Prolonged Menstrual Bleeding: Causes and Solutions

Prolonged menstrual period?

Doctor, I would like to ask you about my situation.
My menstrual cycle has not been very regular.
After my last period in November 2022, I did not have another period until the week of April 22, 2023.
On the 22nd, I visited a gynecologist, and after an ultrasound, the doctor informed me that I had started menstruating.
However, since that day until now, I have been continuously bleeding, with the flow similar to what I would experience on the second or third day of my period.
On April 30, I consulted a traditional Chinese medicine doctor, who told me that since I hadn't menstruated for six months, the lining of my uterus might be thicker, and I should wait for it to finish shedding.
I would like to ask: 1.
Is it true that the uterine lining can become very thick after such a long absence of menstruation? 2.
Should I really just wait for it to finish shedding? Thank you.
🙏

P, 10~19 year old female. Ask Date: 2023/05/02

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle or cause intermenstrual bleeding are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraceptive pills, diet, polycystic ovary syndrome, uterine or cervical lesions, infections, ovulation, pregnancy, miscarriage, and breastfeeding, among others.
It is advisable to consult a gynecologist if symptoms persist or worsen to determine if there is a hormonal imbalance or other underlying causes.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2023/05/02

More Info

Prolonged menstrual bleeding, also known as menorrhagia, can be a concerning issue for many women. It is essential to understand the potential causes and appropriate solutions for this condition. Based on your description, it seems that you have experienced irregular menstrual cycles for an extended period, culminating in prolonged bleeding since April 22, 2023.
1. Thickened Uterine Lining: When menstruation is infrequent or absent for several months, the uterine lining (endometrium) can indeed become thicker. This thickening occurs because the endometrium builds up in preparation for a potential pregnancy. When menstruation resumes, the body may shed this thicker lining, which can result in heavier bleeding. Your healthcare provider's assessment through ultrasound likely indicated that your endometrial lining was indeed thicker than normal, which is a common finding in cases of prolonged amenorrhea (absence of menstruation).

2. Waiting for the Bleeding to Resolve: Your traditional medicine practitioner’s advice to wait for the bleeding to resolve naturally is a common approach, especially if there are no other concerning symptoms such as severe pain, fever, or signs of anemia (like extreme fatigue or weakness). However, it is crucial to monitor your symptoms closely. If the bleeding continues for an extended period or if you experience any alarming symptoms, it is essential to follow up with your healthcare provider.

Additional Considerations:
- Hormonal Imbalance: Prolonged menstrual bleeding can often be attributed to hormonal imbalances, which may result from various factors including stress, weight changes, thyroid issues, or polycystic ovary syndrome (PCOS). A thorough evaluation by a gynecologist can help identify any underlying hormonal issues.

- Uterine Conditions: Conditions such as fibroids, polyps, or adenomyosis can also lead to prolonged bleeding. These conditions can be diagnosed through imaging studies like ultrasounds or hysteroscopies.

- Blood Disorders: In some cases, bleeding disorders such as von Willebrand disease or platelet function disorders can cause heavy menstrual bleeding. If you have a family history of bleeding disorders, it may be worth discussing this with your doctor.

- Management Options: If the bleeding does not resolve or if it significantly impacts your quality of life, there are several management options available. These may include hormonal treatments (like birth control pills) to regulate your cycle, medications to help reduce bleeding, or procedures to remove excess endometrial tissue.

- Lifestyle Factors: Maintaining a healthy lifestyle can also play a role in managing menstrual health. Regular exercise, a balanced diet, and stress management techniques can help regulate hormonal levels and improve overall well-being.

In conclusion, while it is possible that your body may eventually regulate itself and the prolonged bleeding may resolve, it is essential to remain vigilant about your symptoms. If the bleeding persists beyond a reasonable timeframe or if you experience any concerning symptoms, do not hesitate to seek further medical evaluation. Regular follow-ups with your healthcare provider can ensure that any underlying issues are addressed promptly, allowing for appropriate treatment and management of your menstrual health.

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