Prolonged Menstrual Bleeding: Causes and Next Steps - Obstetrics and Gynecology

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Prolonged menstrual bleeding, also known as menorrhagia, can be concerning, especially when it deviates from your usual menstrual pattern. In your case, experiencing an extended period of bleeding for 11 days, particularly when your normal cycle lasts only 5 to 6 days, warrants attention.
Firstly, it’s important to understand that various factors can contribute to prolonged menstrual bleeding. These can include hormonal imbalances, uterine abnormalities (such as fibroids or polyps), certain medical conditions (like thyroid disorders or clotting disorders), and even medications. In your situation, you mentioned that you have been taking gastrointestinal medications, including Dogmatyl (sulpiride), which is primarily used for gastrointestinal disorders and has some effects on the central nervous system. However, it is not typically associated with hormonal changes that would lead to prolonged menstrual bleeding. Your gynecologist's assessment that the gastrointestinal medications do not affect your hormones seems accurate.

The medications prescribed by your gynecologist, Ergometrine and Transamin, are aimed at managing your bleeding. Ergometrine is often used to help contract the uterus and reduce bleeding, while Transamin (tranexamic acid) is an antifibrinolytic agent that helps to reduce excessive bleeding by preventing the breakdown of blood clots. These medications can be effective in managing acute cases of menorrhagia.

Regarding your concern about why your gynecologist did not conduct further tests immediately, it is common practice in medicine to first try conservative management before proceeding to more invasive diagnostic procedures. If the bleeding resolves with the prescribed medications, it may indicate that the issue was temporary or related to a minor hormonal imbalance. However, if the bleeding persists after the course of medication, further investigations such as a pelvic ultrasound, endometrial biopsy, or hormonal evaluations may be warranted to rule out any underlying conditions.

Your emotional well-being is also important during this time. Prolonged bleeding can indeed affect your mood and overall quality of life. It’s essential to communicate your concerns with your healthcare provider. If you feel that your anxiety about the situation is overwhelming, consider discussing this with your doctor, who may provide additional support or resources.

In terms of next steps, follow the advice given by your gynecologist. Take the prescribed medications as directed and monitor your bleeding. If you notice any significant changes, such as increased bleeding, severe pain, or any other concerning symptoms, do not hesitate to return to your doctor for further evaluation. Keeping a record of your menstrual cycle, including the duration and flow of bleeding, can also be helpful for your healthcare provider in assessing your condition in future visits.

In summary, while prolonged menstrual bleeding can be alarming, it is often manageable with appropriate medical intervention. By following your doctor's recommendations and maintaining open communication about your symptoms and concerns, you can navigate this situation more effectively. If the bleeding continues beyond the treatment period or if you have any new symptoms, seeking further evaluation will be crucial in ensuring your health and peace of mind.