Prolonged Bleeding While Taking Diane: What to Do Next?

[Supplementary Note] Continuous bleeding while taking Diane?

According to the doctor's instructions, I started taking the medication on the fifth day after my menstrual period began, so I am still within the treatment period.
After the tenth day of my menstrual cycle, I stopped for one day thinking it was over, but unexpectedly, I started bleeding again.
Initially, the bleeding was light, and I could use a 16cm or 20cm pad for several hours.
Now, counting from the day I mentioned the renewed bleeding, it has been eight days.
Since around the fourth or fifth day, the bleeding has increased, and there are blood clots.
I now need to use 23cm or 28cm pads to manage it (normally, during my regular menstrual period, I use 28cm or 33cm pads, so this isn't excessive for me).
I still have a week’s worth of the medication Diane left.
I am unsure if I need to continue the treatment after I finish this medication when my next menstrual period comes, as I am studying abroad and unable to return for a follow-up appointment.
Therefore, my doctor prescribed a supply for over six months.

CRIMSON, 30~39 year old female. Ask Date: 2015/04/13

Dr. Lin Manying reply Obstetrics and Gynecology

Hello, it is recommended that you wait one week after stopping the medication to see if the bleeding stops or becomes very minimal before starting the next treatment cycle.
Alternatively, you may contact your original physician for further guidance.

Reply Date: 2015/04/13

More Info

When experiencing prolonged bleeding while taking Diane-35, it is essential to understand the potential reasons behind this occurrence and the appropriate steps to take next. Diane-35 is a combined oral contraceptive pill that contains cyproterone acetate and ethinyl estradiol. It is often prescribed not only for contraception but also for managing conditions like acne and hirsutism due to its anti-androgenic properties.

Understanding Prolonged Bleeding
Prolonged bleeding while on Diane-35 can be attributed to several factors:
1. Hormonal Adjustment: When starting or continuing hormonal contraceptives, the body may take time to adjust to the new hormone levels. This adjustment period can lead to irregular bleeding or spotting, especially in the first few months of use.

2. Breakthrough Bleeding: This is a common side effect of hormonal contraceptives, particularly in the initial months of use or if pills are missed. Breakthrough bleeding can occur due to fluctuations in hormone levels.

3. Dosage and Administration: If the pill is not taken consistently at the same time each day, it can lead to hormonal fluctuations that may cause irregular bleeding.
4. Underlying Conditions: Conditions such as fibroids, polyps, or other gynecological issues can also lead to abnormal bleeding patterns.
5. Drug Interactions: Certain medications or supplements can interact with hormonal contraceptives, potentially affecting their efficacy and leading to irregular bleeding.

What to Do Next
Given that you are experiencing prolonged bleeding that has lasted for eight days and is increasing in volume, here are some recommendations:
1. Continue Taking the Pills: Since you have a week of pills left, it is advisable to continue taking them as prescribed. Stopping the medication abruptly can lead to further hormonal imbalance.

2. Monitor Symptoms: Keep track of your bleeding patterns, including the amount and any associated symptoms such as pain or discomfort. This information will be valuable for your healthcare provider.

3. Consult a Healthcare Provider: Since you are studying abroad and may not have immediate access to your usual healthcare provider, consider reaching out to a local gynecologist or a family medicine doctor. Many countries have walk-in clinics or telehealth services that can provide guidance.

4. Consider a Follow-Up: After finishing your current pack, if the bleeding persists or if you experience significant discomfort, it may be necessary to switch to a different contraceptive method or adjust the dosage. A healthcare provider can help determine the best course of action based on your specific situation.

5. Evaluate Lifestyle Factors: Stress, changes in diet, and physical activity can also affect menstrual cycles. Ensure you are maintaining a balanced lifestyle, which can help regulate your hormonal balance.

Conclusion
Prolonged bleeding while taking Diane-35 can be concerning, but it is not uncommon. It is crucial to continue your medication as prescribed while monitoring your symptoms closely. If the bleeding persists beyond the current pack or if you experience any alarming symptoms, seek medical advice promptly. Your health and well-being are paramount, and a healthcare provider can help you navigate this situation effectively.

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