy, saturated, and contains clots).
After 6-8 days, the flow decreases to 1-2 pads a day (gradually lessening and becoming dry).
Four days before my current period, I had abdominal pain and lower back discomfort.
On June 17, the first day of my period, I only changed my pad once throughout the day (the flow was limited to the middle area of the pad, thick, and had an odor).
Today, the 19th, it feels like my period is ending, as the pad has only a small amount of blood, and when I wipe, there is only a little light pink discharge.

1.
Is this normal, doctor?
Answer: It's okay.

2.
Do I need to see a doctor?
Answer: There is no need to see a doctor at this time.

Reply Date: 2018/06/19

More Info

Irregular menstrual cycles and abnormal bleeding can be concerning and may indicate underlying health issues that require attention. Based on your description, it seems that you have been experiencing significant changes in your menstrual cycle since giving birth, including abdominal pain, lower back pain, and variations in the duration and flow of your periods.
Firstly, it's important to understand that after childbirth, many women experience changes in their menstrual cycles. This can include irregular cycles, heavier or lighter bleeding, and changes in the duration of menstruation. These changes can be attributed to hormonal fluctuations as your body adjusts back to its pre-pregnancy state. However, the symptoms you describe, such as prolonged bleeding (7-8 days), the presence of blood clots, and changes in the consistency and odor of menstrual blood, warrant further investigation.

The fact that you are experiencing abdominal pain and lower back pain in conjunction with your menstrual irregularities could indicate several conditions, such as:
1. Hormonal Imbalances: Conditions like polycystic ovary syndrome (PCOS) or thyroid disorders can lead to irregular cycles and abnormal bleeding.

2. Uterine Fibroids or Polyps: These benign growths in the uterus can cause heavy bleeding, prolonged periods, and discomfort.

3. Endometriosis: This condition occurs when tissue similar to the lining of the uterus grows outside the uterus, leading to painful periods and irregular bleeding.

4. Infection: An infection in the reproductive tract can cause abnormal bleeding and changes in menstrual flow, often accompanied by unusual odors.

5. Postpartum Complications: Sometimes, complications from childbirth, such as retained placental tissue, can lead to prolonged bleeding and other symptoms.

Given the changes in your menstrual cycle and the symptoms you are experiencing, it is advisable to consult a healthcare provider. When you see the doctor, it would be helpful to provide a detailed account of your symptoms, including:
- The duration and frequency of your menstrual cycles.

- The amount and consistency of menstrual flow (e.g., how many pads or tampons you use and the nature of the blood).

- Any associated symptoms, such as pain, discomfort, or unusual odors.

- Any other health changes or concerns you may have experienced since childbirth.

Your doctor may recommend a physical examination, blood tests to check hormone levels, and possibly imaging studies like an ultrasound to assess the uterus and ovaries. These evaluations will help determine the cause of your symptoms and guide appropriate treatment options.

In summary, while some irregularities in menstrual cycles can be normal after childbirth, the specific symptoms you describe suggest that it would be prudent to seek medical advice. Early intervention can help address any underlying issues and improve your overall reproductive health.

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