Changes in Menstrual Flow: When to Seek Help

Sudden decrease in menstrual flow?

In the past, my menstrual cycle has been generally normal, with heavy flow for two to three days, where the toilet bowl would be completely red, sometimes even dark red.
Over the past ten years, I have experienced late periods only a few times (about one to two weeks late).
Recently, I started taking psychiatric medication about three weeks ago, and my routine has changed; I feel sleepy and spend about half the day sleeping, and I have little appetite.
My period was expected to start on August 7, but it actually began on August 11 with very minimal bleeding, not even enough to change the color of my urine.
By August 13, there was finally a bit more bleeding, but it was still significantly less than usual.
After using the restroom, the color was only slightly orange-red, and the sanitary pad collected only a small amount of blood.
I feel a bit of warmth and heaviness in my abdomen, but there is no pain, and there is some slight dripping after using the restroom.
Should I see a gynecologist for an examination, or should I wait and observe until my next period? If this is related to the medication and changes in my routine, will it return to normal after improvement?

Xiao Xi, 20~29 year old female. Ask Date: 2022/08/13

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors affecting menstrual flow are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraceptives, diet, polycystic ovary syndrome, uterine or cervical lesions, infections, ovulation, pregnancy, miscarriage, and breastfeeding, among others.
If your symptoms persist, it is advisable to consult a gynecologist to check for medication or hormonal imbalances or other causes.
Most issues can be managed and improved with proper control.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2022/08/13

More Info

Changes in menstrual flow can be concerning, especially when they deviate from what has been a consistent pattern for many years. In your case, it sounds like you have experienced a significant alteration in your menstrual cycle, including a delay and a reduction in flow after starting new medication for mental health. This can understandably lead to questions about whether you should seek medical attention or if the changes are likely temporary.

Firstly, it is important to recognize that various factors can influence menstrual cycles, including stress, changes in routine, diet, and medications. The medications you mentioned may have side effects that impact your menstrual cycle, such as hormonal fluctuations or changes in your body's metabolism. For instance, certain psychiatric medications can lead to weight gain, changes in appetite, and alterations in hormonal balance, all of which can affect menstrual regularity and flow.

Given that you have had a consistent menstrual pattern for many years, the recent changes you described—such as a delayed period, significantly reduced flow, and changes in the color of menstrual blood—are worth noting. The fact that your menstrual blood has changed in color and quantity could indicate a few things. Lighter menstrual flow can sometimes be a sign of hormonal imbalances or other underlying health issues. Additionally, the color of menstrual blood can vary; bright red typically indicates fresh blood, while darker shades can indicate older blood or a slower flow.

In terms of whether you should seek help from a gynecologist, it is generally advisable to consult a healthcare provider if you experience significant changes in your menstrual cycle, especially if these changes persist for more than one cycle. Since you mentioned that your period was significantly delayed and the flow was much lighter than usual, it would be prudent to schedule an appointment. A healthcare provider can perform a thorough evaluation, which may include a physical examination, blood tests to check hormone levels, and possibly an ultrasound to assess your reproductive organs.

If the changes in your menstrual cycle are indeed related to the new medication and lifestyle changes, it is possible that your cycle may normalize once your body adjusts to the medication and your routine stabilizes. However, this is not guaranteed, and monitoring your symptoms is essential. If you notice any additional symptoms, such as severe abdominal pain, unusual discharge, or any other concerning signs, it is crucial to seek medical attention promptly.

In summary, while it is possible that the changes in your menstrual flow are temporary and related to your recent medication and lifestyle changes, it is advisable to consult with a gynecologist to rule out any underlying issues. Keeping track of your menstrual cycle and any accompanying symptoms will provide valuable information to your healthcare provider, aiding in a more accurate diagnosis and appropriate management.

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