Abnormal Bleeding: Causes and Concerns in Women's Health

Abnormal bleeding

I would like to consult a doctor about my menstrual cycle.
My period usually starts on July 5 and lasts for a week, ending around July 12.
It returned again around July 20.
I visited a doctor who prescribed medication, and my period came again on August 4 or 5, but it was very light and the blood was dark and brownish.
When I returned to the doctor, they prescribed more medication, and I noticed that if I didn't take the medication on time, I would experience light bleeding that was also dark in color.

In recent days, I have noticed significant breast swelling, which is not typical premenstrual swelling; it has become so uncomfortable that I can't wear my bra, and there is pain.
My areolas have enlarged, and my nipples have started to hurt.
I also experience dizziness and nausea.
From September 1 to September 2, I sometimes noticed a small amount of bleeding when I urinated, but I am certain it is not from the urinary tract; it is coming from the vagina, as I only see a bit of pinkish blood when I wipe.
This led me to wonder if it could be implantation bleeding.
I also considered whether my period was starting, but after several hours of wearing a panty liner, there was no blood when I went to the bathroom.
On September 3, I visited another clinic, and the doctor told me I have a cyst.
She said it is not a serious issue, but could such symptoms be related to having a cyst? I keep speculating whether I might be pregnant but too early to detect it.
The doctor mentioned that my uterus is tilted backward.
Previously, when I was pregnant, I couldn't get a positive pregnancy test until the 6th to 8th week, and it was only then that an ultrasound could confirm the pregnancy.

I have gone to the clinic, but the doctors have not answered my questions or concerns.

Miss Zhan, 10~19 year old female. Ask Date: 2018/09/04

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On July 5, my period started and lasted for a week, ending on July 12.
By July 20, I was expecting my period again.
I visited the doctor, who prescribed medication, and my period came on August 4 or 5, but it was very light and the blood was dark and brownish.
When I returned for a follow-up, the doctor prescribed more medication.
I noticed that if I didn't take the medication on time, I would experience light bleeding that was also dark in color.

In recent days, I have experienced significant breast tenderness, which is not typical for my menstrual cycle; it feels like my breasts are too full for my bra, and there is pain.
My areolas have enlarged, and my nipples have started to hurt.
I also feel dizzy and nauseous.
On September 1 and 2, I noticed some light bleeding when I urinated, but I was careful to observe that it was not from the urinary tract; it was from the vagina, as I only saw a bit of pinkish blood when I wiped.
This led me to wonder if it could be implantation bleeding.

I also considered that it might be my period, but after wearing a pad for a few hours, there was no blood when I went to the bathroom.
On September 3, I visited another clinic, and the doctor told me that I have a cyst.
She said it was not a major issue and that such symptoms could be associated with having a cyst.
I keep wondering if I might be pregnant but too early to detect it.
The doctor mentioned that my uterus tilts backward, and in a previous pregnancy, I couldn't get a positive pregnancy test until the 6th to 8th week, and only then could it be seen on ultrasound.

Reply Date: 2018/09/04

More Info

Abnormal bleeding can be a significant concern in women's health, and it often raises questions about underlying causes and potential implications for reproductive health. Based on your description, it appears that you have been experiencing irregular bleeding patterns, changes in menstrual flow, and other symptoms such as breast tenderness and nausea. Let's break down the potential causes and considerations regarding your situation.

Understanding Abnormal Bleeding
Abnormal bleeding can manifest in various forms, including intermenstrual bleeding (bleeding between periods), heavy menstrual bleeding, or changes in the color and consistency of menstrual blood. In your case, you mentioned experiencing dark, scanty bleeding, which can be concerning. Here are some common causes of abnormal bleeding:
1. Hormonal Imbalances: Fluctuations in hormone levels, particularly estrogen and progesterone, can lead to irregular bleeding. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt the menstrual cycle.

2. Ovulation: Some women experience ovulation bleeding, which is typically light and may occur around the middle of the menstrual cycle. This could explain some of the bleeding you have experienced.

3. Uterine Conditions: Conditions such as fibroids, polyps, or endometriosis can cause abnormal bleeding. You mentioned that a doctor noted the presence of a cyst (water tumor), which could also contribute to your symptoms.

4. Pregnancy-Related Issues: If there is a possibility of pregnancy, it is essential to consider implantation bleeding, which can occur when a fertilized egg attaches to the uterine lining. However, if you have had negative pregnancy tests, this may be less likely.

5. Infections or Inflammation: Pelvic inflammatory disease (PID) or other infections can lead to abnormal bleeding and should be ruled out through appropriate testing.

Your Symptoms
You noted several symptoms, including breast tenderness, nausea, and intermittent bleeding. These symptoms can be associated with hormonal changes, pregnancy, or other underlying conditions. The fact that your bleeding is dark and scanty may suggest that it is not fresh blood, which could indicate older blood being expelled from the uterus.

Recommendations
1. Follow-Up with Healthcare Providers: It is crucial to maintain open communication with your healthcare providers. If you have concerns about the cyst or any other symptoms, consider seeking a second opinion or asking for further evaluation, such as an ultrasound or hormonal testing.

2. Monitor Your Symptoms: Keep a detailed record of your menstrual cycle, including the timing, duration, and characteristics of your bleeding, as well as any accompanying symptoms. This information can be invaluable for your healthcare provider in diagnosing the issue.

3. Consider Lifestyle Factors: Stress, diet, and exercise can all impact hormonal balance and menstrual health. If you have experienced significant stress or changes in your lifestyle, addressing these factors may help regulate your cycle.

4. Evaluate Medication Adherence: If you have been prescribed medication, ensure that you take it as directed. Missing doses can lead to fluctuations in hormone levels, potentially exacerbating bleeding issues.

5. Pregnancy Testing: If there is any chance of pregnancy, consider taking a home pregnancy test or consulting your healthcare provider for a blood test, especially if your symptoms persist.

Conclusion
Abnormal bleeding can be distressing, and it is essential to investigate the underlying causes thoroughly. While some irregularities can be benign, others may require medical intervention. By working closely with your healthcare providers and monitoring your symptoms, you can gain a clearer understanding of your reproductive health and address any concerns effectively. Remember, your health is a priority, and seeking answers is a vital step in managing your well-being.

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