Abnormal Bleeding and Its Causes in Women: A Comprehensive Guide

Premenstrual bleeding

1.
My menstrual periods were from February 14 to February 19 and from March 20 to March 24.
Then, I experienced bleeding again from April 9 to April 12 for four days.
The flow was not heavy, about the amount of a regular sanitary pad for a day, and I had some abdominal pain.
What could this bleeding be? Is it normal?
2.
On April 28, after some intimate touching with my boyfriend, I had bleeding again, but it was not much—just some blood mixed with discharge.
The discharge was white in the middle with blood on the outer edges, and I experienced slight abdominal pain.
The next day, the bleeding stopped, and I returned to having a lot of white discharge.
My period is expected in seven days.
Is this normal?
3.
I have had intimate touching with my boyfriend on March 25, April 18, April 19, April 21, April 23, and April 28.
I touched him, and he touched me, with fingers inserted, but there was no penetration.
Is there a risk of pregnancy?
4.
I usually go to bed late, around midnight to 1 AM on weekdays, and sometimes as late as 3 to 4 AM on weekends.
I also enjoy eating cold, fried foods and drink bubble tea about twice a week, with other beverages from convenience stores.
Could this affect my health?
5.
Recently, I have noticed a stronger odor from my vagina, and I have been experiencing a lot of wet, white discharge.
Is this normal?

K, 10~19 year old female. Ask Date: 2023/04/29

Dr. Huang Yuande reply Obstetrics and Gynecology

1.
This is abnormal blood and requires clinical examination.

2.
It could be ovulatory bleeding, but that is just speculation.

3.
No.

4.
Excessive vaginal discharge is not normal.

Reply Date: 2023/04/29

More Info

Abnormal bleeding in women can be a source of concern and confusion, especially when it occurs outside of the regular menstrual cycle. Based on the symptoms you've described, let's break down the potential causes and considerations regarding your situation.

1. Understanding Your Bleeding Patterns: Your menstrual cycles appear to be relatively regular, with periods occurring approximately every 28-30 days. The bleeding you experienced from April 9-12 could be classified as intermenstrual bleeding, which is bleeding that occurs between periods. This can be caused by a variety of factors, including hormonal fluctuations, ovulation, or even stress. The abdominal pain accompanying this bleeding may suggest that it could be related to ovulation or other benign causes, but persistent or severe pain should always be evaluated by a healthcare provider.

2. Post-Intercourse Bleeding: The bleeding you experienced after intimate contact on April 28, characterized by a small amount of blood mixed with discharge, could indicate several things. It might be due to minor trauma to the vaginal walls, especially if there was any vigorous activity. It could also be related to hormonal changes or even an infection. The presence of abdominal pain alongside this bleeding warrants further investigation, particularly if it recurs or worsens.

3. Pregnancy Concerns: Regarding your concerns about pregnancy, while the risk is generally low with the activities you've described (manual stimulation without penetration), it is not entirely absent. Sperm can potentially be transferred from fingers to the vaginal area, leading to pregnancy, albeit this is quite rare. If you have concerns about pregnancy, taking a home pregnancy test after a missed period can provide clarity.

4. Lifestyle Factors: Your sleep patterns and dietary habits can indeed impact your menstrual cycle and overall hormonal balance. Irregular sleep, particularly late nights, can disrupt the body's circadian rhythms and hormonal regulation, potentially leading to irregular bleeding. Additionally, a diet high in processed foods and sugars, such as frequent consumption of sugary drinks and fried foods, can also affect hormonal balance and menstrual regularity. It may be beneficial to adopt a more balanced diet and establish a regular sleep schedule to support your reproductive health.

5. Vaginal Discharge Changes: The increased volume and odor of your vaginal discharge could indicate a change in your vaginal flora, which might be due to an infection or other factors. Normal discharge can vary throughout the menstrual cycle, but a strong odor or significant changes in color or consistency may warrant a visit to a healthcare provider for evaluation.

Recommendations:
- Consult a Healthcare Provider: Given the complexity of your symptoms, it is advisable to consult a healthcare provider for a thorough evaluation. They may recommend a pelvic exam, ultrasound, or laboratory tests to rule out any underlying conditions such as infections, hormonal imbalances, or structural abnormalities.

- Track Your Symptoms: Keeping a detailed record of your menstrual cycles, bleeding patterns, and any associated symptoms (like pain or changes in discharge) can be helpful for your healthcare provider in diagnosing any issues.

- Consider Lifestyle Changes: Improving your diet, maintaining a regular sleep schedule, and managing stress can positively influence your menstrual health.

In conclusion, while some irregularities in menstrual bleeding can be normal, persistent or concerning symptoms should always be evaluated by a healthcare professional to ensure there are no underlying health issues.

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