Abnormal Bleeding: When to Seek Medical Attention

Abnormal bleeding

Doctor, my girlfriend's period started on July 20, but it only came again on July 25 after two months.
We had unprotected intercourse, so she took emergency contraception on July 30.
We had sex twice that day, but the second time was drier with some friction.
About two hours later, she started bleeding, and the bleeding has been quite heavy since then.
What could this situation be? Should I take her to the hospital for a check-up? If we go for a consultation, will an internal examination be necessary?

Xiao Guan, 20~29 year old female. Ask Date: 2015/07/31

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your description of symptoms, it is possible that intercourse occurred during your ovulation period.
If no effective contraception was used from days 7 to 30, there is a chance of pregnancy.
The bleeding could be due to hormonal imbalance, implantation bleeding, the effects of emergency contraception, or other reproductive tract issues.
It is advisable to consult a physician for a thorough examination if the bleeding is heavy or persists.
Thank you! Wishing you safety and health.
Dr.
Chang

Reply Date: 2015/07/31

More Info

Abnormal bleeding can be concerning, especially when it occurs unexpectedly or in unusual amounts. In your girlfriend's case, the timeline of events is crucial for understanding the potential causes of her bleeding. She had her menstrual period on July 20, which was already delayed, and then she took emergency contraception (the morning-after pill) after unprotected intercourse. Following this, she experienced significant bleeding after another sexual encounter.

Emergency contraception can sometimes cause changes in menstrual bleeding patterns. It can lead to earlier or later periods, and in some cases, it can cause breakthrough bleeding. The bleeding she is experiencing could be a side effect of the emergency contraceptive, especially if it is heavier than her usual menstrual flow. However, it is also important to consider other factors that could contribute to abnormal bleeding, such as hormonal imbalances, infections, or even pregnancy complications.

Given that the bleeding is described as "a lot," it is advisable to seek medical attention. Heavy bleeding can lead to complications such as anemia or indicate a more serious underlying condition that needs to be addressed. It is particularly important to seek care if the bleeding is accompanied by other symptoms such as severe pain, dizziness, or fainting.

When visiting a healthcare provider, it is likely that they will perform a thorough evaluation, which may include a pelvic exam (internal examination) to assess the source of the bleeding. This examination can help determine if there are any abnormalities in the reproductive organs, such as fibroids, polyps, or signs of infection. Additionally, the healthcare provider may order blood tests to check for anemia and other potential issues, as well as an ultrasound to visualize the reproductive organs.

In summary, while the bleeding could be a side effect of the emergency contraception, it is essential to err on the side of caution and seek medical evaluation. Abnormal bleeding should always be taken seriously, and a healthcare provider can offer the best guidance on how to proceed. It is important to ensure that your girlfriend receives appropriate care to rule out any serious conditions and to manage her symptoms effectively.

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