Menstrual Flow: When to Seek Medical Advice

How to determine the amount (of something) being excessive or insufficient?

Hello, Doctor: I would like to ask about my menstrual cycle.
On April 19 and 20, I had only a little bleeding, but starting April 21, the bleeding increased, and I began to experience abdominal pain and mood swings.
Today, the bleeding has become quite heavy, requiring me to change my pad approximately every two hours, and I am almost through a whole pack in one day.
Is this considered heavy bleeding? Is my cycle unstable? Should I come in for a consultation? I am quite busy with work, but I will make time if necessary.
Also, could you explain what progesterone deficiency is? Thank you.

Zi, 30~39 year old female. Ask Date: 2013/04/22

Dr. Lin Wenbin reply Obstetrics and Gynecology

Bleeding through a pad every two hours is considered heavy.
If it lasts for just one day, it might be acceptable, but if it continues for several days, it can make a person very uncomfortable and may require medical evaluation and treatment.
It could be related to progesterone levels, but a check-up in the clinic is necessary to determine the cause.
I recommend tracking your basal body temperature, as it can help the physician understand your endocrine status.

Reply Date: 2013/04/22

More Info

Menstrual flow can vary significantly from person to person, and understanding what constitutes a normal menstrual cycle is essential for recognizing when to seek medical advice. Based on your description, it seems that your menstrual flow has been irregular, with light bleeding followed by heavier flow and associated symptoms like abdominal pain and emotional changes.
In general, a menstrual cycle is considered normal if it occurs every 21 to 35 days and lasts between 2 to 7 days. The amount of menstrual flow can also vary, but an average period typically involves losing about 30 to 80 milliliters of blood. If you find yourself needing to change a pad or tampon every 1 to 2 hours, this could indicate a heavier flow than normal, known as menorrhagia.
Given that you experienced light bleeding initially, followed by a significant increase in flow, it’s important to consider several factors. Stress, hormonal imbalances, changes in weight, and underlying health conditions can all affect menstrual patterns. The abdominal pain and emotional fluctuations you mentioned could also be related to hormonal changes during your cycle, particularly if you are experiencing premenstrual syndrome (PMS) or dysmenorrhea (painful periods).

Regarding your question about progesterone deficiency, this condition can occur when the body does not produce enough progesterone, a hormone that plays a crucial role in regulating the menstrual cycle. Symptoms of low progesterone can include irregular periods, heavier menstrual bleeding, mood swings, and other premenstrual symptoms. If you suspect that hormonal imbalances are affecting your menstrual cycle, it would be wise to discuss this with your healthcare provider.

In terms of when to seek medical advice, consider the following guidelines:
1. Heavy Bleeding: If you need to change your pad or tampon every hour for several hours, or if you pass large blood clots, it’s advisable to consult a healthcare professional.

2. Severe Pain: If your abdominal pain is severe and not relieved by over-the-counter pain medications, or if it disrupts your daily activities, you should seek medical attention.

3. Irregular Cycles: If your menstrual cycle becomes consistently irregular or if you experience significant changes in your cycle, such as skipping periods or very light or heavy bleeding, it’s important to consult a doctor.

4. Other Symptoms: If you experience symptoms like fatigue, dizziness, or shortness of breath, which could indicate anemia from heavy bleeding, you should seek medical care promptly.

In conclusion, while some variation in menstrual flow is normal, significant changes, especially those accompanied by other symptoms, warrant a visit to your healthcare provider. They can perform necessary evaluations, including hormone level testing or imaging studies, to determine the underlying cause of your symptoms and recommend appropriate treatment options. Taking the time to address these concerns can help ensure your overall health and well-being.

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