Abnormal Uterine Bleeding: Causes and Concerns for Women

Abnormal bleeding

I did not have my period in June, and it was delayed by 23 days in July.
I took medication to end it in mid-August, and my period started again on September 4 and has not stopped since.
What could be the reason for this? A doctor diagnosed me with polycystic ovary syndrome (PCOS).
What is your opinion on this? I am 33 years old, currently have hypertension diagnosed as hereditary, weigh 88 kg, and am 167.5 cm tall.
I have two daughters, and my youngest is two years and five months old.
Additionally, could you please explain if a dilation and curettage (D&C) procedure, aside from causing infertility and amenorrhea, would affect sexual relations?

Luo, 30~39 year old female. Ask Date: 2000/09/14

Dr. Wei Fumao reply Obstetrics and Gynecology

Dr.
Wei Fu-Mao from Pingtung Hospital's Department of Obstetrics and Gynecology responded: Patients with obesity may experience irregular menstruation and could potentially have polycystic ovary syndrome.
A dilation and curettage (D&C) procedure will not affect sexual relations.
Your previous statements are unclear; please come in for a consultation.

Reply Date: 2000/09/14

More Info

Abnormal uterine bleeding (AUB) is a common concern among women and can arise from various causes, ranging from hormonal imbalances to structural abnormalities in the reproductive system. Your situation, characterized by prolonged bleeding and a diagnosis of polycystic ovary syndrome (PCOS), raises several important points that warrant discussion.

Firstly, it’s essential to understand that AUB can manifest in different forms, including heavy menstrual bleeding, bleeding between periods, or prolonged bleeding. In your case, the bleeding that started in September and has not ceased could be attributed to several factors, including hormonal fluctuations associated with PCOS. PCOS is a condition that affects hormone levels, leading to irregular ovulation, which can result in unpredictable menstrual cycles and abnormal bleeding patterns.

Given your age (33 years) and the presence of high blood pressure, it’s crucial to manage these conditions effectively. High blood pressure can complicate the management of AUB, especially if hormonal treatments are considered. Weight management is also an important factor, as obesity can exacerbate the symptoms of PCOS and contribute to insulin resistance, further complicating hormonal regulation.

Regarding your concern about the implications of endometrial scraping (dilation and curettage, D&C), it’s important to note that while this procedure can help diagnose and treat certain conditions, it may have potential side effects. A D&C can lead to scarring of the uterine lining (Asherman’s syndrome), which can affect future fertility. However, many women do not experience significant long-term effects on their menstrual cycles or sexual function after a D&C, provided the procedure is performed correctly and there are no complications.

In terms of sexual health, most women can resume normal sexual activity after a D&C once they have healed, typically within a few weeks. However, individual experiences may vary, and some women may experience discomfort or changes in their menstrual cycle post-procedure. It’s essential to have open communication with your partner and healthcare provider about any concerns you may have regarding sexual activity and the impact of your condition and treatments.

Given your ongoing symptoms, it would be prudent to seek a comprehensive evaluation from a gynecologist who specializes in AUB and PCOS. This evaluation may include blood tests to assess hormone levels, an ultrasound to examine the ovaries and uterus, and possibly a biopsy if there are concerns about the endometrial lining. Treatment options may include hormonal therapies, lifestyle modifications, or other interventions tailored to your specific needs.

In summary, abnormal uterine bleeding can be a multifaceted issue influenced by hormonal, structural, and lifestyle factors. Your diagnosis of PCOS, combined with your current health status, necessitates a thorough evaluation and a personalized treatment plan. It’s essential to address both the physical and emotional aspects of your condition, ensuring that you have the support and resources needed to manage your symptoms effectively. Regular follow-ups with your healthcare provider will be crucial in monitoring your condition and adjusting treatment as necessary.

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