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Ask Dr. Muneeb Ali Your Own Question
Dr. Muneeb Ali
Dr. Muneeb Ali, Intensivist
Category: OB GYN
Satisfied Customers: 3093
Experience:  MBBS, MD, MCCM.Currently working in Critical Care Medicine with 10 year experience in Medicine
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I'm 39 years old and my cycle has always been consistent.

Customer Question

Hello! I'm 39 years old and my cycle has always been consistent. However this last year I noticed that it was fluctuating more than normal (sometimes a week late). This is all normal until last month! My last regular period was Aug 22nd. I knew I was late for Sept and took several pregnancy tests to ease my mind. My boyfriend and I ALWAYS use protection. I started light bleeding on Oct 2nd and it hasn't stopped yet. Ithe color is all over the spectrum....sometimes light pink, bright red, sometimes dark red and others brownish. I would say it's more than spotting at times but would consider a very light flow. What could be causing this?? I have no pain anywhere
JA: Are you in any pain? How regular are your periods?
Customer: No pain at all. My periods when from 32 years ago down to 28 and have been 26 for a year or two now
JA: Anything else in your medical history you think the doctor should know?
Customer: No everything has been normal Have been taking citialpram (so?) for about 2.5 years now for anxiety and has helped with cramping
Submitted: 1 month ago.
Category: OB GYN
Expert:  Dr. Muneeb Ali replied 1 month ago.

Hi,

Im sorry to hear about your symptoms. Can i ask do you have any urinary symptoms?

Any fatigue or exhaustion? Hair loss?

Any excessive exercise or strenous activity over the past month?

Any other systemic symptoms like weight loss or gain? fever? sweating etc?

Customer: replied 1 month ago.
No urinary problems or hair loss. Not more tired than usual either.I have lost and gained about 5 lbs within the last 2 months but I know I haven't been paying attention to what I'm eating so not surprising.No fever or sweatingI had some cramping when the period started but not much
Expert:  Dr. Muneeb Ali replied 1 month ago.

Thanks for the additional information, ill just compose my answer and get back to you in a few mins.

Expert:  Dr. Muneeb Ali replied 1 month ago.

Well from what you are describing this can be due to a number of different conditions. the first one which comes to mind is that this could be the result of a low grade infection in the femal reproductive tract like PID. PID can occur even without pain in the abdomen or the back or urinary symptoms and can present initially with abnormal bleeding. This would need to be evaluated with a pelvic examination and high vaginal swab or a pelvic ultrasound.

Another cause of this can be related to thickening of the lining of the endometrium such as in endomterial hyperplasia. This would cause bleeding which can occur as various intervals and be irregular in nature. Simialrly endometrial or cervical polyps can cause similar symptoms without any pain.

Another cause of these symptoms can be related to pre menopause, which can cause an imbalance of the hormones although if this is due to pre menopause then it would cause symptoms like hot flashes, sweating and fatigue a little later in the course of the process. Usually initial symptoms are irregular periods and excessive bleeding or spotting in between periods. I would keep this down the list and have the other causes ruled out first off.

Lastly, A simple hormonal imbalance unrelated to the menopause can be the cause as well.

Now considering the bleeding has been continuing for the last 10 days and the irregular periods have been occurring for two months, i believe it is time for you to get a pelvic examination and also to get an ultrasound done. this will allow us to determine the exact cause of your problem. In addition hormone tests can be done if needed after the exam. i would suggest that you visit your OB/GYN and have him consider these options.

Do you have any more questions?

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Expert:  Dr. Muneeb Ali replied 1 month ago.

One last thing even though you dont have other symptoms related to the thyroid many female patients initially present with irregular periods or bleeding in cases of thyroid related disorders, the systemic symptoms can develop later on so it would be worthwhile getting a thyroid panel done as well.

Also stress can be a major factor is disrupting periods as well as cause excessive bleeding. if you have been under some sort of stress recently that can be the causative factor as well.

Do you have any more questions?

Please leave a POSITIVE rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating. You can also ask questions from me directly by going on the link below,

http://www.justanswer.com/medical/expert-dr-muneeb-ali/

Expert:  Dr. Muneeb Ali replied 1 month ago.

Would you like to know anything else?