Patient's question:
I discovered some black discharge yesterday afternoon and a bit of blood at night. I thought it wasn't part of my menstrual period, so I had sex with my boyfriend, and then I had a lot of bleeding afterward. I rinsed it with water, and there wasn't much bleeding that night. But this morning, there was a lot more, and it's accompanied by abdominal pain. I'm very scared. I read online that it's absolutely forbidden to have sex during menstruation, fearing bacterial infection and bad consequences. I don't know how to fix this now. I regret it so much. Please help me. Thank you very much.Doctor's answer:
Hello! First of all, I wish you a speedy recovery! I will discuss the issue of "coitus during menstruation" with you.The consequences of coitus during menstruation can only be summarized as "temporary pleasure, endless trouble." During the ovulation period, if a woman does not conceive, the endometrium will naturally shed, resulting in continuous bleeding for 5–7 days. During this time, the physiological barrier of the reproductive tract is weakened. If sexual intercourse occurs, it is easy to damage the reproductive tract and cause bacterial infections, gradually leading to gynecological diseases such as cervical inflammation and pelvic inflammation. According to relevant experts, coitus during menstruation may also the root cause of female infertility and must be.
1) Immunological infertility accounts for about 10–30%
After married couples of childbearing age maintain normal sexual life for two years without using contraception and remain childless, they may suffer from infertility. Among these cases, situations where sperm cannot combine with eggs due to male autoantibodies (ASAb) or the production of ASAb in women are both classified as immunological infertility. Relevant experts believe that about 10–30% of infertility cases are related to immunological factors.
The factors or causes of immunological infertility are usually traced to both men and women. Under normal circumstances, when the immune defense mechanism of the reproductive system is intact, men generally do not produce ASAb. However, when the blood-testis barrier is damaged due to surgery or trauma, sperm is exposed to the immune system, potentially leading to the production of ASAb.
The factors or causes of ASAb production in women are related to individual immune response differences, the lack of immune-suppressing molecules in semen, as well as reproductive tract infections, inflammation, and sexual intercourse under conditions of reproductive tract mucosal damage. According to relevant experts, the medical community abroad discovered decades ago that about 80% of women with unexplained infertility had ASAb detected in their blood tests. Once such antibodies are produced in a woman's body, during sexual intercourse, they cause sperm to clump together and lose mobility, making successful conception impossible.
2) Damaged reproductive tract: Sperm becomes the "number one enemy"
It is reported that the vaginal and cervical mucosa of women have immune functions. If sperm enters the reproductive tract during inflammation or damage, it is recognized as the "number one enemy." Macrophages with the ability to eliminate "foreign invaders" enter the reproductive tract to engulf and digest sperm cells. Meanwhile, antigens carried by sperm activate lymphocytes, while changes in the permeability of the reproductive tract mucosa and the production of immune responses occur.
The result of this series of "actions" is the appearance of high concentrations of ASAb in cervical mucus, making it extremely difficult for sperm to advance in the female reproductive tract and reach the specific location where it can combine with an egg.
Relevant experts indicate that during menstruation or when uterine bleeding or endometritis occurs, if sexual intercourse is insisted upon due to damaged reproductive tract mucosa, it will provide a convenient path for sperm and its antigens to enter the bloodstream and come into contact with immune cells, making it easier to produce ASAb.
3) Coitus during menstruation: Harmful to both parties
Some may ask, "If this time, coitus during menstruation leads to infertility, won't it be fine next time after my wife's period ends?" However, the reality is far from what one wishes. It is reported that during intercourse with endometritis or abnormal reproductive tracts, if a woman has an allergic reaction to seminal antigens, even after the reproductive tract recovers, sexual intercourse will trigger what is known as a "secondary immune response," causing the body to continuously produce ASAb, making it difficult to stop.
Some young men may think, "When my wife has her period, it lasts nearly a week or even longer—how can I resist my desires during that time?" In sexual life, women often find it hard to refuse their partners' requests. Relevant experts point out that men should exercise self-control at this time. Coitus during menstruation can lead to gynecological diseases and immunological infertility, causing far-reaching impacts on future "sexual" happiness and family life. Additionally, a satisfying sexual life requires good physical health and a positive mood. During menstruation, women lose a significant amount of blood, making them relatively weak. How can they enjoy it? Even if they do it this time, the discomfort afterward will leave psychological shadows.
4) Patients can be categorized into four types for dietary and nutritional care
If ASAb is detected during immunological tests, Western medicine typically recommends using condoms during intercourse to isolate sperm and gradually eliminate the antibodies. However, if the antibodies persist, this measure is of little significance. Traditional Chinese medicine believes that infertility is related to "qi stagnation and blood stasis" and emphasizes "promoting qi, activating blood, resolving stasis, and tonifying the kidneys." In recent years, it has further proposed the need for "clearing heat, promoting diuresis, and detoxification."
According to relevant experts, female patients can generally be categorized into four types for treatment: kidney deficiency, liver depression, blood stasis, and damp-heat. Kidney deficiency is characterized by lower back pain, frequent nighttime urination, weakness in the knees and head dizziness. Liver depression is manifested as irritability, depression, costal pain, and bitter taste in the mouth. Blood stasis is characterized by menstrual pain, lower abdominal pain, fixed pain points, severe pain upon pressure, dark purple tongue, and thready pulse. Damp-heat is characterized by reduced urination, abdominal pain, and thick white greasy tongue coating.
On the premise of first treating reproductive tract inflammation, dietary and nutritional care methods can be adopted for treatment. It is recommended to boil soup with ingredients such as scorpions, red beans, kelp, and tianqi, and then add herbs based on individual constitutions. For qi deficiency, red ginseng can be added; for yin deficiency, Dendrobium candidum can be added; for qi-yin deficiency, Panax quinquefolius can be added; and for spleen deficiency, white atractylodes and Poria can be added.
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