Prolonged Menstrual Bleeding: When to Seek Medical Advice

Q: Prolonged Menstrual Bleeding: When to Seek Medical Advice

Ms. <br>Chen： Hello, it is recommended that you take the time to visit the obstetrics and gynecology clinic for an examination. <br>Hualien Hospital, Ministry of Health and Welfare, cares about your health.

Menstruation lasting 10 days with ongoing bleeding?

Hello, doctor: I am 42 years old.
I do not have a sexual partner and have never engaged in sexual intercourse.
My menstrual cycle has been irregular; for example, I might start on the 10th one month and then be 7 days late or early the following month.
However, this month, my period started on May 25 and lasted 10 days longer than usual.
After that, I had a small amount of brown discharge for 2-3 days, and then it stopped.
The following month, my period was also 2 days late and lasted about 5 days.
Then, it was over 2 months late, and I finally started on September 26.
As of today, October 5, I am still experiencing bleeding (bright red), but the amount is not much—approximately the size of two 50-cent coins throughout the day.
After using the restroom, I occasionally notice a quantity equivalent to one 10-cent coin, but sometimes there is none.
I do not feel any discomfort.
Should I seek medical attention? Thank you.

Chen Xiling, 40~49 year old female. Ask Date: 2022/10/05

Dr. Lin Manying reply Obstetrics and Gynecology

Ms.
Chen: Hello, it is recommended that you take the time to visit the obstetrics and gynecology clinic for an examination.
Hualien Hospital, Ministry of Health and Welfare, cares about your health.

Reply Date: 2022/10/05

More Info

Prolonged menstrual bleeding, also known as menorrhagia, can be a concerning symptom, especially when it deviates from your normal menstrual pattern. Given your age of 42 and the irregularities you've described, it is important to take this situation seriously and consider seeking medical advice.

Firstly, it’s essential to understand that menstrual cycles can be influenced by a variety of factors, including hormonal changes, stress, diet, and underlying medical conditions. At 42, you are approaching perimenopause, a transitional phase leading up to menopause, during which hormonal fluctuations can lead to irregular periods. However, significant changes in menstrual patterns, especially prolonged bleeding, should not be overlooked.

Your description indicates that you have experienced irregular cycles, with periods that have been delayed and prolonged bleeding. The presence of fresh red blood, even in small amounts, can be indicative of several conditions, including hormonal imbalances, uterine fibroids, polyps, or even more serious conditions such as endometrial hyperplasia or cancer, especially given your age. While the absence of pain or discomfort is a positive sign, it does not rule out the need for medical evaluation.

Here are some key points to consider regarding when to seek medical advice:
1. Duration of Bleeding: If your menstrual bleeding lasts longer than seven days, it is advisable to consult a healthcare provider. In your case, since you mentioned bleeding that has persisted for an extended period, this warrants further investigation.

2. Volume of Blood: While you noted that the amount of blood is not excessive, any significant change in the volume of menstrual bleeding should be assessed. If you find yourself soaking through pads or tampons every hour for several consecutive hours, this is a medical emergency.

3. Associated Symptoms: Although you mentioned no discomfort, it’s important to monitor for any additional symptoms such as severe cramping, dizziness, fatigue, or shortness of breath, which could indicate anemia or other complications.

4. Age Considerations: At 42, you are at an age where changes in menstrual patterns can be normal, but it is also a time when certain gynecological conditions become more prevalent. A thorough evaluation can help rule out any serious issues.

5. Family History: If there is a family history of gynecological issues, such as fibroids or cancers, it is even more crucial to seek medical advice.

In conclusion, while some irregularities in menstrual cycles can be normal, the prolonged bleeding you are experiencing, especially with the changes in your cycle, should be evaluated by a healthcare professional. A gynecologist can perform a thorough examination, which may include a pelvic exam, ultrasound, or blood tests to determine the underlying cause of your symptoms. Early intervention can help manage any potential issues and provide peace of mind. It is always better to err on the side of caution when it comes to your health.

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