Abnormal Bleeding: Causes and Concerns for Women

Abnormal bleeding

Hello Doctor, my last menstrual period started on October 12 and lasted for seven days.
This month, it started on November 6 (the blood was dark brown) and continued until November 14, with no sexual intercourse during that time.
I had sexual intercourse on November 17, and then on November 20, I started bleeding (the color was bright red), needing to change two pads in an hour and a half.
I have never experienced menstrual pain, but I have a slight tearing sensation in my lower abdomen, although it is not painful.
I would like to know if this bleeding falls within the range of menstrual bleeding.
I had a surgical abortion in July; could my uterus be weakened because of that?

Have a good day, 20~29 year old female. Ask Date: 2019/11/20

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Last month's menstruation started on October 12 and lasted for seven days.
This month, it began on November 6 (the menstrual blood was dark brown) and continued until November 14, with no sexual intercourse during that period.
On November 17, there was sexual intercourse, and on November 20, bleeding started (bright red in color), requiring two pads in an hour and a half.
There has never been menstrual pain, but there is a slight tearing sensation in the lower abdomen, though it is not painful.
I would like to know if this falls within the range of menstrual bleeding.
Answer: This does not fall within the range of menstrual bleeding.
In July, a surgical abortion was performed; could the uterus be weakened as a result? Answer: No.

Reply Date: 2019/11/20

More Info

Abnormal bleeding can be a significant concern for many women, and understanding its causes is crucial for addressing any underlying issues. Based on your description, it appears that you are experiencing a pattern of bleeding that is not typical for your menstrual cycle. Let's break down the potential causes and considerations regarding your situation.

Firstly, your menstrual cycle is typically around 28 days, with your last period starting on October 12 and lasting for seven days. You then had a sexual encounter on November 17, followed by bleeding starting on November 20. The color of the blood you described as bright red, along with the fact that you are experiencing a sensation of mild tearing in your lower abdomen, raises some important points to consider.

1. Timing of Bleeding: The bleeding you are experiencing shortly after your sexual encounter could be related to several factors. One possibility is that it could be postcoital bleeding, which is bleeding that occurs after sexual intercourse. This can happen due to various reasons, including cervical irritation, vaginal dryness, or even minor trauma during intercourse.
2. Hormonal Fluctuations: Given that you have a history of irregular bleeding and have undergone a surgical procedure like an abortion, your hormonal balance may still be adjusting. Hormonal fluctuations can lead to unexpected bleeding, including spotting between periods or changes in the color and consistency of menstrual blood.
3. Cervical or Uterine Issues: Since you mentioned having undergone a dilation and curettage (D&C) procedure, it is important to consider that the procedure can sometimes lead to changes in the cervical or uterine lining. This could potentially make the tissue more sensitive or prone to bleeding. However, if you have had follow-up care and examinations that ruled out significant complications, this may be less of a concern.

4. Infection or Inflammation: Another possibility is that there could be an infection or inflammation in the reproductive tract, which can cause abnormal bleeding. Symptoms such as unusual discharge, odor, or discomfort would warrant further investigation.

5. Stress and Lifestyle Factors: Stress and lifestyle changes can also impact your menstrual cycle. If you have been experiencing increased stress or changes in your routine, this could contribute to irregular bleeding patterns.

6. Need for Medical Evaluation: Given your history of abnormal bleeding, the recent sexual encounter, and the surgical procedure, it is advisable to consult with a healthcare provider. They may recommend a pelvic examination, ultrasound, or other diagnostic tests to rule out any underlying issues such as fibroids, polyps, or other structural abnormalities.

In conclusion, while some degree of irregular bleeding can be common and may not always indicate a serious problem, it is essential to monitor your symptoms closely. If the bleeding persists, increases in volume, or is accompanied by other concerning symptoms (such as severe pain, fever, or unusual discharge), seeking medical attention is crucial. Your healthcare provider can help determine the cause of your bleeding and recommend appropriate treatment options to ensure your reproductive health is maintained.

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