Prolonged Abnormal Menstrual Bleeding: Causes and Concerns

Abnormal menstruation lasting for a week without stopping?

Hello, my menstrual cycle is approximately 30-32 days, and each period lasts about 6 days.
My last menstrual period was from June 24 to June 30.
However, starting on July 3, I began to experience brown discharge, followed by continuous bleeding for 5 days, which is not light bleeding but a normal menstrual flow, requiring a change of sanitary pads every 2-3 hours.
Later, I started to have brown discharge occasionally mixed with a small amount of fresh blood, and this has continued until today, July 10.
I have not had sexual intercourse.
On June 29, during a visit to the orthopedic clinic, the doctor injected steroids into my right groin.
I would like to know if this could be a side effect of the medication or if it is due to hormonal imbalance.
Thank you.

Miss Zhou, 30~39 year old female. Ask Date: 2022/07/11

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle or cause intermenstrual bleeding are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraception, diet, polycystic ovary syndrome, lesions of the uterus or cervix, infections, ovulation, pregnancy, and breastfeeding, among others.
It is recommended that if your symptoms persist or worsen, you should consult a gynecologist to check for hormonal imbalances or other causes.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2022/07/11

More Info

Prolonged abnormal menstrual bleeding can be concerning and may arise from various causes, including hormonal imbalances, structural abnormalities, or even medication side effects. Given your description, it seems that you have experienced a significant change in your menstrual cycle, which warrants further investigation.

Firstly, it’s important to understand the normal menstrual cycle. A typical cycle ranges from 21 to 35 days, with bleeding lasting between 2 to 7 days. Your cycle of 30-32 days with a duration of 6 days is within the normal range. However, the recent occurrence of prolonged bleeding starting shortly after your last menstrual period, especially with a normal flow requiring frequent changes of sanitary products, is atypical and should be evaluated.

Several potential causes for your symptoms could include:
1. Hormonal Imbalances: Fluctuations in hormones, particularly estrogen and progesterone, can lead to irregular bleeding. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt hormonal balance and cause prolonged bleeding.

2. Structural Abnormalities: Uterine fibroids, polyps, or adenomyosis can cause heavy and prolonged menstrual bleeding. These conditions often require imaging studies, such as an ultrasound, for proper diagnosis.

3. Coagulation Disorders: Conditions that affect blood clotting, such as von Willebrand disease or thrombocytopenia, can lead to abnormal bleeding patterns.

4. Medication Side Effects: The steroid injection you received in your right groin could potentially influence your menstrual cycle. Corticosteroids can affect the hypothalamic-pituitary-ovarian axis, leading to changes in menstrual patterns. However, this is less common and would typically depend on the dosage and duration of steroid use.

5. Infections or Inflammatory Conditions: Pelvic inflammatory disease (PID) or other infections can also lead to abnormal bleeding. Symptoms may include pelvic pain, fever, or unusual discharge.

Given that you have not engaged in sexual activity, the likelihood of pregnancy-related complications is low, but it is still essential to rule out any other underlying issues.

Recommendations:
1. Consult a Healthcare Provider: It is crucial to schedule an appointment with a gynecologist or your primary care physician. They may perform a physical examination, pelvic ultrasound, or blood tests to assess hormone levels and rule out any structural abnormalities.

2. Keep a Symptom Diary: Documenting your menstrual cycle, including the duration and flow of bleeding, any associated symptoms (such as pain or changes in discharge), and any medications taken, can provide valuable information for your healthcare provider.

3. Avoid Self-Diagnosis: While it’s tempting to search for answers online, it’s essential to rely on professional medical advice for diagnosis and treatment.

4. Monitor Symptoms: If you experience severe pain, dizziness, or signs of anemia (such as fatigue or paleness), seek immediate medical attention.

In summary, prolonged abnormal menstrual bleeding can stem from various causes, and it is essential to seek medical evaluation to determine the underlying issue. Early diagnosis and treatment can help manage symptoms effectively and prevent potential complications.

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