Patient's question:
Hello, my last menstrual period started on December 10th and ended on December 15th. But yesterday, there was blood coming out from my vagina, and it was dark in color, just like during my period, but the amount was very little, similar to when my period is about to end. Is this very serious? My menstrual cycle is usually normal, but this dark bleeding has occurred within three months!Follow-up question: I don’t have any symptoms, no pain, and it’s no different from usual. Is this very normal?
Doctor's answer:
Hello! During pregnancy, due to the absence of ovulation, estrogen and progesterone in the body continuously increase to adapt to the growth needs of the uterus and fetus, so there is no occurrence of menstruation. After childbirth, the functions of the ovaries and uterus gradually recover, and the time of menstruation resumption varies among postpartum women. The time of menstruation resumption and ovulation is mainly affected by breastfeeding. Non-breastfeeding women usually experience menstruation resumption 6-10 weeks postpartum, with an average return of ovulation function around 10 weeks postpartum. Breastfeeding women may experience a delayed menstruation resumption, with some never experiencing menstruation during breastfeeding. Possible reasons include the influence of prolactin, and ovulation function typically resumes around 6 months postpartum. For postpartum women who resume menstruation later, ovulation function remains normal. Based on your situation, the first menstruation after childbirth may be the first occurrence, not caused by ovulation, and strictly speaking, it cannot be considered a normal menstruation. It is mainly due to changes in estrogen and progesterone levels in the body. The second menstruation resumption may be due to ovulation, as normal menstruation refers to the shedding of the endometrium with cyclical changes in ovarian function, which involves ovulation and endocrine functions. It is also possible that the opposite factors are at play.