Menstruation
Translation: Menstruation
July 17, 2011 | 15,00 EUR | answered by Dr. med. Ralf Berg
I am 45 years old but have no signs of menopausal symptoms yet, and I do not suspect that my problems suddenly stem from them. I usually have a very regular cycle without any spotting or breakthrough bleeding. I have never had that before. I got my period four weeks ago on Friday, a bit later than usual (usually every 25 days, this time after 30 days). The bleeding was normal, slightly lighter than usual. However, this time the bleeding did not stop. It bled normally for 4 days, then there was spotting. Meaning, brownish discharge, especially in the mornings when I went to the toilet. I had this spotting exactly until 14 days after the start of my period, so for 10 days. Again on a Friday, 14 days after my first period, the spotting turned into heavy bleeding, which feels like another menstrual bleeding. It is quite heavy bleeding, now already for three days without getting any lighter. Now my questions: Why suddenly this brownish discharge that I have never had before, why do I have another bleeding after 14 days? Is this a new period? What could all of this be caused by? Especially, what is bleeding so heavily at the moment? Has the lining barely rebuilt in the last 14 days? I must also mention that three weeks ago, my doctor gave me a 20mg cortisone depot injection, which releases cortisone into the body for three weeks, due to severe back pain.
Thank you in advance for all answers. I am very worried.
Dear patient,
You should not be too worried, but you should now get to the bottom of the cause. The whole process, as you yourself say, is very unusual for you.
Now, regarding the possible causes: In addition to the onset of menopause, vaginal or cervical inflammation can also lead to prolonged bleeding. Malformations in the uterine lining can also cause unusual bleeding. These bleeding episodes generally increase in the 5th and 6th decade, regardless of the onset of menopause.
The step you must now take is to visit a gynecologist who has the possibility to perform an abrasion and/or a cervical examination (hysteroscopy), or who can recommend you to appropriate facilities. Gynecological departments of hospitals, resident gynecologists, but also outpatient surgical centers do this. The material obtained after the uterine scraping will then be sent away for examination. This allows for microbiological (testing for bacteria, parasites, infections) and histological (testing for the presence of abnormal tissue) examination. The procedure also aims to stop the bleeding. During the hysteroscopy, the inside of the uterus is additionally inspected with an endoscope.
So please visit a gynecologist soon and schedule an appointment for this procedure. If no external source of bleeding can be found during a normal gynecological examination, this step is unavoidable.
A cortisone injection generally does not cause such symptoms.
With best regards and wishes, Dr. R. Berg
