Abnormal Menstrual Symptoms and Painful Intercourse - Obstetrics and Gynecology

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Could you please provide more context or details about the situation?


1) I had unprotected intercourse in February, and my period was delayed in March.
I experienced abdominal pain that lasted until the end of my period, during which I had several days of heavy bleeding (I had to change my sanitary pad every hour or two, otherwise it would be completely soaked).
This was the first time I had to change so frequently and the bleeding was so heavy.
During my shower, I noticed red streaks in the water that looked like egg whites.
One day, I passed a pink blood clot (similar to a scrape where the skin is worn away, revealing a pink area), and there were a few white spots.
What could this mean?
2) After the abnormal menstrual situation in March ended, I experienced pain during intercourse.
Is this a sign of injury? (Previously, I did not experience pain during intercourse after my period ended.) I have not taken a pregnancy test, so I am unsure if I am pregnant (I assumed it was just an abnormal period).
I went to the hospital and only mentioned the pain and that my period lasted longer than 5 days, extending to over 10 days.
The doctor only prescribed pain medication and did not perform blood tests or urine tests.
Subsequently, I did not get my period at all in April (which was abnormal), and I later returned to manage my condition.

Xue, 20~29 year old female. Ask Date: 2020/05/20

Dr. Cao Guotao reply Obstetrics and Gynecology


Hello, if you are wondering about pregnancy, a pregnancy test should suffice.
It is likely that you are not pregnant.
If you experienced pain during sexual intercourse in March and it hasn't resolved yet, and if your period in May hasn't come, it is advisable to visit a gynecologist for an examination.
Wishing you good health.

Reply Date: 2020/05/20

More Info


Understanding abnormal menstrual symptoms and painful intercourse can be quite complex, especially when there are multiple symptoms involved. Based on your description, there are several key points to consider regarding your menstrual irregularities and the painful intercourse you experienced.

1. Menstrual Irregularities: The delayed menstruation in March following unprotected intercourse in February raises the possibility of pregnancy, although you mentioned not taking a pregnancy test. The heavy bleeding you described, requiring frequent changes of sanitary pads, along with the presence of blood clots and unusual discharge, could indicate several conditions. Heavy menstrual bleeding (menorrhagia) can be caused by hormonal imbalances, uterine fibroids, polyps, or even more serious conditions such as endometriosis or adenomyosis. The presence of bright red blood and clots, especially if they are larger than a quarter, can be concerning and warrants further investigation.

2. Painful Intercourse: The pain during intercourse after your abnormal menstrual cycle could be attributed to several factors. If you experienced significant bleeding and discomfort during your menstrual period, it is possible that your body was still recovering from that episode. Conditions such as pelvic inflammatory disease (PID), endometriosis, or even cervical issues can cause pain during intercourse. It is also important to consider psychological factors; anxiety about the situation can lead to muscle tension, which can exacerbate pain during intercourse.

3. Medical Evaluation: It is concerning that you were only prescribed pain medication without further evaluation. Given your symptoms, it would be prudent to seek a comprehensive evaluation from a healthcare provider. This should include a pelvic examination, possibly an ultrasound, and blood tests to assess hormone levels and rule out any underlying conditions. A pregnancy test should also be performed to confirm or rule out pregnancy, as this can significantly impact your menstrual cycle and overall health.

4. Next Steps: If your symptoms persist or worsen, or if you experience additional symptoms such as fever, severe pain, or unusual discharge, it is crucial to seek medical attention promptly. You may want to consider visiting a gynecologist who specializes in menstrual disorders and sexual health. They can provide a more thorough evaluation and discuss treatment options tailored to your specific situation.

5. Self-Care and Monitoring: In the meantime, keeping track of your menstrual cycle, any pain experienced during intercourse, and other symptoms can be helpful for your healthcare provider. Note any changes in your body, including the nature of your menstrual flow, any pain experienced, and any other unusual symptoms. This information can assist your doctor in making a more accurate diagnosis.

In summary, your symptoms warrant a thorough medical evaluation to determine the underlying cause of your menstrual irregularities and painful intercourse. It is essential to communicate openly with your healthcare provider about all your symptoms and concerns to receive appropriate care.

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