Abnormal Menstrual Bleeding: When to Seek Help

Menorrhagia

Good afternoon, doctor.
My menstrual period was from September 18 to September 25, and the blood flow was less than usual; there were even days when the sanitary pad did not have any blood on it.
For my October period, which was from October 21 to October 25, the blood flow was similar to that of September.
However, on October 30, I suddenly experienced bleeding again, and the amount was similar to what I usually have.
Starting from October 31, the blood flow increased (more than before), and there were blood clots accompanied by dizziness.
As of today (November 6), I am still experiencing bleeding.
I took a pregnancy test during the days without bleeding, and both tests showed one line.

I would like to ask the doctor:
1.
Can the September and October episodes be considered menstrual periods, or are they ovulation bleeding?
2.
Is the situation described above normal?
3.
If I am still bleeding, can I see a gynecologist?
Thank you for taking the time to respond, doctor.

Hananh, 20~29 year old female. Ask Date: 2019/11/06

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Menstrual period in September was from 9/18 to 9/25, with a blood flow that was lighter than usual, even to the extent that there was no blood on the sanitary pad for an entire day.
The menstrual period in October was from 10/21 to 10/25, and the blood flow was similar to that of September.
However, on 10/30, there was a sudden onset of bleeding, with the amount of blood being consistent with previous cycles.
Starting from 10/31, the blood flow increased (more than usual) and was accompanied by blood clots and dizziness.
As of today (11/6), bleeding is still ongoing.
A pregnancy test was conducted during the days without bleeding, and both tests showed a single line.

Doctor's questions:
1.
Can the episodes in September and October be considered as menstrual periods, or are they ovulation bleeding?
Answer: They can be considered as menstrual periods.

2.
Is the situation described above normal?
Answer: It cannot be considered normal.

3.
If bleeding is still occurring, can I see a gynecologist?
Answer: Yes, you can.

Reply Date: 2019/11/06

More Info

Abnormal menstrual bleeding can be a concerning issue for many women, and understanding when to seek medical help is crucial for maintaining reproductive health. Based on your description, it seems you have experienced some irregularities in your menstrual cycle over the past few months, including lighter periods followed by heavier bleeding with clots and accompanying symptoms like dizziness. Let’s break down your questions and provide some insights into your situation.

1. Are the September and October occurrences considered menstrual periods or ovulation bleeding?
The menstrual cycle typically lasts between 21 to 35 days, with bleeding lasting from 2 to 7 days. The lighter bleeding you experienced in September and October could potentially be classified as menstrual periods, especially if they occurred within your expected cycle. However, if the bleeding was significantly lighter than usual and shorter in duration, it might also be indicative of ovulation bleeding, which can occur around the midpoint of your cycle. Ovulation bleeding is usually lighter and shorter than a typical menstrual period. Given the timing and your description, it is possible that what you experienced could be either, but the sudden change in bleeding patterns warrants further evaluation.

2. Is the described situation normal?
While variations in menstrual bleeding can occur due to numerous factors, including stress, hormonal changes, or lifestyle factors, the sudden increase in bleeding volume, the presence of blood clots, and dizziness are concerning symptoms. Normal menstrual cycles can vary, but significant changes, especially those accompanied by other symptoms like dizziness, should not be ignored. It is essential to consider other factors such as pregnancy, hormonal imbalances, or underlying health conditions that could be contributing to these changes.

3. Should you see a gynecologist if you are still bleeding?
Yes, it is advisable to seek medical attention from a gynecologist, especially since you are still experiencing abnormal bleeding. A healthcare professional can perform a thorough evaluation, which may include a physical examination, blood tests, and possibly imaging studies to determine the underlying cause of your symptoms. Given that you have already taken pregnancy tests that returned negative results, it is essential to rule out other potential causes such as hormonal imbalances, uterine fibroids, polyps, or other conditions that could lead to abnormal bleeding.

In summary, your symptoms of irregular menstrual bleeding, especially with the recent increase in volume and associated dizziness, warrant a visit to a healthcare provider. It is crucial to address these changes promptly to ensure your reproductive health is maintained and to rule out any serious underlying conditions. Remember, your health is paramount, and seeking help is always a wise decision when you notice changes in your body.

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