Abnormal Menstrual Cycles: Causes and When to Seek Help

Menstrual irregularities

I used to have regular menstrual cycles until August-September of 2014, when I suddenly experienced an increase in menstrual flow.
In November 2014, I consulted a doctor who prescribed medication to regulate my menstrual cycle.
Initially, my periods were normal each month, but by February and March, the flow decreased.
During this time, I had blood tests, and the doctor indicated that my ovarian function was poor.
After April, my periods stopped completely.
When I returned to the doctor, he prescribed ovulation medication again, but I eventually stopped going.
During this period, he performed vaginal and abdominal ultrasounds, which showed no significant issues.
In September 2015, I visited a traditional Chinese medicine practitioner to improve my health, and I experienced a slight return of my menstrual cycle, but I did not continue the treatment, and it stopped again.
In December, I discovered a hard lump in my vagina and went to a large hospital for examination.
The doctor checked my cervix and found no significant problems.
Later, I asked the doctor about my situation, and he said that at my age, not having been pregnant is normal, and advised me to wait until I want to conceive before seeking treatment.
He also prescribed softening medication, which I was told to take for three months, but my periods did not return.
I took the medication once, and my period lasted about five days, but after adjusting the medication, it stopped again.
Currently, I sometimes notice light brown or dark red discharge with streaks, resembling what I experience during ovulation or menstruation, but it only lasts for 2-3 days and then stops.
I still have not had my period.
I would like to know what might be happening in my case.
Is this normal? Should I go to the hospital for further examination?

Hua Hua, 20~29 year old female. Ask Date: 2016/03/14

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, you may have poor ovulatory function, which could be causing irregular menstruation.
It is recommended to visit a hospital and consult with an obstetrician-gynecologist for a blood test.
Wishing you good health.

Reply Date: 2016/03/14

More Info

Understanding abnormal menstrual cycles can be complex, as they can be influenced by a variety of factors including hormonal imbalances, stress, lifestyle changes, and underlying medical conditions. Based on your description, it seems you have experienced significant changes in your menstrual cycle over the past few years, including increased menstrual flow, irregular cycles, and periods of amenorrhea (absence of menstruation).
Initially, you mentioned that your menstrual flow became heavier around August to September of 2014, and after consulting a doctor, you were prescribed medication to regulate your cycle. It is common for doctors to prescribe hormonal treatments to manage irregular menstruation, especially if there are indications of ovarian dysfunction. The fact that your menstrual cycle initially normalized while on medication suggests that the treatment was effective in addressing some of the hormonal imbalances.

However, you also noted that after a few months, your menstrual flow decreased, and eventually, your periods stopped altogether. This could indicate that your body may not be responding to the medication as expected, or that there are other underlying issues affecting your menstrual health. The presence of a hard lump in your vagina, which was later evaluated and found not to be problematic, could have been a source of concern, but it is reassuring that no significant issues were identified during the examinations.

The irregular spotting you are experiencing now, characterized by light brown or dark red discharge, could be related to hormonal fluctuations. This type of spotting can occur during ovulation or as a result of hormonal changes, especially if your menstrual cycle has been irregular. It is not uncommon for women who have experienced irregular cycles to have spotting between periods, but it is essential to monitor these changes closely.

Given your history and the ongoing irregularities in your menstrual cycle, it is advisable to seek further evaluation from a healthcare provider. Here are some reasons why you should consider returning to the clinic:
1. Persistent Irregularities: Since your menstrual cycle has not returned to a regular pattern and you are experiencing unusual spotting, it is important to investigate the underlying causes. This could include hormonal assessments, imaging studies, or other diagnostic tests.

2. Ovarian Function: You mentioned that your doctor indicated poor ovarian function. This could be a significant factor in your irregular cycles and may require further evaluation and management.

3. Potential Underlying Conditions: Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or other hormonal imbalances can lead to irregular menstrual cycles. A thorough evaluation can help rule out these conditions.

4. Family Planning: If you are considering pregnancy in the future, understanding your menstrual health and ovarian function is crucial. A healthcare provider can guide you on the best steps to take to optimize your reproductive health.

5. Emotional and Physical Well-being: Irregular menstrual cycles can be distressing and may impact your emotional and physical well-being. Seeking help can provide you with reassurance and a plan to manage your symptoms.

In summary, while some irregularities in menstrual cycles can be normal, especially in the context of hormonal treatments and lifestyle changes, your ongoing symptoms warrant further investigation. It is essential to have open communication with your healthcare provider about your concerns and to discuss the possibility of additional tests or treatments that may help restore your menstrual health.

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