Light Menstrual Flow and Post-Menstrual Rectal Bleeding

Blood in the stool and decreased menstrual flow after menstruation?

My menstrual cycle ranges from 29 to 35 days, sometimes being delayed and other times arriving early.
However, in the past two to three months, my flow has only been heavy for the first two days, with only a little bit for the following days, and sometimes there is no flow at all for an entire day.
Additionally, three to four days after my period ends, I notice bright red blood when I have a bowel movement, and the amount is significant, not just a drop or two.
I would like to ask Dr.
Jan why this is happening.
If I need to seek medical attention, should I see a gynecologist or a colorectal surgeon? Thank you!

Xuan Xuan, 20~29 year old female. Ask Date: 2000/11/15

Dr. Zhan Deqin reply Obstetrics and Gynecology

Three to four days after menstruation, if there is still blood during bowel movements, it is usually related to retained menstrual blood in the uterine cavity that has not been fully expelled.
This condition is more common in women with a retroverted uterus.
It is advisable to consult a gynecologist.
If there are any issues, please seek treatment at a gynecology outpatient clinic.

Reply Date: 2000/11/15

More Info

Understanding light menstrual flow and post-menstrual rectal bleeding can be concerning, especially when there are noticeable changes in your menstrual cycle and subsequent bleeding. Based on your description, it seems you are experiencing two distinct issues: changes in your menstrual flow and rectal bleeding following your menstrual period.

Firstly, regarding your menstrual cycle, it is not uncommon for women to experience variations in flow and cycle length. Factors such as stress, hormonal fluctuations, changes in weight, and lifestyle can all contribute to lighter menstrual flows. A light flow, particularly if it is only heavy for the first couple of days and then tapers off, can be a normal variation for some women. However, if this is a significant change from your usual pattern, it may warrant further investigation.

The post-menstrual rectal bleeding you describe is more concerning. Fresh red blood during bowel movements can indicate several potential issues, ranging from benign to more serious conditions. Common causes of rectal bleeding include hemorrhoids, anal fissures, or more serious conditions such as polyps or colorectal cancer. Given that you are experiencing this bleeding consistently after your menstrual period, it is essential to consider the possibility that it may not be directly related to your menstrual cycle.

In terms of seeking medical attention, it would be advisable to consult with a healthcare provider who specializes in women's health, such as a gynecologist, for the menstrual irregularities. They can evaluate your menstrual cycle, perform necessary examinations, and possibly conduct hormone level tests to determine if there are underlying issues contributing to your light flow.

For the rectal bleeding, it would be prudent to also consult a colorectal surgeon or a gastroenterologist. They can perform a thorough evaluation, which may include a physical examination, a digital rectal exam, and possibly imaging studies or endoscopy to assess the source of the bleeding. It is crucial to address this issue promptly, especially since rectal bleeding can sometimes indicate a more serious condition that requires treatment.

In summary, while changes in menstrual flow can be common and often benign, the presence of rectal bleeding should not be overlooked. It is essential to seek medical advice from both a gynecologist and a colorectal specialist to ensure a comprehensive evaluation of your symptoms. Early diagnosis and intervention can lead to better outcomes and peace of mind. Remember to keep track of your symptoms, including the timing and amount of bleeding, as this information can be very helpful for your healthcare providers in determining the cause and appropriate treatment.

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