What Makes Cycle Bleeding Unusual?


I often meet women in my program that have episodes of unusual bleeding.  

But, so often, these women do not understand that their bleeding is unusual in any way. 

Either they had come to accept it as part of their cycle or they were told by a friend or even a doctor that what they were experiencing was completely normal.

One of the benefits of using the standardized system of the Creighton Model FertilityCare System is that these bleeding episodes can be recorded in an accurate way which becomes important when seeking further evaluation from a NaProTechnology doctor.

One does not need to be using the Creighton Model, however, to see the indications of unusual bleeding in their fertility cycle.  Before we discuss what makes cycle bleeding unusual, we need to learn what is considered normal.

What is normal menstruation?

Normal menstruation is one that follows an “ovulatory event.”  This event can be the result of a true ovulation or one that mimics ovulation.  One that mimics ovulation would occur with an unruptured follicle in an anovulatory situation.

Normal menstruation will usually follow a crescendo/decrescendo or decrescendo pattern.

Crescendo/Decrescendo: L-H-M-L-VL

Decrescendo: H-H-M-L

These patterns can be associated with premenstrual breast tenderness, mild low backache and mild menstrual cramps.  Typical length of a menstrual cycle is 6 days or a bit longer.

What makes bleeding unusual?

  • Often is light, very light or brown (black) in color
  • Does not do a crescendo/decrescendo or decrescendo pattern
  • Tends to be similar from day to day
  • Not usually associated on menstrual flow

Many episodes of unusual bleeding have hormonal causes, but some may be organic.

This week, I am going to focus on the hormonal causes, the medical definitions of unusual bleeding and the Creighton Model definition of unusual bleeding.  Next week, we will discuss organic causes on unusual bleeding and how NaProTechnology can help.

Hormonal causes of Unusual Bleeding

  • Ovulatory bleeding
    • Observed around time of ovulation
    • Estrogen – breakthrough bleeding – observed leading up to the time of the Peak Day
    • Estrogen – withdrawal bleeding – observed immediately following the Peak Day in the count of three
  • Bleeding with PCOS, long and irregular cycles
    • Occurs in women who are anovulatory and oligo-ovulatory
    • Observed as periods of L, VL, or B bleeding not associated with menses

Medical Definitions of Unusual Bleeding

  • Menorrhagia – heavier than normal bleeding
  • Metrorrhagia – bleeding between menstrual periods
  • Menometrorrhagia – heavier than normal periods and bleeding between menstrual periods
  • Dysfunctional uterine bleeding (DUB) – uterine bleeding associated with no identifiable organic condition; usually thought to be hormonal in nature
    • The woman must visit her doctor and have a negative pelvic exam and sometimes ultrasound exam to diagnose this kind of bleeding.

These are simple, easy word to remember and pronounce, right?  These definitions as well as a few more added by the Creighton Model are used by NaProTechnology doctors.

Creighton Model Definitions of Unusual Bleeding

  • Postmenstrual brown bleeding – 2 or more days of brown (black) bleeding appearing at the tail-end of the menstrual flow.  We sometimes refer to this kind of bleeding as tail-end brown bleeding.
  • Premenstrual bleeding – 3 or more days of light, very light or brown (black) bleeding occurring prior to the beginning of the first moderate day of menstrual bleeding.
  • Excessively heave menses – At least one 24 – 48-hour period where the woman must change pads, tampons or both more frequently than every 2 hours.

The benefit of learning the Creighton Model FertilityCare System is that chart with the indicators of unusual bleeding can be used by the NaProTechnology doctors to find the underlying cause of the bleeding and treat it in cooperation with your fertility cycle.

The important thing to remember is that if you notice unusual bleeding on a consistent basis, you should seek the help of your medical doctor. 

Next week, I will talk about organic causes of unusual bleeding and how NaProTechnology can help.