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Bruising during menstual cycle
An_196989 posted:
I usually get bruises during my periods (before,during or after). I started noticing that on my mid 30's. I'm now in my late 40's and still get it. The bruise is not tender to touch. Usually appear on my upper arm or thighs. My CBC is normal. My gynecologist didn't give me an explanation about it because she hasn't of this condition. I appreciate your input.
Byroney_WebMD_Staff responded:
Dear Anon_148429,

Perhaps you should seek the opinion of second gynecologist and see if he or she can figure out what's going on? Another thought would be to see a hematologist.

Hope you get it figured out soon,

Jane Harrison Hohner, RN, RNP responded:
Dear Anon: MULTIPLE literature searches at the National Library of Medicine site failed to yield any good published data on bruising during menstruation. The closest citation I could find was a study about bruising in mouth tissues during different phases of the menstrual month:

J Clin Periodontol. 1986 Jan;13(1):27-32.
The occurrence of gingival brushing lesions during 3 phases of the menstrual cycle.

Niemi ML, Ainamo J, Sandholm L.

Since hormonal changes during the menstrual cycle may alter the vulnerability of the female gingiva, the present study was undertaken to investigate whether there are any differences in the number of toothbrushing lesions occurring during different phases of the menstrual cycle. 45 women of 20-35 years of age and with healthy gingiva were examined for overt signs of gingival laceration or ulceration. Such signs were recorded as a brushing injury. Dental plaque was assessed using the visible plaque index (VPI) and gingival inflammation using the gingival bleeding index (GBI). The examinations were made on the 1st day of menstruation (MD), on the estimated ovulation day (OD), and on the day with the predominance of progesterone secretion (PD). The examinations were made during 1-3 menstrual cycles for each individual; the study includes 78 cycles. No statistically significant differences were found between the numbers of brushing injuries on the 3 days of examination (MD, OD, & PD). During PD, a significantly positive correlation (p less than 0.01) was observed between VPI and GBI scores, but on OD and MD, the correlations were highly significant (p less than 0.001). A weak significant positive correlation (p less than 0.05) was found between GBI scores and the number of brushing injuries on the 1st day of menstruation, while during other phases of the menstrual cycle, no such correlation was found. The present study gave little evidence that the hormonal status of women could be of clinical significance in the development of soft tissue trauma from habitual toothbrushing.

Anon, I could not find any data about systemic coagulation factors varying during menstruation. There are local factors excreted from the lining of the uterus which tend to keep it from clotting during flow. However these are not systemic. The only other thing I can think of is capillary fragility--but I couldn't find anything about this and menstruation with the exception of this old citation (in German) where no abstract was given:

Thromb Diath Haemorrh Suppl. 1968;30:165-9.
[Purpura of the premenstrum and climacteric>.

[Article in German>

Stamm H.

ajohnson08099 replied to Jane Harrison Hohner, RN, RNP's response:
Is it that you seem to bruise more during your time of the month? If that is so then I experience much of the same. I have been tested for anemia and a few other things over the years (21 years old currently) But all have come up normal. Do you take a long of pain meds during that time? I really don't know, but I've been told that by taking excess ibprofen which thins the blood? I don't know if that is true or if it is if it would really make that much difference what time period it was.

I certainly would ask your ob/gyn or your regular doctor though! This may not help at all, but just so you know you aren't alone
Jane Harrison Hohner, RN, RNP replied to ajohnson08099's response:
Dear ajohnson: Thanks for contributing your personal experience with bruising during menstruation. Your suggestion about the use of either aspirin or any of the nonsteroidal anti-inflammatory drugs, or NSAIDS, (eg ibuprofen, naproxen sodium, ketoprofen) as a possible contributor to the problem was compelling.

A lit search at the National Library of Medicine site yielded only three citations on ibuprofen and bruising. Here is the most recent:

J Otolaryngol Head Neck Surg. 2009 Oct;38(5):580-6.
Comparison of ibuprofen and acetaminophen with codeine following cosmetic facial surgery.

Chen T, Adamson PA.

Department of Head and Neck Surgery, Southern California Permanente Medical Group, Los Angeles, California, USA.

OBJECTIVES: To compare the efficacy and side effects of ibuprofen and acetaminophen with codeine when given postoperatively following cosmetic facial surgery and to assess whether bruising is worse or the incidence of hematoma is greater when ibuprofen is taken postoperatively.

DESIGN: Prospective, double-blind, randomized trial.

SETTING: Accredited outpatient surgery centre.

METHODS: Study subjects received scheduled doses of either oral ibuprofen 400 mg or acetaminophen/codeine 600/60 mg four times a day through postoperative day 3. They recorded their pain level on a 10 cm visual analogue scale, as well as any untoward side effects, at scheduled times throughout the first 3 postoperative days. Severity of bruising was assessed on postoperative day 4. Any postoperative hematomas were managed and recorded.

RESULTS: There was no significant difference in pain relief or average bruising scores between the two groups. Subjects receiving ibuprofen had significantly fewer adverse side effects and were less likely to change medications than those receiving acetaminophen with codeine. None of the patients in either group developed a postoperative hematoma.

CONCLUSIONS: Ibuprofen 400 mg is as effective as acetaminophen/codeine 600/60 mg for pain relief following cosmetic facial surgery. Ibuprofen is better tolerated, with fewer side effects, than acetaminophen with codeine. Ibuprofen given postoperatively does not result in increased bruising or increased incidence of hematoma.

As you can note, in this limited study, no difference in bruising was found between Tylenol codeine and Advil codeine. Yet, it might be factor for Anon. Perhaps another reader has had increased bruising with these NSAIDS.

Again, thanks for writing and the excellent input.

ladybug3 responded:
I too have this same condition and was told its bleeding under the skin with no explanation. Don't know what to do,I was worried it was signs of clotting.
Jane Harrison Hohner, RN, RNP replied to ladybug3's response:
Dear Ladybug: As you can note from the above discussion, there is no overt cause which has been reported in the medical literature. If you take very large doses of ibuprofen type drugs that MIGHT cause a short term increase in bruising (due to a change in clotting factors). A more distant possibility would be some type of bleeding disorder. Yet, it would be odd for bruising/ easy bleeding to only occur during menstruation. One would assume that a woman with such a disorder would have prolonged and heavy flows.

Ladybug, if you have significant symptoms, perhaps your primary MD could do some coagulation blood tests. A hematologist MD referral can also be done if indicated. ...Thanks for writing about your similar experiences. Perhaps another reader will get a diagnosis and pass that information along.

NCNCgal responded:
my adoptive mom now 83(deceased) bruised onthe inside of her thigh even past menstrual age close to the knee where one would assume she bumped into things. we used to discuss it all the time but never once has she bumped into anything. I have since noted at 40 that I too am getting bruises in the inside thigh area. Not tender to the touch but appears before my cycle starts gets bigger during and fades away afterwards.( not I have not run into anything either). Ive talked to friends who have had similar bruises one of them well into menopause. Ive had my GYN look at it on several occasions and to ensure not a sign for anything and it is a burst blood vessel under the skin. Though with no medical explanation he and I have agreed its my cycles spike in temperature as after doing a temperature study the last time i noted the day the bruise occurred I had a higher temperature that day that spiked ( the day the bruise appeared I'd hit an odd 99.6 or above and then it would return to normal).
Hope that helps I dont thinks its a bad thing too many women have these bruises and we are all still here.
newgirl2010 responded:
I see this is an old post--renewed. I am currently awaiting my in it should start any minute. This morning I woke up with a huge bruise on my arm. My son did take a nip at me last night (teething)...but no way should a bruise like that occur. So this post was very aptly timed. It wasn't long ago I had a complete blood work up done--including kidneys, liver, thyroid--all normal.
ladybug3 responded:
The same thing I am going through. It started two years ago, my doctor has no explanation for it either when I showed him
bbriwn responded:
I too have been plagued with the exact same thing. I also consulted my GYN doc who doesn't have any explanations on why this is happening. I conducted research using medline search engine to NO avail. Using google I came across this post. I began to notice the bruises in my early 30s too, and they appear before during or after my period. I really would like to know what this is and if its normal or not.
livingkidneydonor responded:
I'm in my early 40's, and my period has become progressively worse in pain, flow and duration. This is the first time I experienced bruising in my inner thighs. The bruises don't hurt, however my cramping pains extend to my tailbone and half way down my thighs. I mentioned this to another girlfriend in her 40s and her menstral bruising is so bad that she can't wear skirts any more. I have a question for the other women with this condition, have you had children? My friend and I have not had children, and I understand women who don't bare child are more inclined to ovarian and breast problems later in life.
lilweisgirl replied to livingkidneydonor's response:
I find it pretty amazing that there are so many of us with this same issue and doctors are not able to explain it. TO: livingkidneydonor, I have not had children either and I am 50. Wondering about the others. I see from the posts that some, at least, have children. This "bruising" has been going on for me since I was a long time. One doctor thought I was low on B12, but wasn't the case. Another called it a form of herpes, but again not the case. There are 6 girls in my family and none has had this issue. I'm guessing that since I've had this for 30 years (wow I didn't realize it was so long lol) that it's not serious condition but it would be nice to know what causes it.

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