Managing Menstrual Irregularities with Divina: What to Do When Bleeding Occurs

During the use of Divina, a menstrual regulation medication, bleeding may occur?

Hello Doctor, I suddenly had no menstruation for an entire month last October.
In November, I had a period that lasted 42 days, which stopped on January 10.
Then, from January 11 to February 12, I had another period that lasted 33 days.
I went to the hospital for a check-up, and my hemoglobin dropped to 7.8.
The doctor prescribed Divina for menstrual regulation.
Today is the 10th day of taking the white pill, but I have noticed signs of menstruation.
Should I continue taking the blue pill? Thank you.

Yao Yao, 30~39 year old female. Ask Date: 2018/02/23

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Last October, I suddenly had no menstruation for an entire month.
In November, I had a period that lasted for 42 days, which stopped from January 3 to January 10.
Then, from January 11 to February 12, I had another period that lasted for 33 days.
I went to the hospital for a check-up, and my hemoglobin dropped to 7.8.
The doctor prescribed Divina for menstrual regulation.
Today is the 10th day of taking the white pill, but I noticed that I have started menstruating again.
Should I continue taking the blue pill? Answer: You should continue taking the blue pill.

Reply Date: 2018/02/23

More Info

When managing menstrual irregularities, particularly when using hormonal medications like Divina, it's essential to understand how these medications work and what to do when unexpected bleeding occurs. Divina is a combination hormonal therapy that contains estrogen and progestin, often prescribed to help regulate menstrual cycles and alleviate symptoms associated with hormonal imbalances.

Given your situation, where you've experienced significant menstrual irregularities, including prolonged periods without menstruation followed by extended bleeding episodes, it's understandable that you may have concerns about the current bleeding while on Divina. The fact that your hemoglobin levels dropped to 7.8 indicates that you experienced significant blood loss, which is a serious concern that needs to be monitored closely.

First and foremost, if you are experiencing bleeding while taking Divina, it is crucial to assess the nature of this bleeding. Spotting or light bleeding can be a common side effect when starting hormonal therapy, as your body adjusts to the new hormone levels. However, if the bleeding is heavy or accompanied by severe pain, it is essential to contact your healthcare provider immediately.

Regarding your question about whether to continue taking the blue pills (the progestin phase of the medication), it is generally advisable to follow the prescribed regimen unless directed otherwise by your doctor. The blue pills are typically taken during the second half of your cycle and are intended to help stabilize the uterine lining and prevent excessive bleeding. However, if you are experiencing significant bleeding, it may be necessary to consult your healthcare provider for personalized advice.

In addition to continuing or adjusting your medication, there are several other considerations to keep in mind:
1. Monitoring Symptoms: Keep track of your bleeding patterns, including the amount and duration of bleeding, as well as any associated symptoms like pain or fatigue. This information will be valuable for your healthcare provider in determining the best course of action.

2. Follow-Up Appointments: Regular follow-ups with your healthcare provider are essential, especially after starting a new medication like Divina. They may want to monitor your hemoglobin levels and overall health closely, particularly after experiencing significant blood loss.

3. Lifestyle Adjustments: Maintaining a healthy lifestyle can also support your overall well-being. This includes a balanced diet rich in iron and vitamins, which can help replenish your blood levels, as well as regular exercise, which can improve circulation and overall health.

4. Alternative Treatments: If the bleeding continues or worsens, your healthcare provider may consider alternative treatments or additional diagnostic tests to rule out any underlying conditions that may be contributing to your menstrual irregularities.

5. Emergency Situations: If you experience severe bleeding (soaking through a pad or tampon in an hour), dizziness, or fainting, seek emergency medical attention immediately.

In summary, while it is generally advisable to continue taking your medication as prescribed, it is crucial to communicate openly with your healthcare provider about any changes in your symptoms, especially concerning unexpected bleeding. They can provide guidance tailored to your specific situation and ensure that you receive the appropriate care and support for your menstrual irregularities.

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