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Missing period and started spotting. What is causing this?

Mar 2013
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Practicing since : 1998
Answered : 5968 Questions
I am normally on a 21 day cycle and every 6 months it comes a week early.. the past two months im not bleeding heavy but im still seeing blood only when i wipe and its been 10 days since my last period i am concerned
Posted Sun, 3 Feb 2013 in Menstruation and Miscarriage
Answered by Dr. Aarti Abraham 3 minutes later
Thanks for writing to us.
I would kindly request you to provide me a detailed menstrual history if possible, with the dates and pattern of bleeding to let me assist you better.
Looking forward to hear from you.
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Follow-up: Missing period and started spotting. What is causing this? 13 minutes later
My cycle has been every 21 days for the past 8 years..I do not have a history of cysts or heavy bleeding.. the past few years I get it eary sounds strange but in Jaunary and July a week early that is... but what I am concerned with now is I had my period on time this month but 10 days ago and sometimes when I wipe I see a little pink blood or when I make bowel movement ill wipe and see pink blood and my vagina feels dry
Answered by Dr. Aarti Abraham 1 hour later
I appreciate the prompt reply.

Since you are 47, what you are probably experiencing is the perimenopausal transition.

Perimenopause, or menopause transition, is the stage of a woman's reproductive life that begins several years before menopause, when the ovaries gradually begin to produce less estrogen. It usually starts in a woman's 40s, The average length of perimenopause is four years, but for some women this stage may last only a few months or continue for 10 years. Perimenopause ends the first year after menopause (when a woman has gone 12 months without having her period).

This condition is characterized by irregular periods . Irregular periods are common and normal during perimenopause. Patterns maybe any of the following :

Your periods are very heavy, or accompanied by blood clots
Your periods last several days longer than usual
You spot between periods
You experience spotting after sex
Your periods occur closer together

ALongwith your alteration of the normal menstrual pattern if you are experiencing Hot flashes, Breast tenderness, Worsening of premenstrual syndrome, Decreased libido (sex drive), Fatigue, Vaginal dryness or discomfort during sex, mood swings etc, then the diagnosis is almost confirmed.

Treatment includes diet and lifestyle modification, calcium supplements and hormonal therapy if indicated .

You need to consult a gynecologist to confirm this diagnosis, and also because irregular bleeding might be caused by a few other causes, some of which are important and serious.

An undiagnosed pregnancy, uterine fibroids ( benign tumours ), ovarian cysts, polyps or precancerous lesions on the cervix , endometriosis . blood clotting disorders etc might cause such symptoms also. These can be diagnosed by thorough physical check up, ultrasound and appropriate blood tests as advised.

I hope the bleeding is vaginal in origin and not rectal, as sometimes chronic constipation or anal fissures cause such spotting after bowel movements. This also will be diagnosed by a check up.

Mostly, in this age, vaginal dryness is due to peri menopausal hormonal fluctuations, and your gynecologist will prescribe appropriate ointment/lubricants for the same. Also, other causes such as local skin disorders, allergy, yeast infection etc can be ruled out at the same sitting.

Take care and feel free to ask for further clarifications.
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