Abnormal Bleeding After Menstruation: Causes and Concerns

Q: Abnormal Bleeding After Menstruation: Causes and Concerns

Hello Karin： The situation regarding medication assessment should be related to earlier stages and hormonal imbalances. <br>Additionally, the menstrual regulation medication does not conflict with lipid-lowering medications.

Abnormal bleeding after menstruation?

Hello, Doctor: Over the past five years, my menstrual cycle has shortened by about seven days compared to when I was in my 20s and 30s, averaging around 24 to 27 days, and sometimes even as short as 20 days (it has never been very regular).
Additionally, the flow has noticeably decreased.
My most recent period started on May 13, which was the longest cycle in the past five years at 36 days, and it lasted about seven days.
However, on May 25, I suddenly experienced bright red bleeding, similar to bleeding from a wound, with a distinct smell and color that was different from my usual menstrual blood.
The bleeding continued until June 1, and during this time, it was consistently bright red.
Typically, I experience breast swelling and mild pain about a week before my period, but this time, the breast discomfort persisted from a few days before my period started on May 13 until the abnormal bleeding ended, lasting almost half a month.
After the bleeding stopped, I immediately consulted a gynecologist, who performed a pregnancy test that came back negative.
The doctor then prescribed progesterone for one week, and today, June 13, my period has started again...
I would like to ask the doctor why I experienced this bleeding.
Could it be ovulation bleeding? I am currently taking medication to lower my cholesterol.
If I see a doctor in the future, would it be appropriate for them to prescribe medication to regulate my cycle? Should I inform them about my current medication? Thank you for patiently reading my questions.

Karin, 40~49 year old female. Ask Date: 2023/06/13

Dr. Lin Manying reply Obstetrics and Gynecology

Hello Karin: The situation regarding medication assessment should be related to earlier stages and hormonal imbalances.
Additionally, the menstrual regulation medication does not conflict with lipid-lowering medications.

Reply Date: 2023/06/13

More Info

Abnormal bleeding after menstruation can be concerning and may arise from various underlying causes. Your situation, characterized by a significant change in your menstrual cycle over the past five years, including shorter cycles and a recent episode of bright red bleeding, warrants careful consideration.

Firstly, it is essential to understand that menstrual cycles can vary significantly among individuals and can be influenced by numerous factors, including hormonal changes, stress, lifestyle, and medical conditions. The fact that your cycles have shortened and the menstrual flow has decreased could indicate hormonal imbalances, particularly involving estrogen and progesterone levels.
The sudden episode of bright red bleeding you experienced could potentially be attributed to several factors. One possibility is ovulation bleeding, which can occur around the middle of the menstrual cycle when an egg is released from the ovary. This type of bleeding is usually light and short-lived but can sometimes be more pronounced. However, given the duration and characteristics of your bleeding, it may not fit the typical profile of ovulation bleeding.

Another consideration is the possibility of an underlying condition such as uterine fibroids, polyps, or endometrial hyperplasia, which can cause abnormal bleeding. Additionally, hormonal contraceptives or medications, including those for lowering cholesterol, can also affect menstrual patterns. It is crucial to inform your healthcare provider about all medications you are taking, as they may influence your menstrual cycle and bleeding patterns.

The breast tenderness you experienced prior to your abnormal bleeding could be related to hormonal fluctuations, particularly if you have a history of premenstrual syndrome (PMS). Hormonal changes can lead to breast swelling and discomfort, which may persist longer than usual, as you described.

Since you have already consulted with a gynecologist and received a negative pregnancy test, it is a positive step that you are seeking medical advice. The prescription of progesterone (黄体素) is often used to help regulate menstrual cycles and can assist in addressing abnormal bleeding. It is essential to follow your doctor's instructions regarding this medication and to monitor your symptoms closely.

In terms of next steps, it is advisable to maintain open communication with your healthcare provider. If your abnormal bleeding recurs or if you experience additional symptoms such as severe pain, dizziness, or fatigue, you should seek medical attention promptly. Your doctor may recommend further evaluations, such as an ultrasound or blood tests, to assess your hormonal levels and rule out any structural abnormalities in the uterus.

In conclusion, while your recent episode of abnormal bleeding may be related to hormonal fluctuations or ovulation, it is essential to continue monitoring your menstrual patterns and communicate any changes to your healthcare provider. Keeping a detailed record of your cycles, including the duration, flow, and any accompanying symptoms, can be beneficial for your doctor in determining the underlying cause and appropriate treatment. Always inform your healthcare provider about any medications you are taking, as this information is crucial for managing your health effectively.

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