Abnormal Menstrual Bleeding: Causes and Concerns

Menstrual bleeding issues?

Hello doctor, I have been taking the medication for a year regularly.
My menstrual flow is usually normal, lasting about 3-5 days.
However, on the fifth day of my period this month, the flow was light in the morning, indicating that it was about to end.
But in the evening of the same day, the bleeding suddenly increased significantly, accompanied by large blood clots.
It has become difficult to distinguish whether it is menstrual blood or bleeding, and the color is bright red.
There is no pain, and this situation has persisted for two days.
Could this be related to lifting heavy boxes beyond my capacity on the third day of my period, or is there something else I should be concerned about? Thank you.

Xiao Xin, 30~39 year old female. Ask Date: 2019/08/24

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have been taking the contraceptive pill for a year, and my menstrual flow has been normal, lasting about 3-5 days.
However, on the fifth day of my period this month, the flow was light in the morning, indicating that it was about to end.
But that evening, the bleeding suddenly increased significantly, accompanied by large blood clots.
It has become difficult to distinguish whether it is menstrual blood or bleeding, and the color is bright red.
There has been no pain, and this situation has persisted for two days.
Could this be related to lifting heavy boxes beyond my capacity on the third day of my period, or is there something else I should be concerned about? Answer: A medical examination is necessary to determine if there is any issue.

Reply Date: 2019/08/24

More Info

Abnormal menstrual bleeding can be concerning, especially when there are sudden changes in flow or the presence of blood clots. In your case, experiencing a significant increase in menstrual flow on the fifth day of your period, accompanied by large blood clots, warrants attention. While it is not uncommon for menstrual cycles to vary slightly from month to month, the abrupt change you described could be indicative of several underlying issues.

Firstly, it is important to consider the potential impact of physical activity on your menstrual cycle. Lifting heavy objects, such as boxes, can sometimes lead to increased abdominal pressure, which might affect the uterine lining and cause heavier bleeding. However, this is not a common cause of such a drastic change in menstrual flow. It is more likely that other factors are at play.

One possible explanation for the sudden increase in bleeding could be hormonal fluctuations. Since you have been taking a hormonal contraceptive (悦己) for a year, it is essential to consider that any changes in your body, stress levels, or even diet can influence hormone levels, leading to variations in menstrual bleeding. Breakthrough bleeding or changes in flow can occur, especially if there have been any missed doses or inconsistencies in taking the medication.

Another potential cause could be the presence of uterine fibroids or polyps. These benign growths can lead to heavier menstrual bleeding and the formation of blood clots. They are often asymptomatic but can cause changes in menstrual patterns. Additionally, conditions such as endometriosis or adenomyosis can also lead to abnormal bleeding patterns and should be evaluated if symptoms persist.

It is also crucial to rule out any potential bleeding disorders. Conditions such as von Willebrand disease or platelet function disorders can lead to increased bleeding during menstruation. If you have a family history of bleeding disorders or if you notice other symptoms such as easy bruising or prolonged bleeding from minor cuts, it would be wise to discuss these concerns with your healthcare provider.

Given that you have experienced this abnormal bleeding for two days without any accompanying pain, it is still essential to monitor your symptoms closely. If the heavy bleeding continues, or if you start to experience pain, dizziness, or any other concerning symptoms, you should seek medical attention promptly. A healthcare provider may recommend a pelvic exam, ultrasound, or blood tests to assess your hormone levels and check for any underlying conditions.

In summary, while lifting heavy objects may have contributed to your symptoms, it is essential to consider other potential causes of abnormal menstrual bleeding. Hormonal fluctuations, uterine fibroids, polyps, or bleeding disorders could all be factors. Monitoring your symptoms and consulting with a healthcare provider will help ensure that any underlying issues are addressed appropriately. Remember, it is always better to err on the side of caution when it comes to changes in your menstrual cycle.

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