Abnormal Menstrual Cycles: When to Seek Gynecological Care

Female reproductive tract issues?

Hello, doctor.
My normal menstrual cycle is 37-40 days (with a duration of about 5 days).
Last month, I had my period on time, but the flow was light and the color was dark brown.
Two weeks later, I had another period, which was still light but more than the previous one, and the color was bright red (the duration extended to 8 days).
Interestingly, as of now, two days have passed since the last day of my period, and there is still a bit of light brown discharge, as if the menstruation hasn't completely finished.
Additionally, starting from the last day of my period, I noticed an unusual odor when using the restroom (this smell suddenly appeared on the last day of my period).
It is not the metallic smell of menstrual blood nor a fishy odor; it's difficult to describe, but it's not a pleasant smell.
I would like to know what this situation might indicate.
Should I continue to observe for a few more days, or should I see a gynecologist immediately? Thank you.

Xiao Song, 20~29 year old female. Ask Date: 2021/07/07

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
"Vaginal infections" can cause abnormal discharge, perineal itching, unpleasant odor, burning sensation during urination, frequent urination, and bleeding.
In more severe cases, it may lead to abdominal pain or fever.
The "treatment methods" vary depending on the symptoms and require proper health education.
It is recommended to visit an outpatient clinic for examination and evaluation by a specialist in obstetrics and gynecology.
2.
The menstrual cycle is influenced by various psychological and physiological factors.
A normal menstrual cycle ranges from 21 to 42 days, and the duration of menstruation varies by age, typically lasting about 3 to 10 days.
If the cycle is consistently outside the normal range, it is advisable to consult a specialist in obstetrics and gynecology for evaluation.

Reply Date: 2021/07/07

More Info

Abnormal menstrual cycles can be a source of concern for many women, and understanding when to seek gynecological care is crucial for maintaining reproductive health. Based on your description, it appears that you are experiencing irregularities in your menstrual cycle, including variations in flow, color, and an unusual odor. Let's break down your symptoms and discuss potential causes and when to seek medical advice.

Firstly, your normal menstrual cycle of 37-40 days is slightly longer than the average cycle, which typically ranges from 21 to 35 days. However, variations can occur due to various factors, including stress, hormonal imbalances, changes in weight, or underlying medical conditions. The fact that you experienced a second period within two weeks, with changes in flow and color, could indicate a few possibilities.

1. Hormonal Imbalance: Hormonal fluctuations can lead to changes in menstrual patterns. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or perimenopause can cause irregular cycles and abnormal bleeding. The deep brown color of your first period may suggest older blood, which can occur when the blood takes longer to exit the uterus.

2. Uterine Conditions: Conditions such as fibroids, polyps, or endometriosis can also lead to irregular bleeding and changes in menstrual flow. These conditions can cause the uterus to shed its lining irregularly, resulting in variations in the menstrual cycle.

3. Infection: The unusual odor you described, especially if it is not typical of menstrual blood, could indicate an infection, such as bacterial vaginosis or a sexually transmitted infection (STI). Infections can lead to changes in discharge and may cause additional symptoms like itching or discomfort.

4. Pregnancy-Related Issues: If there is any possibility of pregnancy, it is essential to consider that irregular bleeding could be a sign of an early pregnancy complication, such as a miscarriage or ectopic pregnancy.

Given these possibilities, it is essential to monitor your symptoms closely. If you experience any of the following, you should seek gynecological care promptly:
- Severe Pain: If you experience significant abdominal or pelvic pain that is not relieved by over-the-counter medications.

- Heavy Bleeding: If you soak through a pad or tampon in an hour or less for several hours.

- Foul Odor: If the odor persists or worsens, especially if accompanied by other symptoms like fever, chills, or unusual discharge.

- Prolonged Symptoms: If your irregular bleeding continues for more than a few cycles or if you have concerns about your menstrual health.

In your case, since you have already experienced two unusual cycles and are noticing a concerning odor, it would be prudent to schedule an appointment with a gynecologist. They can perform a thorough evaluation, which may include a pelvic exam, ultrasound, or blood tests to assess hormone levels and rule out any underlying conditions.

In conclusion, while some menstrual irregularities can be benign, it is always better to err on the side of caution. Seeking medical advice can provide peace of mind and ensure that any potential issues are addressed promptly. Your reproductive health is important, and understanding when to seek care is a vital part of maintaining it.

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