Irregular Menstruation: Is Your Bleeding Real or Not?

Q: Irregular Menstruation: Is Your Bleeding Real or Not?

Hello： Normal menstruation is caused by the decline in progesterone levels, leading to the shedding of the secretory phase endometrium. <br>Emotional stress can suppress the secretion of luteinizing hormone (LH), preventing the release of mature follicles. <br>As a result, the co

Irregular menstruation and medication usage?

Recently, I experienced a delay in my menstrual period.
Due to emotional factors and an upcoming exam, my period, which was supposed to start on October 3, did not arrive.
Therefore, on October 11, I took "Lemiprim" for two days, one tablet per day.
Three days later, on October 14, I started to bleed.
The instruction leaflet mentioned that this bleeding might not be a true menstrual period.
I would like to ask if this is a true menstrual period or not.
If it is not, when is this bleeding likely to stop?

111, 10~19 year old female. Ask Date: 2013/10/15

Dr. Yang Wangjun reply Obstetrics and Gynecology

Hello: Normal menstruation is caused by the decline in progesterone levels, leading to the shedding of the secretory phase endometrium.
Emotional stress can suppress the secretion of luteinizing hormone (LH), preventing the release of mature follicles.
As a result, the corpus luteum cannot form.
The endometrium continues to be stimulated by estrogen without the influence of progesterone, remaining in the proliferative phase.
When the proliferative phase endometrium becomes too thick to be supported, it will begin to shed locally, resulting in anovulatory menstruation, commonly referred to as menstrual irregularity.
Typically, after a missed period and confirming no pregnancy, we can use progesterone to address the excessively thick proliferative endometrium, transforming it into a secretory phase endometrium.
After stopping the medication, the decline in progesterone levels will lead to normal menstruation.
The luteal phase usually lasts about 10-14 days, so using progesterone to induce a secretory phase endometrium is best done for at least 7 days.
If you only took it for 2 days and at a low dose, it raises the question of whether it can effectively convert the excessively thick proliferative endometrium into a secretory phase endometrium.
If it does not fully convert, it may still lead to localized shedding of the endometrium, resulting in daily vaginal bleeding and menstrual irregularity.
Thank you for your message!

Reply Date: 2013/10/15

More Info

Irregular menstruation can be a perplexing issue for many women, and understanding the nature of your bleeding is crucial for managing your reproductive health. Based on the information provided, it seems you experienced a delay in your menstrual cycle, which can be influenced by various factors, including stress, hormonal imbalances, and lifestyle changes. You mentioned taking "利美信" (likely referring to a medication that affects hormonal levels) after your period was late, which may have contributed to the bleeding you experienced afterward.

When it comes to understanding whether the bleeding you experienced after taking the medication is a true menstrual period or not, it is essential to consider a few factors:
1. Nature of the Bleeding: If the bleeding is light, irregular, or accompanied by unusual symptoms (such as significant pain or clots), it may not be a true menstrual period. Medications that affect hormonal levels can cause withdrawal bleeding, which may mimic a period but is not the same as a regular menstrual cycle.

2. Timing and Duration: Typically, a menstrual period lasts anywhere from 3 to 7 days. If your bleeding is shorter or significantly lighter than your usual period, it may indicate that it is not a true menstrual cycle. Withdrawal bleeding from hormonal medications can vary in duration and intensity.

3. Hormonal Influence: Medications like "利美信" can alter your hormonal balance, leading to changes in your menstrual cycle. If the bleeding you experienced is a result of the medication, it may stop once your body adjusts to the hormonal changes, which can take a few days to a couple of weeks.

4. Stress and Lifestyle Factors: Emotional stress, such as that from exams, can significantly impact your menstrual cycle. Stress can lead to hormonal fluctuations that may cause irregular bleeding or missed periods.

5. Consultation with a Healthcare Provider: If you are uncertain about the nature of your bleeding or if it persists beyond a few days, it is advisable to consult with a healthcare provider. They can perform a thorough evaluation, including a physical examination and possibly blood tests, to determine the cause of your irregular bleeding and provide appropriate guidance.

In summary, the bleeding you experienced after taking "利美信" may not be a true menstrual period but rather a response to hormonal changes induced by the medication. It is essential to monitor the bleeding and any accompanying symptoms. If it continues or if you have concerns about your menstrual health, seeking medical advice is the best course of action. Your healthcare provider can help clarify the situation and ensure that any underlying issues are addressed.

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