Abnormal Bleeding: Symptoms and Concerns in Women's Health

Abnormal bleeding

Hello, doctor.
My menstrual period in March started on the 29th.
It began with a brown discharge, but the bleeding was unstable.
I only experienced bleeding when I stood for long periods, moved around, or lifted things, and the color and amount of blood were different from my usual periods.
By the second day, I no longer felt like my period was coming; instead, I experienced pain in my lower abdomen whenever I stood for a long time.
On the third day, the discharge was still brown, and I noticed some blood and bloody discharge on the toilet paper.
This symptom persisted until I finished work and rested at home, after which it stopped.
On the second and third days, I also did not experience any bleeding after lying down to rest at night.
Today, on the fourth day, I had a slight amount of bleeding in the morning, but it stopped again.
Can you help me determine whether this is a normal menstrual period or abnormal bleeding? Additionally, I've been experiencing emotional instability and loss of appetite this week, which is unusual for me during my periods, even though my workload is the same or even less than before.

ivy, 20~29 year old female. Ask Date: 2019/04/01

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The menstrual period in March started on March 29th, initially presenting as brown in color.
However, the amount of bleeding and its condition were very unstable, occurring only during prolonged standing, walking, or lifting.
The color and volume were different from previous menstrual cycles.
By the second day, there was no sensation of menstruation; instead, there was pain in the lower abdomen whenever standing or laboring for a long time.
On the third day, the blood color remained brown, and there were traces of blood and blood-tinged discharge on the toilet paper.
These symptoms persisted until after work when lying down to rest alleviated them.
On the second and third days, there was no bleeding when resting in bed at night.
Today, April 1st, the fourth day, there was slight bleeding in the morning, but it stopped again.
Is it possible to distinguish whether this is a normal menstrual cycle or abnormal bleeding? Answer: It is not possible to distinguish between normal menstruation and abnormal bleeding.
Additionally, this week has also seen emotional instability and loss of appetite, which is unusual compared to previous menstrual cycles, despite the workload being the same or even less physically demanding than before.

Reply Date: 2019/04/01

More Info

Abnormal bleeding can be a significant concern for many women, and understanding its symptoms and implications is crucial for maintaining reproductive health. Based on the symptoms you've described, it appears that you are experiencing irregular bleeding that is not typical for your menstrual cycle. This can be distressing, especially when accompanied by other symptoms such as abdominal pain, emotional instability, and changes in appetite.

Firstly, it’s important to differentiate between what constitutes normal menstrual bleeding and what may be classified as abnormal. Normal menstrual cycles can vary in length, flow, and symptoms, but they typically follow a predictable pattern. Abnormal bleeding can manifest as bleeding between periods, excessively heavy periods, or bleeding that lasts longer than usual. In your case, the presence of brownish discharge and blood only during certain activities, along with abdominal pain, suggests that this may not be a typical menstrual cycle.

The fact that you experience bleeding primarily when engaging in physical activities, such as standing or moving around, could indicate that the bleeding is related to increased pressure on the pelvic region. This could be due to a variety of factors, including hormonal fluctuations, stress, or even physical strain. The emotional instability and loss of appetite you mentioned could also be linked to stress or anxiety, which can significantly impact hormonal balance and menstrual cycles.

From a medical perspective, several potential causes for your symptoms could be considered:
1. Hormonal Imbalance: Fluctuations in hormones, particularly estrogen and progesterone, can lead to irregular bleeding. Stress, changes in lifestyle, or even diet can affect hormone levels, leading to symptoms like yours.

2. Ovulation Bleeding: Some women experience light bleeding or spotting during ovulation, which can sometimes be mistaken for an irregular period. This is typically light and short-lived.

3. Uterine Conditions: Conditions such as fibroids, polyps, or endometriosis can cause abnormal bleeding. These conditions may not always present with pain but can lead to irregular bleeding patterns.

4. Infections: Pelvic inflammatory disease (PID) or other infections can cause abnormal bleeding and discomfort. If there is any suspicion of an infection, it is essential to seek medical evaluation.

5. Stress and Lifestyle Factors: As you mentioned, your work environment and emotional state have changed. Stress can lead to significant hormonal changes, which may manifest as irregular bleeding or changes in menstrual patterns.

Given the complexity of your symptoms and their potential implications, it is advisable to consult with a healthcare provider for a thorough evaluation. This may include a physical examination, blood tests to check hormone levels, and possibly imaging studies like an ultrasound to assess the reproductive organs.
In the meantime, keeping a detailed record of your symptoms, including the timing, duration, and nature of the bleeding, as well as any associated symptoms, can be helpful for your healthcare provider in making an accurate diagnosis.
In conclusion, while some irregularities in menstrual cycles can be benign, persistent or concerning symptoms warrant professional evaluation to rule out any underlying conditions. Your health and well-being are paramount, and addressing these symptoms early can lead to better management and peace of mind.

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