Irregular Menstruation and Possible Inflammation Issues

Suspected inflammation

Hello, Doctor.
Since I started my period in junior high, my menstrual cycle has been irregular (sometimes normal, but mostly once every three months).
On around July 17, I visited a gynecology clinic due to symptoms of greenish discharge, which I believe indicates inflammation.
The doctor prescribed an internal ointment (performed a pelvic exam and a urinalysis).
Later, on the 20th, I noticed white particles inside the vagina with some blood streaks.
After returning for a follow-up on the 22nd, I was given a suppository and an external antifungal ointment (also had a pelvic exam).
My period started on the 24th (last month it started on the 14th), but the first couple of days had a low blood flow, and I didn't experience my usual symptoms.
On the night of the 26th, the bleeding suddenly increased to what I would expect for the next day, and there were quite a few blood clots, some as large as a 50 NT dollar coin.
During my follow-up on the 27th, the doctor mentioned that it might be due to hormonal imbalance and prescribed medication (no pelvic exam, but a urinalysis was done).
However, I noticed that even after showering, I was still experiencing bright red bleeding.
I looked online and suspect it might be a uterine issue.
Should I go to a larger hospital for an examination? Should I wait until my period ends before seeking further evaluation?

Wǎnshàng, 10~19 year old female. Ask Date: 2015/07/27

Dr. Lin Manying reply Obstetrics and Gynecology

If the menstrual bleeding lasts longer than 7 days and the intervals between recent cycles are irregular, which indicates abnormal menstruation, it is recommended to visit a hospital for examination without waiting for the end of the menstrual period.

Reply Date: 2015/07/27

More Info

Irregular menstruation can be a complex issue influenced by various factors, including hormonal imbalances, infections, and underlying health conditions. Based on your description, it seems you have been experiencing irregular menstrual cycles since middle school, with periods occurring as infrequently as every three months. This long-standing irregularity, combined with recent symptoms such as greenish discharge, white particles with blood, and sudden changes in menstrual flow, suggests that a thorough evaluation is warranted.

Your initial visit to a gynecologist was a good step, especially since you reported symptoms indicative of potential inflammation or infection. The green discharge you mentioned could suggest a bacterial infection, which is often treated with topical medications. The subsequent development of white particles and bleeding could indicate a yeast infection or another type of vaginitis, which can also affect menstrual cycles.

The fact that your menstrual flow has changed, with a sudden increase in blood volume and the presence of large clots, is concerning. Menstrual blood clots can be normal, but when they are large (like the size of a fifty-cent coin), it may indicate a more significant issue, such as hormonal imbalance or uterine abnormalities. The bleeding you experienced after bathing could also suggest that the cervix or vaginal walls are inflamed or irritated, which can happen with infections or other conditions.

Given your symptoms and the ongoing nature of your irregular cycles, it would be prudent to seek further evaluation at a larger medical facility. A comprehensive examination can help rule out conditions such as polycystic ovary syndrome (PCOS), uterine fibroids, endometriosis, or other hormonal disorders. These conditions can significantly impact menstrual regularity and overall reproductive health.

You might wonder whether to wait until your period ends before seeking further medical attention. While some practitioners may suggest waiting for the bleeding to stop, it is often better to seek care sooner, especially if you are experiencing unusual symptoms like persistent bleeding or significant changes in your menstrual cycle. A healthcare provider can perform necessary tests, including blood tests to check hormone levels, imaging studies like an ultrasound to examine the uterus and ovaries, and possibly a pelvic exam to assess for any abnormalities.

In summary, your symptoms warrant further investigation, and it is advisable to consult a gynecologist or a reproductive health specialist at a larger medical institution. They can provide a more comprehensive evaluation and tailored treatment plan based on your specific needs. Early intervention can help address any underlying issues, improve your menstrual health, and alleviate any discomfort you may be experiencing.

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