Menstrual Changes and Post-Sexual Bleeding: A Guide

Menstrual Duration and Post-Coital Bleeding

My last menstrual period started around February 15, and I usually have a regular cycle of 28 days.
However, the last three cycles have been every 21 days.
This time, my period lasted about 9 days, while it typically ends around day 6.
What could be the reason for this? Do I need to take medication?
Recently, I have had sexual intercourse, and the male partner has a long penis, which caused some discomfort when penetrating deeply.
After changing positions, I felt a strong urge to urinate in the areas that were being rubbed.
After intercourse, I experienced a burning sensation in the vagina that lasted for half a day.
When I wiped after using the restroom, I noticed a clear fluid with a slight tint of blood on the toilet paper.
The next day, I started to feel itching around the labia.
I visited a doctor that day but felt too shy to mention my sexual activity, and I wondered if I might have an infection.
The doctor prescribed medication for two days, but I still felt itchy in the genital area.

Before taking a shower, I looked in the mirror and noticed a lot of white, solid-looking discharge at the vaginal opening, resembling semi-solid soy milk.
I was unsure if this was related to the medication.
After stopping the medication for a day, everything returned to normal, and I felt much better the following day.
On the third day after stopping the medication, I had sexual intercourse again.
This time, it was not as uncomfortable as before, and I used a water-based lubricant.
However, in certain positions, I still felt the urge to urinate during friction.
Should I avoid certain sexual positions? After intercourse, I experienced bleeding again.
In the morning, I felt dryness in the genital area, and after drinking some water and exercising, I noticed a watery discharge with blood when I went to the restroom.
Could this be vaginitis?

Lili, 30~39 year old female. Ask Date: 2019/03/02

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The last menstrual period started around February 15, and I usually have a regular cycle of 28 days.
However, the last three cycles have been every 21 days.
This time, my period lasted about 9 days, whereas it typically ends around day 6.
What could be the reason for this? Do I need to take medication?
Answer: This may be due to hormonal imbalance.
Medication is not necessary.

Recently, I had sexual intercourse, and my partner has a relatively long penis, which caused some discomfort during deep penetration.
After changing positions, I felt a strong urge to urinate in the areas that were rubbed.
After finishing, I experienced a burning sensation in the vagina that lasted for half a day.
When I wiped after using the restroom, I noticed a clear fluid with a slight tinge of blood on the toilet paper.
The next day, I started to feel itching around the labia.
I went to see a doctor that day but was too shy to mention the sexual activity, thinking it might be an infection.
The doctor prescribed medication for two days, but I still felt itchy in the genital area.
Before taking a shower, I looked in the mirror and found a lot of white, solid-looking discharge at the vaginal opening, resembling semi-solid soy milk.
I wasn't sure if this was related to the medication.
After stopping the medication for a day, things returned to normal, and I felt much better the following day.
On the third day after stopping the medication, I had sexual intercourse again.
This time, it wasn't as uncomfortable as before, and I used a water-based lubricant.
However, in certain positions, I still felt the urge to urinate during friction.
Should I avoid certain sexual positions?
Answer: The bleeding after intercourse is concerning.
In the morning, I felt dryness in the genital area, and after drinking some water and exercising, I noticed a watery discharge with blood when I went to the restroom.
Is this vaginitis?
Answer: Bleeding after intercourse requires a consultation with a physician.

Reply Date: 2019/03/02

More Info

Understanding menstrual changes and post-sexual bleeding can be complex, especially when experiencing symptoms that deviate from your normal cycle. Based on your description, it seems you are facing several issues that may be interrelated, including changes in your menstrual cycle, discomfort during intercourse, and unusual discharge.

Firstly, regarding your menstrual cycle, you mentioned that your periods have shifted from a regular 28-day cycle to a 21-day cycle over the last three months. This change can be attributed to various factors, including hormonal fluctuations, stress, changes in weight, or underlying medical conditions such as polycystic ovary syndrome (PCOS). It is essential to monitor these changes, especially if they are accompanied by other symptoms. The duration of your last period lasting nine days, compared to the usual six, could indicate a heavier flow or prolonged bleeding, which warrants further investigation.

The discomfort you experienced during intercourse, particularly with the sensation of needing to urinate and the burning feeling afterward, could suggest several possibilities. One common issue is vaginal dryness, which can occur for various reasons, including hormonal changes, lack of arousal, or insufficient lubrication. The use of a water-based lubricant, as you mentioned, is an excellent step to alleviate discomfort. However, if certain positions continue to cause discomfort, it may be wise to avoid them and communicate with your partner about what feels comfortable for you.

The presence of a faint blood-tinged discharge after intercourse, along with itching and the observation of white, solid-like discharge, raises the possibility of a vaginal infection or inflammation. The white discharge you described could be indicative of a yeast infection, especially if it has a cottage cheese-like appearance. It is also possible that the irritation and subsequent discharge are due to friction during intercourse, particularly if there was insufficient lubrication.

You mentioned visiting a doctor who prescribed medication, but you felt that the itching persisted. It is crucial to communicate openly with your healthcare provider about your sexual history and any symptoms you are experiencing. This information is vital for accurate diagnosis and treatment. If the symptoms do not resolve with the prescribed medication, or if they recur, a follow-up appointment is necessary to explore other potential causes, such as bacterial vaginosis or sexually transmitted infections (STIs).

In terms of whether you should stop certain sexual positions, it may be beneficial to experiment with positions that do not cause discomfort. Listening to your body is essential; if a position feels uncomfortable or painful, it is advisable to change it. Additionally, ensuring adequate foreplay and lubrication can help reduce friction and discomfort during intercourse.

In summary, the changes in your menstrual cycle, discomfort during sex, and unusual discharge warrant a thorough evaluation by a healthcare professional. It is essential to maintain open communication with your doctor about your symptoms and sexual history to receive appropriate care. If symptoms persist or worsen, do not hesitate to seek further medical advice. Regular gynecological check-ups are also recommended to monitor your reproductive health and address any concerns that may arise.

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