Abnormal Menstrual Bleeding and Its Causes - Obstetrics and Gynecology

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Abnormal menstrual bleeding can be a concerning issue for many women, and understanding its causes is crucial for proper management and treatment. In your case, experiencing a prolonged absence of menstruation followed by an extended period of heavy bleeding can indicate several underlying conditions that warrant further investigation.

Firstly, it is essential to differentiate between normal menstrual bleeding and abnormal bleeding. Normal menstrual cycles typically last between 21 to 35 days, with bleeding lasting from 2 to 7 days. When menstruation is absent for three months (a condition known as amenorrhea) and then followed by prolonged bleeding, it may suggest hormonal imbalances, uterine abnormalities, or other medical conditions.

One potential cause of your symptoms could be related to hormonal fluctuations. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or even stress can lead to irregular menstrual cycles. Hormonal imbalances can cause the endometrium (the lining of the uterus) to grow excessively, leading to heavy bleeding when it finally sheds.

Another possibility is the presence of uterine fibroids or polyps, which are non-cancerous growths in the uterus that can cause heavy bleeding and prolonged menstrual periods. These growths can disrupt the normal shedding of the uterine lining, leading to irregular bleeding patterns.

Regarding your previous diagnosis of cervical erosion (often referred to as cervical ectropion), this condition occurs when the cells from the inside of the cervical canal are present on the outside of the cervix. While cervical erosion itself is not typically a direct cause of abnormal menstrual bleeding, it can lead to increased sensitivity and potential bleeding during sexual intercourse or gynecological examinations. It is generally safe to engage in sexual activity unless specifically advised otherwise by your healthcare provider, but it is essential to communicate any discomfort or unusual bleeding that occurs during or after intercourse.

Given your symptoms, it is advisable to consult with a healthcare provider for a thorough evaluation. This may include a pelvic examination, ultrasound imaging, and possibly blood tests to assess hormone levels and rule out any underlying conditions. Your healthcare provider may also consider a biopsy if there are concerns about abnormal cells in the uterus or cervix.

In summary, while your recent heavy bleeding could be related to hormonal changes or uterine abnormalities, it is crucial to seek medical advice to determine the exact cause. Early diagnosis and appropriate management can help address any underlying issues and restore your menstrual cycle to a more regular pattern. Always prioritize open communication with your healthcare provider about your symptoms and any concerns you may have regarding your reproductive health.