Irregular Menstrual Bleeding: Causes and Concerns

Menstrual irregularities or abnormal bleeding?

Hello Doctor, my last menstrual period was from April 8 to April 13.
The app indicates that my ovulation day was April 25, and my cycle varies between 31 to 43 days.
I had sexual intercourse on April 25, 28, and May 3, using condoms and withdrawing before ejaculation.
I was originally expecting my period on May 9, but it was delayed by 4.5 days.
On May 13, I noticed brown discharge and had consumed 250cc of Qingguan No.
1 that day.
On May 14 and 15, I experienced bright red bleeding, but the amount was very minimal (much less than my usual menstrual flow), with only slight traces on the pad.
I only noticed more blood occasionally when using the restroom.
Typically, I experience cramping 3-4 days before my period, but this time there was no pain, just a feeling of abdominal bloating and discomfort.
I took a pregnancy test on the morning of May 15, which was negative.
I would like to ask the doctor:
1.
Is the small amount of blood I am experiencing my period, or is it abnormal bleeding?
2.
Could it be that my period is just not flowing properly? (I suspect it may be due to irregular sleep patterns and the consumption of Qingguan No.
1, which is considered cold in nature?)
3.
Is there a possibility that this could be early pregnancy bleeding or implantation bleeding? I am worried it might be early pregnancy bleeding, but it was too early to detect with the test.
4.
If I need to see a doctor, what tests should I request to ensure that I am not pregnant and that it is just a case of irregular menstruation? Thank you, Doctor!

Lin, 20~29 year old female. Ask Date: 2022/05/15

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the failure rate of condom use for contraception is over 5%.
It is not possible to determine pregnancy based on subjective symptoms.
If your period has not arrived, it is advisable to consult a physician for a check-up.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2022/05/15

More Info

Understanding irregular menstrual bleeding can be quite complex, as it can stem from various causes, including hormonal imbalances, stress, lifestyle changes, and even underlying medical conditions. Based on your description, let's break down your concerns and provide some insights.

1. Current Bleeding: Is it Menstrual or Abnormal?
The bleeding you are experiencing, which started as brown discharge and then turned to a small amount of bright red blood, could be classified as irregular menstrual bleeding. Given that your menstrual cycle typically ranges from 31 to 43 days, the timing of your bleeding (starting on May 13) is slightly delayed from your expected period (May 9). The fact that the flow is much lighter than usual and lacks the typical premenstrual symptoms (like cramping) suggests that this may not be a typical menstrual period. Instead, it could be a result of hormonal fluctuations or other factors affecting your cycle.

2. Could It Be Menstrual Blood Not Flowing Properly?
It is possible that your menstrual blood is not flowing as it typically would due to various factors, including stress, changes in routine, or dietary influences (like consuming certain herbal teas). Hormonal fluctuations can also lead to lighter periods or spotting. If your lifestyle has changed recently, such as sleep patterns or stress levels, these could contribute to your irregular cycle.

3. Could It Be Early Pregnancy or Implantation Bleeding?
While you mentioned that you took a pregnancy test on May 15 and it was negative, it’s important to note that some women experience early pregnancy bleeding or implantation bleeding, which can occur around the time of expected menstruation. However, implantation bleeding is usually light and short-lived. If you had unprotected intercourse, even with withdrawal, there is still a risk of pregnancy. If you suspect pregnancy, it may be worthwhile to wait a few days and retest, as hormone levels can take time to rise enough to be detected.

4. What to Discuss with Your Doctor?
If your bleeding continues or if you have further concerns, it would be advisable to consult with a healthcare provider. When you see the doctor, consider asking for the following:
- A thorough evaluation of your menstrual history and any recent changes in your lifestyle or health.

- Blood tests to check hormone levels, including thyroid function and progesterone levels, which can affect your menstrual cycle.

- An ultrasound may be warranted to rule out any structural issues within the uterus, such as fibroids or polyps, which can cause irregular bleeding.

- If necessary, a pregnancy test can be repeated to confirm or rule out pregnancy.

In conclusion, while the irregular bleeding you are experiencing may not be alarming, it is essential to monitor your symptoms and consult with a healthcare professional if they persist or worsen. Maintaining a healthy lifestyle, managing stress, and keeping track of your menstrual cycle can also help in understanding your body better. Remember, your health is paramount, and seeking professional advice is always a wise choice when it comes to concerns about your menstrual cycle.

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