Intermenstrual Bleeding: When to Seek Medical Advice

Intermenstrual bleeding

On September 18, I had my menstrual period (my cycles have always been regular).
However, I experienced abnormal bleeding from October 4 to October 5, which was significant enough that I needed to use sanitary pads (I changed them three times a day).
The bleeding worsened when I exerted myself while urinating.
By the morning of October 6, the bleeding had inexplicably decreased to the point where I only needed to use panty liners.
If I confirm that the bleeding has stopped, do I still need to take hemostatic medication? Should I consider the abnormal bleeding on October 4 as the start of a new cycle, or should I continue to count from September 18? If I have another menstrual period in mid-October, should I see a doctor again? Thank you very much, Dr.
Cao, for taking the time to review and respond to my questions amidst your busy schedule.
Wishing you all the best.
Thank you and I am grateful.

Jenny, 40~49 year old female. Ask Date: 2020/10/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it could be ovulatory bleeding.
Let's observe it next month.
Wishing you good health.

Reply Date: 2020/10/06

More Info

Intermenstrual bleeding, or bleeding that occurs between menstrual periods, can be concerning, especially when it is heavy enough to require the use of sanitary products. In your case, the bleeding that occurred on October 4th and 5th, which was significant enough to warrant the use of pads, raises several important considerations regarding your menstrual health.

Firstly, it is essential to understand that intermenstrual bleeding can have various causes, including hormonal imbalances, uterine fibroids, polyps, infections, or even more serious conditions such as endometrial hyperplasia or malignancies. Given that your menstrual cycles have been regular in the past, the sudden onset of heavy bleeding could indicate a disruption in your hormonal balance or another underlying issue that may need to be addressed.

Regarding your specific questions:
1. Should you take hemostatic medication? If the bleeding has stopped and you feel well, it may not be necessary to take any medication to stop the bleeding. However, if you experience any further episodes of heavy bleeding or if you have concerns about your menstrual cycle, it is advisable to consult with a healthcare provider. They can evaluate your situation and determine if any treatment is necessary.

2. How to count your menstrual cycle? The start date of your menstrual cycle is typically counted from the first day of your last menstrual period (in this case, September 18). The bleeding on October 4th and 5th should not be counted as a new menstrual cycle unless it is confirmed to be a new period by a healthcare professional. If you experience another episode of bleeding in mid-October, it would be wise to consult your doctor, especially if it resembles the previous intermenstrual bleeding.

3. When to seek medical advice? It is crucial to seek medical attention if you experience any of the following:
- Heavy bleeding that requires changing pads or tampons every hour for several consecutive hours.

- Bleeding accompanied by severe pain or cramping.

- Symptoms of anemia, such as fatigue, weakness, or dizziness.

- Any other unusual symptoms, such as fever or foul-smelling discharge.

In summary, while occasional intermenstrual bleeding can be benign, it is essential to monitor your symptoms closely. If you have any concerns or if the bleeding recurs, it is advisable to consult with a healthcare provider for a thorough evaluation. They may recommend tests such as a pelvic ultrasound or hormonal assessments to determine the underlying cause of the bleeding. Regular gynecological check-ups are also important for maintaining reproductive health and addressing any potential issues early on.
In conclusion, while the bleeding you experienced may not necessarily indicate a serious problem, it is always better to err on the side of caution and seek medical advice if you have any doubts or if your symptoms change. Your health and well-being are paramount, and a healthcare professional can provide you with the best guidance tailored to your specific situation.

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