Abnormal Bleeding: When to Seek Medical Advice

Abnormal bleeding

I started taking the contraceptive pill, Yejih, on the third day of my period this month as instructed by my doctor to regulate my cycle.
However, starting from the fifth day of taking the pill, I began to experience brown discharge.
On the eighth day, I returned to the clinic to see my doctor, who prescribed Medroxyprogesterone to be taken alongside the Yejih pill, advising me to complete this course of medication.
Despite taking the Medroxyprogesterone, I still have not stopped experiencing light abnormal bleeding and brown discharge.
This bleeding has continued up to now.
I would like to ask if this is normal and whether I need to schedule another appointment.

Xuan Xuan, 20~29 year old female. Ask Date: 2021/06/07

Dr. Chen Zhiyu reply Obstetrics and Gynecology

There are many causes of abnormal bleeding in women, and hormonal imbalance is just one of them.
If the prescribed medication does not achieve the expected results, it is advisable to return to the original treating physician for further evaluation.

Reply Date: 2021/06/07

More Info

Abnormal bleeding can be a concerning issue for many women, and understanding when to seek medical advice is crucial for maintaining reproductive health. In your case, it appears that you have been experiencing persistent abnormal bleeding despite taking hormonal medications, which can understandably lead to anxiety and confusion.

First, let's clarify what constitutes abnormal bleeding. This term generally refers to any bleeding that occurs outside of your normal menstrual cycle, including spotting between periods, heavy bleeding during your period, or bleeding after sex. In your situation, the presence of brown discharge and continued light bleeding after starting hormonal treatment is indeed a cause for concern and warrants further evaluation.

The medications you are taking, such as the contraceptive pill (悦己) and the progesterone (美得能), are designed to regulate your menstrual cycle and manage abnormal bleeding. However, it is not uncommon for women to experience some irregularities when starting or adjusting hormonal treatments. This can include breakthrough bleeding or spotting, especially in the initial months of use. The body may take time to adjust to the hormonal changes, and it is not unusual for some women to experience side effects during this adjustment period.

However, given that your abnormal bleeding has persisted for an extended period, it is essential to follow up with your healthcare provider. Here are a few reasons why returning for a check-up is advisable:
1. Persistent Symptoms: If the bleeding continues beyond a few weeks or becomes heavier, it is crucial to seek medical advice. Prolonged abnormal bleeding can sometimes indicate underlying issues such as hormonal imbalances, uterine fibroids, polyps, or other conditions that may require treatment.

2. Evaluation of Treatment Efficacy: Since you have been prescribed additional medication (美得能) to help manage the bleeding, it is important to assess whether this treatment is effective. If you are still experiencing symptoms, your doctor may need to consider alternative treatments or further investigations.

3. Rule Out Serious Conditions: While many cases of abnormal bleeding are benign, it is essential to rule out more serious conditions, especially if there is a change in your bleeding pattern or if you experience other symptoms such as severe pain, dizziness, or fatigue.

4. Monitoring Hormonal Levels: Hormonal treatments can sometimes lead to fluctuations in hormone levels, which can affect your menstrual cycle. Your doctor may want to monitor your hormone levels to ensure they are within a normal range and adjust your treatment accordingly.

5. Personal Health History: Given your medical history and any other symptoms you may be experiencing, your healthcare provider may want to conduct further tests, such as an ultrasound or blood tests, to gain a clearer understanding of your situation.

In summary, while some irregular bleeding can be a normal side effect of starting hormonal treatments, persistent or worsening symptoms should not be ignored. It is always better to err on the side of caution and consult with your healthcare provider for a thorough evaluation. They can provide personalized advice based on your specific situation and help you navigate any necessary changes to your treatment plan. Remember, your health and peace of mind are paramount, and seeking medical advice is a proactive step in managing your reproductive health.

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