Abnormal Bleeding: Causes and Concerns in Women’s Health

Abnormal bleeding

Menstruation occurred from October 8 to October 13, and more than two weeks have passed since then.
There was bleeding during the ovulation period, but even after the ovulation period, there are still brownish discharge and a small amount of blood (not ovulation bleeding) present.
The amount is slightly less than what would fill a panty liner.
I have visited a gynecologist last month and this month, but no issues were detected (an abdominal ultrasound was performed).
Since I have not engaged in sexual intercourse, the doctor did not agree to a pelvic examination.
However, the ultrasound did not reveal any problems, and taking medication has not provided significant relief (I have taken medication twice already).
For the past two days, I have also experienced pain in the lower abdomen, and there are still six to seven days until my next period.
I am really concerned.
Is it true that a virgin cannot undergo a pelvic examination? If there is indeed a problem with the uterus, wouldn't it be difficult to detect?

yju, 10~19 year old female. Ask Date: 2023/11/01

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, generally, individuals without sexual experience do not require a pelvic examination.
Young people typically do not have major issues.
If there are still discomforts, please follow up with your gynecologist for further evaluation.
Wishing you good health.

Reply Date: 2023/11/01

More Info

Abnormal bleeding in women can be a source of significant concern and confusion, particularly when it occurs outside of the expected menstrual cycle. Your situation, characterized by post-ovulatory bleeding and the presence of brown discharge, raises several important considerations regarding potential causes and the appropriate steps for management.

Firstly, it is essential to understand that abnormal bleeding can arise from various factors, including hormonal imbalances, anatomical issues, or even stress. In your case, the timing of the bleeding—occurring after your menstrual period and during a time when you expect to be in the luteal phase of your cycle—suggests that it may not be typical menstrual bleeding. The brown discharge you describe is often old blood, which can be a normal finding, but when accompanied by other symptoms, it warrants further investigation.

The fact that you have undergone abdominal ultrasound examinations and have not been found to have any significant issues is reassuring. Ultrasound is a valuable tool for assessing the uterus and ovaries, allowing for the identification of conditions such as fibroids, polyps, or cysts. However, it is important to note that not all conditions can be diagnosed through ultrasound alone. For instance, endometrial issues or certain hormonal imbalances may require additional testing, such as blood tests to evaluate hormone levels or a hysteroscopy for direct visualization of the uterine cavity.

Regarding your concern about being a virgin and the reluctance of healthcare providers to perform a pelvic examination, it is important to communicate openly with your healthcare provider about your concerns. While some practitioners may be hesitant to perform an internal examination on someone who has not engaged in sexual intercourse, it is not universally the case. A pelvic exam can provide critical information about the health of your reproductive organs, and if you are experiencing symptoms that suggest a potential issue, it is reasonable to request a thorough evaluation.

In terms of management, if hormonal imbalance is suspected, your healthcare provider may consider prescribing hormonal contraceptives, which can help regulate your menstrual cycle and reduce the occurrence of abnormal bleeding. Additionally, lifestyle factors such as stress, sleep patterns, and diet can significantly impact hormonal balance and menstrual health. It may be beneficial to explore stress management techniques, maintain a regular sleep schedule, and ensure a balanced diet to support overall health.

Lastly, if you continue to experience abnormal bleeding or if the symptoms worsen, it is crucial to follow up with your healthcare provider. Persistent or worsening symptoms may require further investigation to rule out conditions such as endometriosis, polycystic ovary syndrome (PCOS), or other underlying issues that could be contributing to your symptoms.

In summary, while abnormal bleeding can be distressing, understanding the potential causes and seeking appropriate medical care can help alleviate concerns. Open communication with your healthcare provider, thorough evaluation, and consideration of lifestyle factors are essential steps in addressing your symptoms and ensuring your reproductive health.

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