Urinary Symptoms and Blood Clots Before Menstruation

Urinary issues with bleeding?

I would like to ask the doctor about experiencing a physiological response after watching adult films, which leads to a feeling of needing to urinate.
During urination, I notice that blood clots and urine are expelled together, although the amount of blood clots is minimal.
There is no pain or itching during urination.
This occurs only in the days leading up to my menstrual period when I watch adult films and have a physiological response.
If I do not watch adult films and do not have a physiological response in the days before my menstrual period, urination is normal and does not involve blood clots.
Outside of the days leading up to my menstrual period, urination is also normal and does not involve blood clots.

Yan, 20~29 year old female. Ask Date: 2020/10/31

Dr. Wu Xianghui reply Obstetrics and Gynecology

If hematuria is confirmed, please consult a urologist or visit a urology clinic for examination and evaluation by a specialist.

Reply Date: 2020/10/31

More Info

Understanding urinary symptoms, especially in relation to menstruation, can be complex and concerning. The presence of blood clots and blood in urine (hematuria) can arise from various physiological and pathological conditions. In your case, the timing of these symptoms—occurring just before your menstrual period and after experiencing sexual arousal—raises several considerations.

Firstly, it’s important to distinguish between menstrual blood and blood originating from the urinary tract. Since you mentioned that the blood clots appear during urination and not during menstruation, it suggests that the source may be related to the urinary system rather than the menstrual cycle. However, the proximity of your symptoms to your menstrual period complicates the situation, as hormonal changes can affect both the menstrual cycle and urinary tract health.

One potential explanation for the blood clots in your urine could be related to the increased vascularity and sensitivity of the pelvic region that occurs in the days leading up to menstruation. Hormonal fluctuations, particularly the rise in estrogen and progesterone, can lead to changes in the lining of the bladder and urethra, making them more susceptible to irritation or injury. This could result in minor bleeding, which may manifest as blood clots in the urine.

Additionally, if you are experiencing heightened sexual arousal, it may lead to increased pelvic floor tension or contractions, which could also contribute to irritation of the urinary tract. This irritation might not be painful but could result in the presence of blood or clots during urination.

It’s also essential to consider other potential causes of hematuria, such as urinary tract infections (UTIs), kidney stones, or even more serious conditions like bladder or kidney issues. While you mentioned that there is no pain or itching during urination, which often accompanies infections, it does not entirely rule out the possibility of a UTI or other underlying conditions.

Given the complexity of your symptoms and their potential implications, it is crucial to seek medical evaluation. A healthcare provider can perform a thorough assessment, including a urinalysis and possibly imaging studies, to determine the cause of the blood in your urine. They may also want to rule out any gynecological issues, especially since your symptoms are occurring close to your menstrual cycle.

In summary, while the presence of blood clots in urine before menstruation can be related to hormonal changes and pelvic floor dynamics, it is essential to consult a healthcare professional to rule out any serious underlying conditions. Early diagnosis and appropriate management are key to addressing any potential health issues and ensuring your overall well-being.

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