Abnormal Bleeding: When Is It Menstrual or Not?

Intermenstrual bleeding

Hello doctor, I used to have very regular menstrual cycles.
On June 21, my period started, and I had sexual intercourse on July 2 with a condom.
On July 8, I experienced bleeding and consulted a doctor, who determined that the bleeding was caused by changes in my routine and psychological factors, stating that it was not my period.
Then, on July 18, I bled again.
I would like to know if this is the start of my period for this month or if it is another episode of bleeding...
😓😓😓

Hūhū, 20~29 year old female. Ask Date: 2022/07/18

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle or cause bleeding outside of menstruation are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraceptive pills, diet, polycystic ovary syndrome, lesions of the uterus or cervix, infections, ovulation, pregnancy, and breastfeeding, among others.
Additionally, the failure rate of condoms as a contraceptive method is over 5%, making it less reliable compared to other methods.
If you are uncertain whether the bleeding is part of your menstrual period, it is advisable to consult a gynecologist to determine if it is due to hormonal imbalance or other causes.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2022/07/18

More Info

Abnormal bleeding can be a source of confusion and concern for many individuals, especially when it deviates from what is considered a normal menstrual cycle. Based on your description, it seems you have experienced irregular bleeding following a period of regular cycles. It’s important to understand the various factors that can contribute to abnormal bleeding and how to differentiate between menstrual bleeding and other types of bleeding.

Firstly, it’s essential to clarify what constitutes a normal menstrual cycle. A typical menstrual cycle ranges from 21 to 35 days, with bleeding lasting from 2 to 7 days. Any bleeding that occurs outside of this pattern can be classified as abnormal. In your case, you mentioned that you had a regular cycle until recently, which suggests that the changes you are experiencing may be linked to external factors.

The bleeding you experienced on July 8th, which was assessed by your doctor as being related to lifestyle and psychological factors, may indicate that it is not part of your menstrual cycle. Stress, changes in routine, and psychological factors can significantly impact hormonal balance, leading to irregular bleeding. This type of bleeding is often referred to as "anovulatory bleeding," which occurs when the ovaries do not release an egg, resulting in hormonal fluctuations that can cause unexpected bleeding.

On July 18th, you experienced bleeding again. It’s crucial to consider the timing of this bleeding in relation to your typical menstrual cycle. If your cycle is usually around 28 days, then July 18th could potentially align with the start of your next period. However, if this bleeding is significantly different in color, consistency, or duration compared to your usual menstrual bleeding, it may warrant further investigation.

Several factors can contribute to abnormal bleeding, including:
1. Hormonal Imbalances: Fluctuations in estrogen and progesterone levels can lead to irregularities in the menstrual cycle.

2. Stress: Psychological stress can affect the hypothalamus, which regulates the menstrual cycle, leading to irregular bleeding.

3. Lifestyle Changes: Changes in diet, exercise, or sleep patterns can also impact hormonal balance.

4. Medical Conditions: Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or uterine abnormalities (like fibroids or polyps) can cause abnormal bleeding.

5. Medications: Certain medications, including hormonal contraceptives, can lead to changes in bleeding patterns.

Given that you have already consulted with a physician, it would be advisable to keep track of your bleeding patterns, including the timing, duration, and characteristics of the bleeding. If the irregular bleeding persists or worsens, or if you experience additional symptoms such as severe pain, fatigue, or significant changes in your cycle, it would be prudent to seek further evaluation from a healthcare provider. They may recommend additional tests, such as blood tests to check hormone levels or imaging studies to assess the reproductive organs.

In summary, while the bleeding you experienced on July 18th could potentially be your menstrual period, it is essential to monitor its characteristics and consult with a healthcare provider if you have concerns. Understanding the underlying causes of abnormal bleeding can help alleviate anxiety and guide appropriate management. Remember, your health and well-being are paramount, and seeking professional advice is always a wise choice when faced with uncertainties regarding your menstrual health.

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