Prolonged Menstrual Bleeding: Causes and Solutions

Menstrual bleeding continues?

Hello: I have never engaged in sexual intercourse.
My last menstrual period started on January 25, and I have not had a period for nearly three months.
I am unsure if this is due to stress from my upcoming internship or staying up late during the winter break.
However, on May 5, I finally noticed signs of menstruation (there was blood when I wiped).
Prior to this, I had been experiencing brown discharge for about a week.
On May 6, the menstrual flow was light and somewhat brown, but by the evening, there was fresh blood.
As of today (May 13), I am still experiencing intermittent bleeding, maintaining a relatively consistent amount, but it does not reach the level of hemorrhaging.
It is manageable, but there is still fresh blood continuously emerging when I wipe.
I would like to ask the doctor what I should do.

Sandy, 20~29 year old female. Ask Date: 2021/05/13

Dr. Huang Yuande reply Obstetrics and Gynecology

1.
If the amount of bleeding is not significant, it may be observed, as it could be caused by stress leading to endocrine disruption.
2.
If it is causing any daily life disturbances, it is still advisable to seek medical attention.

Reply Date: 2021/05/13

More Info

Prolonged menstrual bleeding, or menorrhagia, can be concerning and may stem from various causes. In your case, it seems that you experienced a significant gap in your menstrual cycle, followed by a return of bleeding that has persisted for several days. Understanding the potential causes and solutions for this situation is essential for managing your health effectively.

Possible Causes of Prolonged Menstrual Bleeding
1. Hormonal Imbalances: Stress, changes in lifestyle, or significant life events (like starting an internship) can lead to hormonal fluctuations. These imbalances can affect the regularity and flow of your menstrual cycle.

2. Ovulatory Dysfunction: If ovulation does not occur regularly, it can lead to irregular bleeding. This is often seen in younger women or those with polycystic ovary syndrome (PCOS).

3. Uterine Conditions: Conditions such as fibroids, polyps, or adenomyosis can cause prolonged or heavy bleeding. These are non-cancerous growths in or on the uterus that can disrupt normal menstrual flow.

4. Infections: Pelvic inflammatory disease (PID) or other infections can lead to abnormal bleeding. If you have any accompanying symptoms like fever, unusual discharge, or pelvic pain, this could be a concern.

5. Thyroid Issues: An underactive or overactive thyroid can also impact menstrual cycles, leading to irregularities in bleeding.

6. Medications: Certain medications, especially hormonal contraceptives or anticoagulants, can affect menstrual bleeding patterns.

Recommended Solutions
1. Monitor Your Symptoms: Keep a detailed record of your menstrual cycle, including the duration and amount of bleeding, any accompanying symptoms (like pain or unusual discharge), and any lifestyle changes that may have occurred.

2. Stress Management: Since you mentioned stress related to upcoming internships, consider incorporating stress-reducing activities into your routine. Techniques such as yoga, meditation, or deep-breathing exercises can be beneficial.

3. Consult a Healthcare Provider: Given that you have experienced a significant change in your menstrual cycle, it is advisable to consult a healthcare professional. They may perform a physical examination, order blood tests to check hormone levels, and possibly conduct imaging studies (like an ultrasound) to assess for any uterine abnormalities.

4. Lifestyle Adjustments: Ensure you maintain a balanced diet, stay hydrated, and get regular exercise. These factors can help regulate your menstrual cycle.

5. Consider Hormonal Treatments: If hormonal imbalances are identified, your doctor may recommend hormonal contraceptives or other medications to help regulate your cycle.

6. Follow-Up: If your bleeding persists or worsens, or if you experience severe pain or other concerning symptoms, seek medical attention promptly. It’s crucial to rule out any serious underlying conditions.

Conclusion
While occasional irregularities in menstrual cycles can be common, prolonged bleeding should not be ignored. By understanding the potential causes and taking proactive steps, you can better manage your health. Always prioritize open communication with your healthcare provider to ensure you receive appropriate care tailored to your specific situation.

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