Post-Menstrual Bleeding: Causes and Concerns

Menstruation has ended but there is still ongoing bleeding?

Doctor, I would like to ask you about something.
Since my period ended on November 16th, I have been experiencing continuous bleeding, and there are also blood clots.
I would like to know what might be causing this.

Hong Jiajia, 20~29 year old female. Ask Date: 2016/03/01

Dr. Tian Yiwen reply Obstetrics and Gynecology

Abnormal bleeding is advised to be evaluated in a gynecology clinic; it cannot be diagnosed remotely via the internet.

Reply Date: 2016/03/01

More Info

Post-menstrual bleeding, or bleeding that occurs after the menstrual period has ended, can be concerning and may have various underlying causes. In your case, since you mentioned that the bleeding has persisted since November 16 and includes blood clots, it is important to consider several potential factors that could be contributing to this issue.

1. Hormonal Imbalances: One of the most common causes of post-menstrual bleeding is hormonal imbalances. The menstrual cycle is regulated by hormones, and fluctuations in estrogen and progesterone levels can lead to irregular bleeding. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can also affect hormone levels and lead to abnormal bleeding.

2. Uterine Fibroids or Polyps: These are non-cancerous growths in the uterus that can cause heavy bleeding or bleeding between periods. Fibroids can vary in size and number, and they may lead to symptoms such as prolonged menstrual bleeding, pelvic pain, or pressure.

3. Endometrial Hyperplasia: This condition involves the thickening of the uterine lining and can result from prolonged exposure to estrogen without adequate progesterone. It can lead to irregular bleeding and, in some cases, may increase the risk of developing endometrial cancer.

4. Infections: Pelvic inflammatory disease (PID) or other infections of the reproductive organs can cause abnormal bleeding. Symptoms may include pelvic pain, fever, and unusual discharge.

5. Pregnancy-Related Issues: If there is a possibility of pregnancy, it is essential to rule out conditions such as miscarriage or ectopic pregnancy, which can present with abnormal bleeding. A pregnancy test can help clarify this.

6. Medications: Certain medications, particularly hormonal contraceptives, can lead to irregular bleeding. If you have recently started or changed any medications, this could be a contributing factor.

7. Other Medical Conditions: Conditions such as endometriosis, adenomyosis, or bleeding disorders can also lead to abnormal bleeding patterns.
Given that you are experiencing persistent bleeding with blood clots, it is crucial to consult a healthcare provider for a thorough evaluation. They may recommend a pelvic examination, ultrasound, or other diagnostic tests to determine the underlying cause of your symptoms.
In the meantime, it is important to monitor your symptoms closely. Note any additional symptoms such as severe pain, fever, or changes in the volume of bleeding, as these may indicate a more serious condition that requires immediate medical attention.

In summary, while post-menstrual bleeding can have various benign causes, persistent bleeding, especially with blood clots, warrants further investigation to rule out any serious underlying conditions. Seeking medical advice is the best course of action to ensure appropriate diagnosis and treatment.

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