Unexplained Vaginal Bleeding: Causes and Concerns for Women

Abnormal vaginal bleeding

About three weeks ago, I noticed brown discharge that resembled the end of a menstrual period, so I didn't pay much attention to it.
After a few days, it gradually turned into a small amount of bright red blood.
Even with a panty liner, I could go three hours without needing to change it, so I thought it was my period.
However, it felt a bit different; menstrual blood is usually thicker, and I typically experience some mild cramps.
This time, there were no such sensations, and the blood seemed clean, almost like from a wound, with no feeling when it flowed.
I assumed it was just my period and didn't think much of it until the end of the second week when the bleeding still hadn't stopped, and the amount remained the same without increasing.
It was even less during the night.
By the beginning of the third week, there was one day with no bleeding, just a small amount of brown discharge, leading me to think it was indeed a prolonged period.
However, the next day, the bleeding started again.
Now, it's almost the end of the third week.

Before this strange occurrence, I hadn't changed my diet, sleep schedule, or experienced any injuries.
Suddenly, this happened.
Can you provide me with some advice or possible causes?

W, 20~29 year old female. Ask Date: 2004/10/24

Dr. Lin Zhaopei reply Obstetrics and Gynecology

Possible causes of abnormal bleeding can be attributed to several factors, especially since the individual is only 20 years old and malignant tumors (such as those of the uterus, cervix, or ovaries) can be temporarily excluded.
More likely causes include hormonal imbalances, benign ovarian tumors, endometritis, or polyps.
If no cause is identified, liver or kidney dysfunction could also be a possibility.
Additionally, pregnancy-related conditions should not be overlooked.
It is recommended to visit a gynecological clinic for further evaluation.

Reply Date: 2004/10/24

More Info

Unexplained vaginal bleeding can be concerning for many women, and your experience raises several important points that warrant discussion. Based on the symptoms you've described, it seems that you have been experiencing irregular bleeding that does not align with your typical menstrual cycle. This can be attributed to various factors, and understanding these can help you navigate your concerns more effectively.

Firstly, it's essential to recognize that vaginal bleeding outside of your regular menstrual period can have multiple causes. Some common reasons include hormonal imbalances, ovulation bleeding, uterine fibroids, polyps, or even more serious conditions such as endometriosis or uterine cancer. Given that you mentioned the bleeding started as brown discharge, which is often associated with the tail end of a menstrual period, it could initially seem benign. However, the transition to bright red blood and the persistence of the bleeding for several weeks is noteworthy and should not be overlooked.

Hormonal fluctuations are a frequent culprit in cases of abnormal bleeding. Conditions such as polycystic ovary syndrome (PCOS), which you mentioned you have, can lead to irregular cycles and unexpected bleeding. In PCOS, the hormonal imbalance can cause the endometrial lining to build up and shed irregularly, leading to episodes of bleeding that may not correspond with your menstrual cycle.
Another possibility is ovulation bleeding, which occurs in some women when the ovary releases an egg. This can cause a small amount of bleeding due to the rupture of the follicle. However, this typically lasts only a day or two and is usually accompanied by some mild discomfort.

The fact that you have experienced this bleeding for an extended period (almost three weeks) without any significant changes in your lifestyle or diet is concerning. It is crucial to consider that prolonged bleeding can also be a sign of more serious conditions, such as fibroids or polyps, which are benign growths in the uterus but can cause significant symptoms. In rare cases, persistent bleeding could indicate malignancy, especially if you are over the age of 35 or have other risk factors.

Given your symptoms, it is highly advisable to seek a thorough evaluation from a healthcare professional. This should include a pelvic examination, possibly a transvaginal ultrasound, and blood tests to assess hormone levels and rule out any underlying conditions. A Pap smear may also be warranted if you are due for one, especially if you have had any changes in your sexual health or history.

In the meantime, keep track of your symptoms, including the amount and color of the bleeding, any associated pain, and any other changes in your body. This information will be invaluable to your healthcare provider in determining the cause of your bleeding.

Lastly, while it may be tempting to wait and see if the bleeding resolves on its own, it is essential to prioritize your health and seek medical advice sooner rather than later. Early intervention can often lead to better outcomes and peace of mind. Remember, your health is paramount, and any persistent changes in your menstrual cycle should be taken seriously.

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