Abnormal Bleeding: Causes, Treatments, and When to Seek Help

Abnormal bleeding

Hello Doctor: I have been searching for related questions that have already been asked here, but it seems I cannot find the answers I need.
I apologize for asking, but could you please help me with my question? My last menstrual period ended at the end of July, but I continued to bleed for ten more days without stopping.
After seeing a doctor, I was diagnosed with endometriosis and uterine fibroids.
The doctor prescribed me Danazol, which helped stop the bleeding, but I finished the medication by September 1st and my period returned.
I did not get a refill, but I started feeling dizzy.
I then went to another hospital, where the doctor advised against taking Danazol and prescribed Tranexamic Acid instead.
However, I noticed that the bleeding has not stopped and I am experiencing blood clots, shortness of breath, and overall fatigue.
Should I consider switching to another hemostatic medication, or should I resume taking Danazol? Do I need to go back to the hospital? Thank you, Doctor.

mty, 40~49 year old female. Ask Date: 2022/09/04

Dr. Huang Yuande reply Obstetrics and Gynecology

1.
Danazol is a hormonal suppressor, while Tranexamic acid is a hemostatic agent; their functions are different.
Therefore, if using Danazol, it should be taken according to the physician's instructions, and it should not be discontinued arbitrarily to avoid menstrual irregularities.
Tranexamic acid is merely a hemostatic agent, which may be useful for minor bleeding, but it is not considered for heavy bleeding.
2.
Therefore, it is recommended that if endometriosis has not improved, you should discuss with your physician whether to continue using Danazol.
3.
It is still advisable to communicate and discuss with your clinical physician.

Reply Date: 2022/09/04

More Info

Abnormal bleeding can be a significant concern for many women, and it is essential to understand the potential causes, treatment options, and when to seek further medical help. Based on your description, it seems you are experiencing prolonged bleeding, which has been linked to endometriosis and uterine fibroids. These conditions can lead to various symptoms, including heavy menstrual bleeding, pain, and fatigue.

Causes of Abnormal Bleeding
1. Hormonal Imbalances: Fluctuations in hormones can lead to irregularities in the menstrual cycle, causing abnormal bleeding. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can contribute to these imbalances.

2. Uterine Fibroids: These benign tumors in the uterus can cause heavy bleeding, prolonged periods, and even pain. They can vary in size and number, and their presence can significantly affect menstrual patterns.

3. Endometriosis: This condition occurs when tissue similar to the lining of the uterus grows outside the uterus, leading to pain and abnormal bleeding. It can cause significant discomfort and may require specific treatments.

4. Infections: Pelvic inflammatory disease (PID) or other infections can lead to abnormal bleeding. These infections may also cause pain and discomfort.

5. Structural Abnormalities: Conditions such as polyps or adenomyosis can also lead to abnormal bleeding. These require evaluation and may need surgical intervention.

6. Medications: Certain medications, including hormonal treatments, can affect bleeding patterns. It's crucial to discuss any medications you are taking with your healthcare provider.

Treatment Options
1. Medications: Depending on the underlying cause, various medications may be prescribed. For instance, hormonal treatments can help regulate the menstrual cycle and reduce bleeding. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and reduce bleeding.

2. Surgical Options: In cases where fibroids or endometriosis are causing significant symptoms, surgical options may be considered. This could include procedures to remove fibroids or laparoscopic surgery for endometriosis.

3. Lifestyle Modifications: Maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help manage symptoms. Stress management techniques can also be beneficial.

4. Monitoring: Regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary.

When to Seek Help
You should seek medical attention if you experience any of the following:
- Prolonged bleeding lasting more than a week.

- Heavy bleeding that soaks through one or more pads or tampons every hour for several consecutive hours.

- Severe pain that is not relieved by over-the-counter medications.

- Symptoms of anemia, such as extreme fatigue, weakness, or shortness of breath.

- Any new or unusual symptoms that concern you.

Given your situation, where you have experienced prolonged bleeding, dizziness, and fatigue, it is crucial to consult with your healthcare provider again. The fact that you are experiencing blood clots and shortness of breath is particularly concerning and warrants immediate medical evaluation. Your doctor may need to reassess your treatment plan, possibly considering different medications or further diagnostic tests to understand the underlying cause of your symptoms better.

In summary, abnormal bleeding can stem from various causes, and understanding these can help guide appropriate treatment. It is essential to maintain open communication with your healthcare provider and seek help when symptoms persist or worsen. Your health and well-being are paramount, and timely intervention can lead to better outcomes.

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