Abnormal Vaginal Bleeding: Causes and Concerns

Intermenstrual bleeding

Hello Dr.
Huang, my menstrual cycle started on July 12, and my usual cycle length is about 36 to 38 days (sometimes it can be longer, up to 50 or 60 days).
However, on July 22, 25, 27, 28, and 29, I experienced vaginal bleeding during bowel movements, and the blood was very bright red (I am certain it is vaginal blood, not from the rectum).
The amount of bleeding was similar to the third day of my regular menstrual flow, and there were small blood clots (about 0.1 cm).
The bleeding only occurred during bowel movements; at other times, even when exercising, there was no pain or any signs of infection.
Additionally, I have not engaged in sexual intercourse, so pregnancy is not a possibility.

Jennifer, 20~29 year old female. Ask Date: 2019/07/29

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On July 12, my menstrual cycle started.
My usual cycle is about 36 to 38 days (sometimes it can be longer, up to 50 or 60 days).
However, on July 22, 25, 27, 28, and 29, I experienced vaginal bleeding during bowel movements, with a very bright red color (I confirmed it was vaginal blood, not from the rectum).
The amount was similar to the third day of my regular menstrual flow, and there were small blood clots (about 0.1 cm).
The bleeding only occurred during bowel movements; at other times, even when exercising, there was no pain or signs of infection.
Answer: It is likely ovulation.
P.S.
There was no sexual intercourse, so pregnancy is not a possibility.

Reply Date: 2019/07/29

More Info

Abnormal vaginal bleeding can be a concerning symptom for many women, and understanding its potential causes is crucial for addressing any underlying issues. Based on your description, it appears that you are experiencing bleeding that is not typical for your menstrual cycle, which can understandably lead to anxiety and confusion.

Firstly, it’s important to note that menstrual cycles can vary significantly among individuals. While a typical cycle ranges from 21 to 35 days, some women may experience longer cycles, as you mentioned, with intervals extending to 50 or even 60 days. This variability can sometimes be attributed to hormonal imbalances, stress, lifestyle changes, or underlying health conditions.

The bleeding you described occurring during bowel movements raises some interesting considerations. Since you confirmed that the blood is from the vagina and not the rectum, it’s essential to explore potential causes. One possibility is that the pressure from bowel movements could be causing minor trauma to the vaginal walls or cervix, especially if there is any straining involved. This could lead to small amounts of bleeding, which may explain the fresh red blood and the presence of small clots.

Another potential cause could be related to hormonal fluctuations. Hormonal imbalances can lead to irregular bleeding patterns, including spotting or bleeding between periods. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt normal hormonal regulation, leading to unexpected bleeding. Additionally, if you have a history of irregular cycles, this could further suggest that hormonal factors are at play.

It’s also worth considering the possibility of cervical or vaginal issues. Conditions such as cervical polyps, which are benign growths on the cervix, can cause abnormal bleeding. Similarly, vaginal infections or inflammation could lead to bleeding, although you mentioned there are no signs of infection. It’s crucial to keep in mind that even without pain or other symptoms, some conditions can still lead to abnormal bleeding.

Given that you have not engaged in sexual intercourse, the likelihood of pregnancy-related bleeding is eliminated. However, it’s still essential to rule out other potential causes through appropriate medical evaluation. A thorough examination by a healthcare provider, including a pelvic exam and possibly an ultrasound, can help identify any structural issues or hormonal imbalances that may be contributing to your symptoms.

In summary, while the bleeding you are experiencing could be due to a variety of factors, including hormonal imbalances, minor trauma from bowel movements, or cervical/vaginal conditions, it is essential to seek medical advice for a proper diagnosis. Keeping a detailed record of your menstrual cycle, any associated symptoms, and the timing of the bleeding can provide valuable information to your healthcare provider. This will aid in determining the most appropriate course of action to address your concerns and ensure your reproductive health is managed effectively.

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