Irregular Menstruation: Causes and Concerns for Women

Irregular menstruation?

Hello Doctor: In November of 1999, my first child passed away due to a sudden umbilical cord twist at ten months in utero.
Since then, my menstrual cycle has been irregular, and each time I visit a doctor, the treatment is not always effective.
I have also experienced recurrent urinary tract infections and kidney inflammation with fever.
Currently, I have not had my period for three months, and I am not pregnant.
During this time without menstruation, I have noticed an increase in vaginal discharge that has a fishy odor.
Sometimes the discharge is white, and other times it is yellow.
My vulva is very itchy, and I have developed small bumps that are also itchy.
I tend to squeeze them like pimples, and they can be expressed like pimples, although some cannot be squeezed out.
Doctor, I am very worried that there may be some pathological changes.
Why is it that some doctors cannot help regulate my menstrual cycle? I have taken strong medications to induce menstruation, but they have not been effective.
The last time my period did not come, the doctor mentioned it might be related to a urinary tract infection, but I am unsure if that is true.
I have also consulted a urologist, yet my period still has not returned.
Doctor, please help me! Thank you!

cc, 20~29 year old female. Ask Date: 2000/12/17

Dr. Zhan Deqin reply Obstetrics and Gynecology

1.
There are many reasons for irregular menstruation; please come to the hospital for an examination, as most cases can be treated.
2.
Itching discharge is often caused by an infection; please consult a gynecologist.
Additionally, do not squeeze or rupture any pimples in the vulvar area.
If you continue to have issues, please visit the obstetrics and gynecology outpatient clinic.

Reply Date: 2000/12/17

More Info

Irregular menstruation can be a source of significant concern for many women, particularly when accompanied by other symptoms such as unusual discharge, itching, and a history of reproductive health issues. In your case, the combination of missed periods, changes in discharge, and discomfort raises several important considerations.

Firstly, it is essential to understand that menstrual irregularities can stem from a variety of factors, including hormonal imbalances, stress, underlying medical conditions, and lifestyle changes. Given your history of pregnancy complications and urinary tract infections (UTIs), it is possible that these factors may have contributed to your current situation. Hormonal imbalances, particularly involving estrogen and progesterone, can disrupt the normal menstrual cycle, leading to missed periods or irregular bleeding.

The absence of menstruation for three months, known as amenorrhea, can be caused by several factors. Pregnancy is the most common cause, but since you have confirmed that you are not pregnant, other potential causes must be explored. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, and significant weight changes (either loss or gain) can all lead to irregular menstrual cycles. Additionally, stress and lifestyle factors, such as changes in diet, exercise, and sleep patterns, can also play a significant role in menstrual irregularities.

The increase in vaginal discharge, particularly if it has a foul odor or changes in color, may indicate an infection. Conditions such as bacterial vaginosis or yeast infections can cause changes in discharge and may also lead to itching and discomfort. The presence of small bumps that resemble acne may suggest a skin condition or an infection, and it is crucial to avoid squeezing or popping these lesions, as this can lead to further irritation or infection.

Given your symptoms and history, it is advisable to seek a comprehensive evaluation from a healthcare provider. This evaluation should include a thorough pelvic examination, laboratory tests to assess hormone levels, and possibly imaging studies to rule out structural abnormalities in the reproductive system. It may also be beneficial to consult with both a gynecologist and a urologist, considering your history of bladder infections, to ensure that all potential causes of your symptoms are addressed.

In terms of treatment, managing underlying conditions is crucial. If hormonal imbalances are identified, your doctor may recommend hormonal therapy or lifestyle modifications to help regulate your menstrual cycle. If an infection is diagnosed, appropriate antimicrobial treatment will be necessary. Additionally, addressing any psychological stressors through counseling or stress management techniques can also be beneficial.

In summary, irregular menstruation can be multifactorial, and your symptoms warrant a thorough investigation to identify the underlying causes. It is essential to communicate openly with your healthcare providers about your concerns and to advocate for a comprehensive approach to your health. By addressing both the physical and emotional aspects of your health, you can work towards achieving a more regular menstrual cycle and alleviating your symptoms.

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