Abnormal Bleeding: Causes, Treatment, and When to Seek Further Help

Abnormal bleeding

Hello, Doctor.
My menstrual cycles have been regular, lasting about 7-8 days, and I have not had any sexual intercourse.
This time, I started bleeding on April 13, and the bleeding has not stopped (bright red).
I went to a gynecology clinic for an ultrasound, and the doctor prescribed uterotonics, which reduced the bleeding to a brownish color, but it has not completely stopped.
After my follow-up on April 26, I was prescribed medication to regulate my menstrual cycle, but I am still experiencing light bleeding.
I would like to ask: 1.
Are there other possible conditions that may not have been detected? My mother has a history of uterine fibroids; is this considered a hereditary condition? 2.
How many days should I take the medication to completely stop the bleeding? 3.
Would it be safer to ask the clinic doctor for a referral? Thank you for your response.

amy, 30~39 year old female. Ask Date: 2019/04/30

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The menstrual cycles have been regular, approximately 7-8 days, with no sexual intercourse.
This time, menstruation started on April 13, but there has been continuous bleeding (bright red).
An ultrasound examination at the obstetrics and gynecology clinic was performed, and the doctor prescribed uterine contraction medication, which reduced the bleeding to a brownish color, but it has not completely stopped.
After a follow-up on April 26, menstrual regulation medication was prescribed, but there is still slight ongoing bleeding.
I would like to ask: 1.
Are there other possible symptoms that have not been detected? My mother has a history of uterine fibroids; is this considered a hereditary condition? Answer: Uterine fibroids are not classified as a hereditary disease.
2.
How many days should I take the menstrual regulation medication for the bleeding to completely stop? Answer: It varies.
3.
Should I ask the clinic doctor for a referral for safety? Answer: Since there is only slight ongoing bleeding, treatment can continue without the need for a referral.

Reply Date: 2019/04/30

More Info

Abnormal bleeding can be a concerning issue for many women, and understanding its causes, treatment options, and when to seek further medical help is crucial for managing this condition effectively. Based on the information provided, it appears that you have been experiencing prolonged bleeding that has not resolved with initial treatments. Let’s delve into your questions and provide some insights.

1. Potential Undetected Causes
While you have undergone an ultrasound and received treatment, it is essential to consider that not all causes of abnormal bleeding may be immediately evident. Conditions such as hormonal imbalances, uterine fibroids, polyps, or even endometriosis can contribute to abnormal bleeding. Given your family history of uterine fibroids, it is worth noting that while fibroids themselves are not directly inherited, there may be a genetic predisposition to developing them. This means that if your mother had fibroids, you might be at a higher risk of developing them as well.

Additionally, other factors such as stress, significant weight changes, or underlying medical conditions (like thyroid disorders or clotting disorders) can also lead to abnormal bleeding. If your symptoms persist or worsen, further evaluation may be warranted, including blood tests to assess hormone levels or additional imaging studies.

2. Duration of Treatment with Hormonal Medications
Regarding the use of hormonal medications to regulate your cycle, the duration it takes for these medications to stop bleeding can vary. In many cases, hormonal treatments may take a few days to a couple of weeks to stabilize the endometrial lining and reduce bleeding. If you are taking a prescribed medication, it is essential to follow your healthcare provider's instructions closely. If bleeding continues beyond the expected timeframe or if it worsens, you should reach out to your healthcare provider for further evaluation.

3. Seeking a Second Opinion
It is always within your rights as a patient to seek a second opinion, especially if you feel that your concerns are not being adequately addressed. If you are considering a referral to a specialist, such as a gynecologist with expertise in abnormal bleeding, it can provide you with more comprehensive care. A specialist may offer additional diagnostic tests or treatment options that your current provider may not have considered.

Additional Considerations
- Monitoring Symptoms: Keep a detailed record of your bleeding patterns, including the amount, color, and any accompanying symptoms (such as pain or fatigue). This information can be invaluable for your healthcare provider in determining the underlying cause of your bleeding.

- Lifestyle Factors: Consider lifestyle factors that may influence your menstrual cycle. Stress management, regular exercise, and a balanced diet can positively impact hormonal balance and overall reproductive health.

- When to Seek Immediate Help: If you experience heavy bleeding (soaking through a pad or tampon every hour for several hours), severe pain, or any signs of infection (fever, chills, foul-smelling discharge), seek immediate medical attention.

In conclusion, while abnormal bleeding can be distressing, understanding the potential causes and treatment options can empower you to take control of your health. Don’t hesitate to advocate for yourself and seek further evaluation if your symptoms persist. Your health and well-being are paramount, and there are resources available to help you navigate this challenging situation.

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