Dr. Mishra Keeranmayee Mihirkumar
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 23-year-old female who is currently struggling with the unknown of what is happening to my body. Since I first started menstruating, it has always been heavy and longer than average. My normal periods last for 8-10 days, and I use typically 1.5 complete boxes of tampons during a cycle. I am in a long term relationship and have only had this singular sexual partner since 2017. I am not on birth control of any means and in some cases, I have had to use emergency contraceptives post intercourse. In the past two months, I have used contraceptives twice, once in the end of March, and most recently about two weeks ago. Since then, and this is the first time experiencing this, I have had dark brown, clumpy discharge, the closest comparison would be like damp coffee grounds.
Within the past week, I had also gotten a thing flesh-toned or white clot with blood on it, about 2.5 inches in length. I have started to feel concerned as the discharge has not stopped and I believe that is occurring rather than a menstrual cycle, at the time I am writing this I should have had my period cycle now, but instead, I have this dark brown discharge. At this time, I fear going to a doctor’s office for the safety of myself during this pandemic but also do not want to prolong any critical issues I may be facing. I have taken photographed images of all of this in worry if the typed description does not come across correctly. Please help.
Hi,
Welcome to icliniq.com.
Do not be stressed, I am here to help.
According to your history, you have not got periods this month and you are having some abnormal discharge. I saw the picture. (attachment removed to protect patient identity). My first suggestion would be to do get a urine pregnancy test. I understand that you have used emergency contraceptive but sometimes it fails. We need to know whether you have a pregnancy in which cases sometime the discharge is of nature as you described. You may be in the process of a miscarriage. If this is negative, then the next step would be to get a pelvic ultrasound done because the discharge seems unusual. But let me assure you that there are more chances of you having a miscarriage due to the failure of emergency contraceptives.
In case your urine pregnancy test is positive you need to take proper treatment like pregnancy termination kits or Misoprostol tablets depending on the condition of the conceptus (baby) at this time. In case your pregnancy test is negative you need a pap smear, ultrasound, and biopsy of the tissue you are discharging. Whatever it is, it can be managed properly if it is addressed on time. There is no need for panic. Please follow up with your pregnancy test results.
I hope this helps.
The Probable causes
Investigations to be done
Differential diagnosis
Treatment plan
Patient's Query
Thank you doctor,
I have taken two tests, the first showed a definitive line and a very faint second line. The second test I took was only one line. At this point, I will be going forward and getting a second round of urine tests and following up at the gynecologist.
Hi,
Welcome back to icliniq.com.
I think getting another urine test would be the right thing to do. Please let me know the results and if you intend to go to a gynecologist then kindly update me regarding your diagnosis and treatment.
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Obstetrics and Gynecology
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