Abnormal Menstrual Symptoms: When to Seek Medical Advice

Menstrual irregularities

Hello, doctor.
I would like to ask about an issue I experienced.
In May, on a certain day, I noticed a faint pinkish blood streak when I wiped after urinating, which occurred intermittently.
A few days later, my menstrual period started.
This continued for several months.
On October 15, I experienced the same situation, but this time there was a faint pinkish color every time I wiped after urinating.
One day, I even dampened a panty liner.
I thought my period was starting, but when I used a sanitary pad, it remained clean.
This situation lasted for about three to four days, and it seems I did not have a menstrual period that month.
Yesterday (November 6), I noticed the faint pinkish color again when wiping.
I am currently 37 years old, unmarried, and my menstrual periods have been quite regular in the past.
In October, I was busier and had insufficient sleep, which made me feel a bit tired.
November has also been stressful with lack of sleep, and I feel extremely fatigued with many worries.
I would like to ask the doctor: does the situation I experienced in October count as my menstrual period? Given that I have been experiencing faint pinkish streaks when wiping before my period for the past few months, should I see a doctor? What could be the overall situation? Should I see a doctor, or how can I regulate my body to return my menstrual cycle to normal? Thank you for your response, doctor.

Xun, 30~39 year old female. Ask Date: 2023/11/07

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle or cause intermenstrual bleeding are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraceptive pills, diet, polycystic ovary syndrome, lesions of the uterus or cervix, infections, ovulation, pregnancy, and breastfeeding, among others.
It is advisable to consult a gynecologist if symptoms persist or worsen to determine if there is a hormonal imbalance or other underlying causes.
Thank you! Wishing you peace and health, Dr.
Chang.

Reply Date: 2023/11/07

More Info

Understanding abnormal menstrual symptoms can be quite complex, especially when they involve unusual bleeding patterns or changes in your menstrual cycle. Based on your description, it seems you are experiencing intermittent light pink spotting, which is not typical for your usual menstrual cycle. This spotting has occurred before your expected period and has continued for several months, along with a notable absence of your regular menstrual flow in October.

Firstly, it’s important to clarify that spotting can occur for various reasons, and it does not always indicate a menstrual period. In your case, the light pink blood you are noticing when wiping could be considered "spotting," which is different from a full menstrual period. Spotting can happen due to hormonal fluctuations, stress, changes in sleep patterns, or even physical exertion. Given that you mentioned increased stress and sleep deprivation in October and November, these factors could potentially contribute to your irregularities.

At 37 years old, you are approaching a stage in life where perimenopause may begin to affect your menstrual cycle. Perimenopause is the transitional phase before menopause, where hormonal changes can lead to irregular periods, spotting, and other symptoms. However, it’s also essential to rule out other potential causes of abnormal bleeding, such as:
1. Hormonal Imbalances: Fluctuations in estrogen and progesterone can lead to irregular bleeding patterns.

2. Uterine Fibroids or Polyps: These benign growths can cause spotting or heavier menstrual bleeding.

3. Infections: Conditions such as pelvic inflammatory disease (PID) or sexually transmitted infections (STIs) can lead to abnormal bleeding.

4. Pregnancy-related Issues: If there is any chance of pregnancy, it’s crucial to rule out implantation bleeding or other complications.

5. Thyroid Issues: An underactive or overactive thyroid can also affect menstrual cycles.

Given the persistence of your symptoms, it would be advisable to seek medical advice. A healthcare provider can perform a thorough evaluation, which may include a physical examination, pelvic ultrasound, and possibly blood tests to check hormone levels and rule out other conditions.
In terms of managing your symptoms, here are a few recommendations:
- Stress Management: Since you mentioned feeling stressed, consider incorporating relaxation techniques such as yoga, meditation, or deep-breathing exercises into your routine.

- Sleep Hygiene: Prioritize good sleep habits to improve your overall well-being. Aim for 7-9 hours of quality sleep each night.

- Nutrition: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support hormonal balance.

- Regular Exercise: Physical activity can help reduce stress and improve hormonal regulation.

In conclusion, while occasional spotting can be normal, the pattern you’ve described warrants further investigation to ensure there are no underlying health issues. It’s always better to err on the side of caution when it comes to changes in your menstrual cycle. Consulting with a healthcare provider will provide you with clarity and appropriate management options to help restore your menstrual cycle to its previous regularity.

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