Intermenstrual Bleeding: Causes and Concerns for Women

Intermenstrual bleeding

I have been experiencing menstrual pain for a long time and have undergone several ultrasound examinations at a Western medicine clinic, all of which reported no issues.
Later, I consulted a Traditional Chinese Medicine (TCM) practitioner who prescribed herbal medicine.
In the first month, I started experiencing intermenstrual bleeding, which I had not encountered before.
However, I only took the herbal medicine for two months and then stopped.
Now, for the past three months, I have had intermenstrual bleeding three times, occurring about 15 days after my menstrual period.
The amount is not significant, lasting only about two to three days.
My questions are: 1.
Since I have never experienced this before and now it has happened for three consecutive months, is this normal? Could it be due to the herbal medicine? I have taken TCM before to regulate my body, so I don't understand why this is happening.
2.
If this continues to happen every month, is that considered normal?

Hua, 30~39 year old female. Ask Date: 2009/11/27

Dr. Chen Changfu reply Obstetrics and Gynecology

Abnormal vaginal bleeding during menstruation in women, after several gynecological examinations showing no abnormalities, can be reassuring; it may be physiological ovulation bleeding.
You may consider taking a month of oral contraceptives to suppress ovulation and observe whether the bothersome abnormal vaginal bleeding persists during that month.

Reply Date: 2009/11/27

More Info

Intermenstrual bleeding, or bleeding that occurs between menstrual periods, can be a source of concern for many women. Understanding the potential causes and implications of this condition is essential for addressing any underlying issues and alleviating anxiety.
Firstly, it is important to recognize that intermenstrual bleeding can have various causes, and not all of them are indicative of a serious health problem. Common causes include hormonal fluctuations, which can be influenced by factors such as stress, changes in weight, or lifestyle modifications. For instance, if you have recently started or stopped taking medications, including herbal remedies or hormonal contraceptives, these changes can disrupt your hormonal balance and lead to unexpected bleeding.

In your case, you mentioned experiencing intermenstrual bleeding after starting traditional Chinese medicine (TCM) treatment. While TCM can be beneficial for many women, it is also possible that the herbs or formulations you were prescribed may have influenced your hormonal levels, leading to the bleeding you are experiencing. Some herbal treatments can have estrogenic effects or may affect the menstrual cycle in various ways, which could explain the onset of intermenstrual bleeding after starting the treatment.

Additionally, it is worth noting that intermenstrual bleeding can sometimes be a sign of ovulation. Some women experience spotting around the time of ovulation due to the hormonal changes that occur as the body prepares for the release of an egg. This type of bleeding is typically light and lasts only a few days, which aligns with your description of the bleeding lasting two to three days.

However, if this bleeding continues to occur regularly, it is essential to consult with a healthcare provider to rule out any underlying conditions. Potential causes of persistent intermenstrual bleeding can include:
1. Hormonal Imbalances: Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can lead to irregular bleeding patterns.

2. Uterine Fibroids or Polyps: These benign growths in the uterus can cause abnormal bleeding, including intermenstrual bleeding.

3. Endometrial Hyperplasia: This condition involves the thickening of the uterine lining and can lead to irregular bleeding.

4. Infections: Pelvic inflammatory disease (PID) or sexually transmitted infections (STIs) can cause abnormal bleeding.

5. Pregnancy-Related Issues: Although you mentioned that previous evaluations ruled out pregnancy, it is essential to consider this possibility if there are changes in your sexual activity or contraceptive methods.

Given that you have experienced this bleeding for three consecutive months, it is advisable to follow up with your healthcare provider. They may recommend further evaluations, such as blood tests to check hormone levels, or imaging studies to assess the uterus and ovaries.
In summary, while occasional intermenstrual bleeding can be normal, especially if it coincides with ovulation or hormonal changes, persistent or recurrent bleeding should be evaluated by a healthcare professional. This will help ensure that any underlying issues are identified and managed appropriately, allowing you to maintain your reproductive health and peace of mind.

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