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| Human blood as seen through microscope |
1. Spotting: As the name shows, this is not a proper flow but few drops of blood that we can find occasionally in the urine, on the toilet paper or in the panties. Generally it has brownish (old blood) or light pink color or it might make the cervical fluid streaky with red. Spotting can occur for 1-2 days around menstruation, it can also be a result of ovulation or the implantation of a fertilized egg. In every other case or if it lasts more than 2 days it is considered abnormal and should be examined. Abnormal spotting can have various reasons, like insufficient progesterone production, cyst, injured cervix, ectopic pregnancy, miscarriage etc.
2. Menstruation: Menstruation occurs when ovulation is not followed by fertilization and therefore the corpus luteum withers, the progesterone level decreases, the thickened uterine lining sheds and exits through the vagina, causing bleeding. The flow usually lasts for 3-5 days, varies between light and heavy, during which we loose about 25-80 ml of blood. If any aspect is out of the ordinary there might be some problem in the background, it is advised to get it looked into (taking contraceptive pill is not a solution!!)
3. Breakthrough bleeding: We are talking about breakthrough bleeding when, for some reason, ovulation does not happen in a cycle and, due to the lack of progesterone to support it, the uterine lining cannot hold itself and sheds, leaving the body with blood flow. Those who do not chart their cycles often mistake it to be menstruation but that is incorrect. Menstruation is always preceded by ovulation! In case of breakthrough bleeding the cycle does not end yet, new cycle starts with true menstruation.
4. Withdrawal bleeding: When taking contraceptive pills, the blood flow in the 4th week is called (hormone-)withdrawal bleeding. As we already know, the pill shuts the system down completely, stops all the natural hormone production and makes the cycle non existent (that the doctors 'forget' to tell us about, otherwise there would not be such a huge market for it), therefore we obviously cannot talk about menstruation in this case. Bleeding occurs because they withdrew the artificial hormones from the 4th week's pills to make the endometrium shed and exit, imitating menstruation and therefore making women believe that they have normal cycles. (The first versions of the pill provided hormones continuously, not causing any blood flow, but this made women doubtful about the efficacy.)
Many people ask about tricks to make the bleeding happen earlier or later to avoid collision with the vacation or the honeymoon etc, but I believe that those who have been following this blog so far can clearly see that there is no natural way to do that. The only solution is the pill, you will bleed when you take the ones without hormone. But let me ask you this: is it really worth it??
5. Postpartum bleeding: This bleeding occurs postpartum, as the name shows, in case of vaginal birth it can last for weeks but it might stop sooner after Cesarean section. Lot of different aspects together determine when fertility will return but we can talk about menstruation only after ovulation starts happening again.
+1. Vaginal bleeding in case of abortion or miscarriage: I don't think this category requires too much explanation, these events can also cause extensive, heavy blood flow. It is always advised though to ask the doctor how long is normal and when we might start to suspect some underlying problem. In these cases fertility returns quite soon but there might be changes in the cycles compared to the ones preceding the pregnancy: different length, cervical fluid pattern, different symptoms occurring in certain phases.
I hope you learnt something useful today, ask questions or share comments on the topic, subscribe with your e-mail address and sign up for the course, it's really worth it! 😉
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