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Pattern of menstruation has changed with bleeding followed by clear discharge, no STD and PAP test normal. Concerned?

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Practicing since : 2004
Answered : 816 Questions
I first began menstruating when I was 13 years old. In the first two years or so I was very irregular and then I was regular but with a long cycle of about 35 to 38 days until I turned 30.

For the past 7 years I have been very regular and on a 28 day cycle. I used to bleed very heavily over a period of 5 days with another two days of light bleeding for a 7 day period. Lately, I have been bleeding very heavily for 2 or 3 days and then having liquid discharge that is clear with very little colour for an additional 3 or 4 days, for a total of period 6 or 7 days.

I have had the same man for a sexual partner for many years and have no STDs. All my PAP have been normal.

My questions are as follows:

1. Should I be concerned that the pattern of my bleeding has changed, from fairly heavy for most of the 7 days to heavy for only 2 or 3 days.

2. What is the clear liquid that is coming out which is not blood?

3. Does the appearance of clear liquid that is not blood during my period indicate menopause? If not, what might it indicate?
Posted Thu, 5 Sep 2013 in Women's Health
Answered by Dr. Monika Choudhary 26 minutes later
Brief Answer:
you are not menopausal

Detailed Answer:
Thanks for posting your query.
Due to hormonal variation bleeding pattern from 7 days to 2-3 days keeps on changing & hormonal variation can be due to weight gain, excessive weight reduction, stress or anxiety.
However bleeding should be normal if you are having heavy bleeding then it is a matter of concern & get one ultrasound scan done to rule out any pelvic pathology like uterine polyp, fibroid or adenomyosis.
Bleeding occurs due to breakdown of upper layer of endometrium along with blood vessels & at last blood vessel get retracted & menstrual blood gets converted into serosanguinous followed by serous discharge.
So if you are having clear liquid after menstruation it is physiological & nothing to be worried about it.
Near menopausal phase menstrual flow keeps on decreasing along with increased interval between periods.
Right now you are of 37 years & it is very rare to have menopause at such age.
However if you still want to be sure get serum FSH test done to rule out menopause.
I hope your queries have been answered. I will be available for your further queries.
Above answer was peer-reviewed by
Follow-up: Pattern of menstruation has changed with bleeding followed by clear discharge, no STD and PAP test normal. Concerned? 42 minutes later
Dear Dr. Choudhary,

Thank you for your prompt and clear response. I have the following additional information to relate.

I have always bled quite heavily, about 100 to 150 ml. Last year there was a duration of several months when I bled about 250 ml during my period and I had an transvaginal ultrasound performed in order to investigate the reason. There were two fibroids found. One was subserosal and the other intramural. Because they were on the outside of the uterus and not large enough to merit surgery, my doctor didn't believe that they were causing the heavy bleeding. He advised me to take Advil every month during my period in order to slow down the flow of blood. I took Advil for a few months during my period and then after that stopped taking Advil but my bleeding resumed in the 100ml to 150ml range which is what I am used to.

1. In your experience, do subserosal and intramural fibroids contribute to changes in the bleeding pattern?

2. While I am used to bleeding 100ml to 150ml per month, I am concerned that this is still a large amount. I am Asian and I find that the medical research in the West mainly cite Caucasian female subjects when measuring flow and the numbers range from 30ml to 80ml. Is 100ml to 150ml normal for an Asian woman?

Thank you for your time and consideration.
Answered by Dr. Monika Choudhary 4 hours later
Brief Answer:
Intramural fibroid can change bleeding pattern

Detailed Answer:
Welcome back,
Subserous fibroid has no significant role but intramural fibroid can cause excessive bleeding.
100 to 150 ml is quite heavy bleeding & in Asian women also it ranges from 50-80 ml.
so consult your gynaecologist for further evaluation.
I hope your query has been answered.
Above answer was peer-reviewed by
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