A:
This is a very interesting observation on your part. If it has no odor, it is then probably hormonally related. Your progesterone levels are higher at this time, and perhaps it is related to that. The only way to know for sure is to have it diagnosed by your health care provider at the time. It may be a variation on yeast if it causes irritation and redness. Another common vaginal infection is Gardnerella, and that sometimes shows up around the menstrual cycle time. Another option is to look at your diet at this time and see if you are eating any differently. For example if you are eating more sugar or even carbohydrates, you might see an increased reaction to these foods. Sometimes the burning is related to more glucose in your body. Try changing the way you eat by eating more protein and less of the sugary carbohydrates. Keep a very careful food journal of what you are eating. Here's a web link that might provide you with more information:
http://www.obgyn.net/women/conditions/conditionsn-z.htm#Vaginal

Pat Sonnenstuhl, ARNP, CNM, MS, 
OBGYN.net Editorial Advisor
P.S. Remember that this is for educational purposes only.

A:
It is difficult to evaluate this over the internet, and if it has been 5 years since you've had a pap smear, you probably need to get one. You need infections ruled out, and to be sure there aren't any cervical abnormalities that need attention. If this has been going on for three months, it is concerning, and unusual. While waiting for an appointment keep a careful calendar of when you are having the spotting. Here are a couple of links that might be helpful to you: http://www.obgyn.net/women/conditions/conditionsa-f.htm#cervicaldysplasia
http://www.obgyn.net/women/conditions/conditionsn-z.htm#Vaginal

Pat Sonnenstuhl, ARNP, CNM, MS, 
OBGYN.net Editorial Advisor
P.S. Remember that this is for educational purposes only.

A:
It is very normal for women to have a white vaginal discharge that doesn't itch or smell. This is just a mixture of the old cells from inside the vagina, mixed with some mucus from the cervix.

Taking birth control pills can sometimes make the discharge increase. The mucus-secreting cells which are usually inside the cervix sometimes appear on the outer surface of the cervix because of the estrogen in the pill.

Any discharge which is yellow or green, or which smells bad, itches or burns should be investigated by your health care provider.

Betsy Hyde, CNM, MSN, 
OBGYN.net Editorial Advisor
P.S. Remember that this is for educational purposes only.

A:
Perhaps this was just then end or your cycle, and just monitor it. You didn't mention whether you were on birth control, and since your provider screened you for infections it possibly was just from some trauma. It probably won't happen again. If so, keep a calendar of these events, and discuss them with your provider. It doesn't seem to be anything concerning.

Pat Sonnenstuhl, ARNP, CNM, MS, 
OBGYN.net Editorial Advisor
P.S. Remember that this is for educational purposes only.

A:
I think your situation is unusual, and keep a very close calendar of when you had bleeding, and how much. There perhaps is a stress element involved, but I doubt the heavy lifting did anything. It is perhaps just a bad month, and might resolve itself. I was having trouble understanding how much bleeding you were having. I'm sure a visit to your provider will be helpful, to rule out anything unusual. As you aren't sexually active, and you can rule out certain vaginal infections, and pregnancy, I see no reason to push your appointment up. However if the bleeding gets heavy, and you are concerned, call and get in sooner. Your provider might suggest putting you on the birth control pill to regulate your periods. Hope this was helpful.

Pat Sonnenstuhl, ARNP, CNM, MS, 
OBGYN.net Editorial Advisor
P.S. Remember that this is for educational purposes only.

A:
Thanks for your question. It is very common to bleed on Depo, and then not bleed, sometimes for months. So, nothing is wrong. At some point if you continue to not have a period, a provider might want to give you something called Provera to stimulate a period. The key thing now is to use something so you don't get pregnant while waiting for a period. If you really get concerned, so your health care provider, but you can wait another month or two, as this is very common. You will probably find some helpful information on this web site: http://www.cnm.wa.org/reprodhc.htm

Pat Sonnenstuhl, ARNP, CNM, MS, 
OBGYN.net Editorial Advisor
P.S. Remember that this is for educational purposes only.

A:
Lots of factors contribute to the various symptoms you describe. Keeping track of your cycles is an excellent way to approach your menstrual cycle, as if you talk to your provider about your concerns, a calendar in front of you will be very helpful. First of all, you didn't say when you started your periods. The first several years are very erratic, and it is hard to know what to expect. Also, in general your ovaries alternate ovulation, so one month might be different than the other. The amount of your period is determined by the hormonal action during the month leading up to your period. Also, the 'normal' range for periods is 26-35 days, so you might just normally have 'longer' cycles, not a 'late' period. This is why tracking your cycles is so helpful. Also, if you have ever been on birth control pills, this will make your cycles very regular and predictable. Then when you go off the pill, sometimes the periods will be irregular again. You might find this article and the book references useful: http://www.obgyn.net/yw/articles/PatS_fertility_0799.htm
Also of interest: http://www.obgyn.net/women/conditions/conditions.asp
The bloating you are experiencing might be part of your hormonal changes, and is important to track also. It is very difficult to evaluate what you describe by email. You might schedule an appointment with your provider to discuss you specific concerns, especially after tracking your cycles for a few months. Some women notice more bloating after eating certain foods, and this can change as your hormones change throughout the month. Some women also notice changes in their bowels just before their periods, and it is felt this is also related to the increasing prostiglandins just before a period. So, keeping a good journal is the first step, tracking things for a few months, and then discussing your findings with your health care provider. It does not sound like anything you describe is an emergency, so tracking things for a few months will be very helpful.

Pat Sonnenstuhl, ARNP, CNM, MS, 
OBGYN.net Editorial Advisor
P.S. Remember that this is for educational purposes only.

A:
You should have a complete physical exam and seek the advice of a gynecologist.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Stress and exercise can disturb your cycle. In your case, pregnancy is unlikely but not impossible.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
You need a thorough exam and lab work. Get a second personal opinion.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
A complete history, physical exam and lab work is necessary to evaluate abnormal uterine bleeding. You should seek the advice of your gynecologist.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Stress can disturb your cycle, but anyway... get a blood pregnancy test.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
If you are breastfeeding regularly you will not get your cycle back. On the other hand, breastfeeding is not a safe birth control method. Go see a doctor for advice on a safe birth control method to use while you are breastfeeding.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Dear Stephanie,
Irregular (and sometimes heavy) bleeding is expected during the first 18-24 months after menarche (first period). Persistent heavy bleeding and overweight needs to be corrected. Go to the gynecologist (with your daughter).

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
You should see a gynecologist for a complete physical exam and information.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
No need to be concerned. Talk with your gynecologist about your problems.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Your weight problem may be related. You should definitely see a doctor (endocrinologist).

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Get a blood pregnancy test and if it is negative, talk to your gynecologist.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Usually about 6 weeks after a miscarriage.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
It does not sound like anything serious. In young adolescents the first menstrual periods are irregular for a couple of years. It is what we call "dysfunctional bleeding". Take your daughter to a gynecologist for more info.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Your lack of period may be due to anovulatory (not ovulating) cycles. Talk with your gynecologist.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
No, it isn't normal. Ask your doctor about ultrasonography, hysteroscopy or hysterosalpingography. Also, you should definitely get a second opinion.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
You are probably having anovulatory cycles (when the "egg" does not come out from the ovary). Go see a gynecologist to discuss causes and treatment.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
You are probably having anovulatory cycles. It doesn't seem to be serious but you should go to a gynecologist ASAP.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Adolescent bleeding is usually associated with lack of ovulation (anovulation). Following menarche (first menstrual period) the female reproductive system continues to mature for approximately 3-4 years. Take your daughter to a gynecologist.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
The specific cause of your irregular periods (excluding pregnancy) can only be determined by a thorough history, physical exam (including gyn) and laboratory, radiographic tests.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
What was the D&C pathologist report? Usually the cause is what we call "Dysfunctional Uterine Bleeding" (benign). You should ask your gynecologist about this.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Spotting and bleeding between menstrual periods (usually for months) are common side effects with low dose oral contraceptives.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
The anovulatory patient may complain of lack of menses, irregular cycles or heavy flow. You should ask your gynecologist about causes of anovulation, exams and treatment.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
No need to worry. Just wait for exam results...and talk with your gynecologist.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Maybe it isn't a serious problem, but you should go to a gynecologist to get a complete physical and pelvic exam as soon as you can.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
You should see a gynecologist as soon as possible to check out what your problem is.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Breasts can become tender during menstruation. Menstrual periods are 28 days apart with normal variations of about 7 days. Deviations from these norms are not uncommon.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Exercise programs, stress and some medical conditions can cause skipped menstrual periods. Go to your gynecologist for a complete exam.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
I don't think it has anything to do with the spacing of your children. Weight loss, exercise programs, and stress are some common causes of skipped menstrual periods.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
It depends on various factors:
Oral contraceptives are highly effective, but patients beginning oral contraceptives commonly notice a decrease in the amount of flow and sometimes no flow at all.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
Want to help in any way? Just take her to another gynecologist ASAP.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
The pills helped you to regulate your cycle. Once you stop taking them, your cycle will become irregular again.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.

A:
I suggest keeping the appointment for the second opinion.

Marta Mendez MD, 
OBGYN.net Co-Chair Young Woman Editorial Advisory Board
P.S. Remember that this is for educational purposes only.