Q: Good day Ma’am. Please ma’am, I am supposed to be on my menses though it’s just coming as a stain on my pad but it is darkish red. Please what’s wrong and what can I do? I am afraid please
A: Towards the end of a period, the blood usually becomes dark due to older blood not being expelled fast enough from the body. It is not usually a cause for concern and should not prevent pregnancy. If, however, the dark colour is present all through the menstrual period, please see your doctor. Better safe than sorry.
Issues that can cause a decrease in flow include pregnancy (the supposed period may be an implantation bleed). Implantation bleeding is typically a small amount of light bleeding that occurs about 10 to 14 days after conception. This is thought to be due to implantation as the fertilized egg implants itself in the uterus (womb). This usually occurs in early pregnancy, close to or about the same time as the menstruation would be seen and is thus often mistaken for a period. But, it is usually lighter than menstrual…typically without clots. It would stop on its own and does not require further treatment. If the bleeding is heavier, associated with cramps or any other complication, please see your doctor. As a rule of thumb really, any bleeding in pregnancy should be investigated as they may be due to more serious conditions like ectopic pregnancy, miscarriage and infections.
Other causes of decrease in menstrual flow include: crash dieting (when you want to lose all the weight you added in 5 years in one week :D), intense physical activity, Polycystic Ovary Disease (PCOD), imbalance of hormones and use of contraceptives. Previous instrumentation like Dilatation and Curettage (D and C), where the procedure was too ‘vigorously’ done can result in a condition called Asherman’s syndrome which manifests as reduction in menstrual flow. In the same way that stress can delay a menstrual period, it can also cause a reduction in flow.
You must work with your gynaecologist in order to manage this. If the cause is PCOD, focus will be on the treatment; if due to intense exercise, reducing intensity will be helpful; if due to crash dieting, focus on eating a proper balanced diet will help etc. Your gynaecologist will carry out a detailed examination and investigation to arrive at the cause and advice on treatment.