Dr. Sameer Kumar
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 have discussed a lot with you about this issue before. Since I last asked for advice, my periods have still been messed up. They seem to come every six weeks and yet nothing really on the pad. I only see blood when I go to the toilet and urinate. The flow of my period must be very bad as I need to urinate for it to come out. Why are my periods still every six weeks and still nothing really on the pad? I have not been pregnant so far. Hopefully, I am not. Now, I have a new concern. A few days ago, I was masturbating, rubbing my clitoris and vagina and I noticed a bit of blood on my finger. I did not feel any pain, but I saw the blood. Two days in a row, I masturbated and saw blood on my finger. I am not sure where exactly the blood is from. This is the first time I have seen blood while masturbating. I have masturbated so many times and never noticed any blood. I thought it might be the start of a period, but I have not seen any blood in the toilet for it to be a period. My last period started five weeks ago. My period is due to come anytime, but it tends to keep coming every six weeks and is always messed up. It has been like this for maybe a year now, and I do not know why. I have been sexually active too but with a condom. Why is there bleeding? Why has it come up the last two times I have masturbated? I did not look inside to see where exactly it was coming from. I just saw blood on my finger the last two times I rubbed my vagina and the clitoris. It has made me worried. I hope it has nothing to do with being pregnant. Does the bleeding when masturbating mean you are pregnant? Does this happen to pregnant women? I always freak out about being pregnant. Also, why is my period still messed up in terms of not having a good flow at all? As mentioned earlier, it only comes in the toilet and nothing on the pad, and it comes every six weeks. Also, many times, I get big clots in the toilet, so I guess that my blood flow is thick. What do lots of clots mean and why is my period still messed up? I have been stressed for ages, but that should have gone by now. Maybe my hormone levels are low. The blood when I masturbated the last two times is of concern to me. Please, can you explain why my periods are still messed up? Why are there clots? Why was there blood when I masturbated the last two times as I have not had any blood before? Hope you can give me a detailed answer.
Hello,
Welcome to icliniq.com.
The current irregularity in your menses since the last one year and the occasional passage of clots indicate a possibility of PCOS (polycystic ovarian syndrome). This can be evaluated with a hormonal profile including FSH (follicle-stimulating hormone), LH (luteinizing hormone), and AMH (Anti-Mullerian hormone) levels and a pelvic ultrasound to rule out polycystic ovaries. High testosterone and low myoinositol levels can bring about delayed menses or oligomenorrhea. This can be treated by a low dose of oral contraceptive pills like Ginette 35 (Ethinylestradiol and Cyproterone) for at least six cycles. These shall regulate your hormone levels and shall regularise your periods. Consult your specialist doctor, discuss with him/her and take the medicines with their consent.
Also important would be to get a thyroid profile and a serum prolactin level checked which too can cause oligomenorrhea.
Thirdly, the blood spots while masturbation is likely to be due to a frictional lesion or a minor cut, which would have bled and then healed in the next six hours without any associated pain.
Your concern about pregnancy can be dealt with by undertaking a urine pregnancy test with early morning urine sample. If negative then you are not pregnant. The spotting is not an implantation bleed. Bleeding during masturbation is not indicative of pregnancy, but most of the times, it is a frictional sore or a lesion that bleeds. My suggestion would be to get the above hormonal profile and investigations done so that the diagnosis can be reached and a specific treatment can be planned for you.
Regards.
Patient's Query
Thank you doctor,
I have now noticed that I have a brown discharge when I wipe my vagina with a tissue. Nothing comes into the toilet when I go to urinate, but it looks like there is blood that is brown in color mixed with a little white which is a bit stringy and sticky. I am wondering if menses are coming. But I do not even think it is a period. What is it? The last period started five weeks ago. So, it should come next week as then it is six weeks since the last period. Can the brown discharge mean I am pregnant? I am worrying again. I am not sure if the Canesten cream on the vagina will help. When I wipe, there is definitely a blood which is brown in color. I am very worried. What is this? Is it some kind of an infection? When will it stop? Does it have any connection to my periods? I do not think so as I never had a discharge before a period started. I only see it when I wipe the vagina with a tissue. My fiance inserted his penis in my vagina today and it felt a little weird. It was not very pleasurable as it felt like something was in the way like a little bump. There was this brown discharge on the condom. We did not really have sex as it was not enjoyable and on the contrary got worried about the discharge. I hope I am not pregnant. With messed up periods like they coming every six weeks and that too not on the pad and only in the toilet, I have gone to doctors, and they do not say much. They blame it on my stress. I have never completely recovered from the stress, but still surely messed up periods cannot all be from the stress. You did suggest quite a few things, but I do not think the other doctors suggest much. Are there any supplements or vitamins that can improve periods like hormones or estrogen, etc.?
Hello,
Welcome back to icliniq.com.
This is an irregular shedding which can occur especially due to progesterone deficiency which is causing the darkish brown discharge. This can last for two to four days; however, the treatment remains that you have to be started on oral contraceptive pills to regulate your cycle.
Natural supplements or foods like tofu (bean curd), alpha sprouts (shoots of the alfalfa plant), and flaxseeds are known to be high in phytoestrogens (plant-derived xenoestrogens) and isoflavones (plant-derived compounds). You can incorporate them into your diet. But at present with one year of irregularity in menses, the treatment of choice would be low dose oral contraceptive pills and not injectables.
Pregnancy seems unlikely as there was no ejaculation involved, but if there was, then even an implantation bleed can often be present in a similar manner accompanied with a mild lower abdominal ache and nausea. So, to rule out any chances of pregnancy, I suggest you get a serum beta hCG test, which is a blood test. If the hCG levels are less than 5 mIU/mL, then there is no pregnancy.
Regards.
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