Abnormal Menstrual Bleeding: Causes and Solutions

Abnormal bleeding

My usual menstrual cycle is about 30 days, and my period lasts around 7 days before it completely finishes.
However, after my period in December, I expected my period to come in early January, but I experienced nearly a week of brown discharge without menstruation.
It wasn't until mid-January, after taking progesterone at the gynecologist's office, that my period finally started.
After my period ended on January 27, I noticed brown discharge again on January 30 when I went to the bathroom, which looked like old blood that hadn't been expelled.
I have not experienced this before; typically, by the fifth day, the menstrual flow gradually decreases, and by the seventh day, the discharge returns to normal.

Recently, my cycles have been as follows:
- 2018/10/18
- 2018/11/10 (23 days)
- 2018/12/15 (35 days)
- 2019/1/21 (37 days)
- 2019/1/27 (most recent period end date)
I had an HPV and Pap smear test done at the end of September, and both abdominal and transvaginal ultrasounds were performed, showing no abnormalities.
From November to January, I also experienced influenza, tonsillitis, and gastrointestinal discomfort, for which I took Western medicine.
I'm unsure if this has affected my cycle or if I need further evaluation or adjustments to my menstrual cycle.

Noah, 20~29 year old female. Ask Date: 2019/01/30

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The usual menstrual cycle is about 30 days, with menstruation lasting approximately 7 days until it is completely finished.
However, after my period in December, I expected my period to start in early January, but I experienced nearly a week of brown discharge without menstruation.
It wasn't until mid-January, after taking progesterone prescribed by my gynecologist, that my period finally started.
After my period ended on January 27, I unexpectedly had brown discharge again on January 30, resembling old blood that hadn't fully cleared.
I have not experienced this situation before; typically, my menstrual flow gradually decreases around day 5, and by day 7, the discharge returns to normal.
My recent cycles are as follows: 10/18/2018, 11/10/2018 (23 days), 12/15/2018 (35 days), 1/21/2019 (37 days), and the last menstrual period ended on 1/27.
I had an HPV and Pap smear test done at the end of September, along with abdominal and vaginal ultrasounds, which showed no abnormalities.
Between November and January, I also dealt with influenza, tonsillitis, and gastrointestinal discomfort, for which I took Western medicine.
I am unsure if this has affected my cycle or if I need further examinations or adjustments.
Answer: No further examinations or adjustments to the cycle are necessary.

Reply Date: 2019/01/30

More Info

Abnormal menstrual bleeding can be a concerning issue for many women, and understanding its causes and potential solutions is essential for maintaining reproductive health. Based on the information provided, it appears that you have experienced irregularities in your menstrual cycle, including prolonged periods of brown discharge and variations in cycle length. Let's delve into the possible causes and solutions for your situation.

Causes of Abnormal Menstrual Bleeding
1. Hormonal Imbalances: The menstrual cycle is regulated by a complex interplay of hormones, including estrogen and progesterone. Any disruption in these hormones can lead to irregular bleeding. Factors such as stress, significant weight changes, and hormonal contraceptives can contribute to these imbalances.

2. Menstrual Cycle Variability: It is not uncommon for menstrual cycles to vary in length. A typical cycle ranges from 21 to 35 days, but factors such as illness, lifestyle changes, and age can influence cycle regularity. Your recent experiences with illness (flu and tonsillitis) and gastrointestinal discomfort may have temporarily affected your hormonal balance and menstrual cycle.

3. Uterine Conditions: Conditions such as fibroids, polyps, or endometriosis can lead to abnormal bleeding. While your ultrasounds did not indicate any abnormalities, it is important to remain vigilant, especially if symptoms persist.

4. Infections: Pelvic inflammatory disease (PID) or other infections can cause irregular bleeding. If you experience additional symptoms such as pelvic pain, fever, or unusual discharge, it is crucial to seek medical attention.

5. Medications: Certain medications, including those for treating infections or hormonal treatments, can impact your menstrual cycle. If you have recently started or changed medications, this could be a contributing factor.

Solutions and Recommendations
1. Monitoring Your Cycle: Keep a detailed record of your menstrual cycle, including the start and end dates, flow intensity, and any accompanying symptoms. This information can be invaluable for your healthcare provider in diagnosing any underlying issues.

2. Consulting a Healthcare Provider: Given the irregularities you've experienced, it would be prudent to consult with a gynecologist. They may recommend further tests, such as blood tests to check hormone levels or a repeat ultrasound, to ensure there are no underlying conditions affecting your menstrual cycle.

3. Lifestyle Modifications: Maintaining a healthy lifestyle can help regulate your menstrual cycle. This includes a balanced diet, regular exercise, and stress management techniques such as yoga or meditation. Reducing caffeine and alcohol intake may also help.

4. Medication Review: If you are taking medications, discuss them with your healthcare provider to determine if they could be influencing your menstrual cycle. They may suggest alternatives or adjustments.

5. Follow-Up Care: If your symptoms persist or worsen, follow up with your healthcare provider. They may consider additional diagnostic procedures, such as a hysteroscopy, to examine the uterine cavity more closely.

Conclusion
Abnormal menstrual bleeding can stem from various causes, ranging from hormonal imbalances to underlying medical conditions. It is essential to monitor your symptoms closely and seek professional medical advice to ensure proper diagnosis and treatment. By taking proactive steps and maintaining open communication with your healthcare provider, you can work towards achieving a more regular and healthy menstrual cycle. Remember, your health is a priority, and addressing these concerns early can lead to better outcomes.

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