Abnormal Bleeding: Causes and Concerns for Women

Q: Abnormal Bleeding: Causes and Concerns for Women

Hello： Vaginal bleeding should first be evaluated with a pelvic examination to rule out organic causes of bleeding, such as vaginal lacerations, cervical polyps, or cervical erosion. <br>Next, a pregnancy test should be performed to exclude bleeding due to miscarriage or ectopic

Intermenstrual bleeding

Hello, my last menstrual period started on January 17, and the last time I had intercourse was on January 14, during which I used a condom and confirmed that there was no ejaculation inside.
However, on February 9, I suddenly experienced a discharge of brown fluid, and on February 10, there was dark red blood, which I am certain is not my menstrual period.
Before my period, I usually have noticeable breast swelling and tenderness, but this time I did not.
I have irregular periods, occurring every two to three months, and each cycle lasts about four to five days with light flow.
I started traditional Chinese medicine treatment for my body two and a half years ago and had not engaged in intercourse until one year ago.
Since then, I have frequently experienced post-coital bleeding, which I had never encountered before.
This time on February 9, I experienced unexplained bleeding without having intercourse and it is not my menstrual period.
I am unsure about the possible causes.

Xigua, 20~29 year old female. Ask Date: 2015/02/10

Dr. Yang Wangjun reply Obstetrics and Gynecology

Hello: Vaginal bleeding should first be evaluated with a pelvic examination to rule out organic causes of bleeding, such as vaginal lacerations, cervical polyps, or cervical erosion.
Next, a pregnancy test should be performed to exclude bleeding due to miscarriage or ectopic pregnancy.
A transvaginal ultrasound should be conducted to check for issues like endometrial hyperplasia.
Once these conditions are ruled out, most bleeding is classified as menstrual irregularity, which can be managed with hormonal therapy to regulate the menstrual cycle.
Thank you for your inquiry!

Reply Date: 2015/02/10

More Info

Abnormal bleeding can be a concerning issue for many women, and understanding its causes is essential for addressing any underlying health problems. Based on your description, it seems you have experienced unusual bleeding outside of your menstrual cycle, which can be attributed to several factors.

Firstly, it is important to note that the menstrual cycle can be influenced by various physiological and psychological factors. Stress, hormonal imbalances, and changes in lifestyle can all contribute to irregular bleeding. In your case, you mentioned that you have a history of experiencing bleeding after sexual intercourse, which could indicate cervical or vaginal irritation, especially if there was any trauma during intercourse or if there are underlying conditions such as cervical ectropion or infections.

The fact that you experienced coffee-colored discharge followed by dark red blood on February 10, which is not typical for your menstrual cycle, raises some questions. This type of bleeding could be related to ovulation, which can sometimes cause mid-cycle spotting due to hormonal fluctuations. However, since you mentioned that you have not had sexual intercourse recently, it is less likely to be related to ovulation.

Another possibility is that the bleeding could be related to hormonal changes, especially considering your history of irregular cycles and the fact that you have been undergoing traditional Chinese medicine treatment for two and a half years. Hormonal therapies can sometimes lead to changes in menstrual patterns, including breakthrough bleeding. If your body is adjusting to these treatments, it may cause unexpected bleeding episodes.

Additionally, you should consider the possibility of other medical conditions that can cause abnormal bleeding. Conditions such as polycystic ovary syndrome (PCOS), endometriosis, or uterine fibroids can lead to irregular bleeding patterns. It is also essential to rule out any infections or sexually transmitted diseases, which can cause inflammation and bleeding.

Given that you have not experienced breast tenderness this time, which is often associated with premenstrual syndrome (PMS), it could indicate that your hormonal levels are fluctuating differently than in previous cycles. This change could be a result of stress, lifestyle changes, or the effects of any treatments you have been undergoing.

In light of these factors, it is crucial to consult with a healthcare provider who can conduct a thorough evaluation, including a pelvic exam, ultrasound, and possibly blood tests to check hormone levels. This will help in identifying the underlying cause of your abnormal bleeding and determining the appropriate course of action.

In summary, abnormal bleeding can arise from various causes, including hormonal imbalances, stress, infections, or structural issues within the reproductive system. It is essential to seek medical advice to ensure that any potential health concerns are addressed and to provide you with peace of mind regarding your reproductive health. Regular check-ups and open communication with your healthcare provider about your symptoms and concerns will be beneficial in managing your menstrual health effectively.

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