Unidentified Uterine Masses and Prolonged Bleeding

Intrauterine mass of unknown origin?

Hello, doctor.
My menstrual cycle has always been regular at 28 days, lasting about six days.
However, this time I have been experiencing continuous bleeding.
The first day of my period was on October 29, and I visited the clinic on November 7, where I received uterine contraction medication, hemostatic agents, and iron supplements, but I am still bleeding with many bright red clots.
I returned to the clinic on November 11 and was prescribed three doses of Dali, but the bleeding persists.

I have a couple of questions:
1.
How long will it take for the bleeding to stop? When should I return to the clinic?
2.
I previously had an ultrasound, which showed a fibroid on the anterior wall of the uterus and an unknown mass measuring 28 x 9 mm within the uterine cavity.
Could the unknown mass be the reason for the continuous bleeding? What treatment options are available? Thank you, doctor.

Niming, 30~39 year old female. Ask Date: 2015/11/12

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
Please first confirm the cause of the unknown intrauterine mass: is it a blood clot, a tumor, or a pregnancy? If necessary, a referral to a medical center can be made.

2.
The cause must be determined before deciding on the treatment approach.

Respectfully, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2015/11/12

More Info

Dear Patient,
Thank you for your detailed inquiry regarding your prolonged bleeding and the presence of unidentified uterine masses. It’s understandable to feel concerned about these symptoms, especially when they disrupt your regular menstrual cycle. I will address your questions and provide some insights based on medical knowledge.

1. Duration of Bleeding and When to Return to the Clinic: The duration of abnormal bleeding can vary significantly depending on the underlying cause. In your case, since you have been experiencing prolonged bleeding since October 29, it is crucial to monitor the situation closely. If you have already been prescribed medications such as uterotonics and hemostatic agents, it is expected that they should help in managing the bleeding. However, if the bleeding persists beyond a week or worsens, it is advisable to return to your healthcare provider sooner rather than later. Continuous bleeding, especially with the presence of clots, can indicate that the treatment may need to be adjusted or that further investigations are necessary.

2. Impact of the Uterine Masses on Bleeding: The presence of a uterine fibroid (myoma) and an unidentified mass within the uterine cavity can indeed contribute to abnormal bleeding. Fibroids can cause heavy menstrual bleeding (menorrhagia) due to their size and location, which can interfere with the normal contraction of the uterus. The unidentified mass you mentioned, measuring 28x9 mm, could also be a polyp or another type of growth that may lead to irregular bleeding patterns. It is essential to determine the nature of this mass through further imaging studies, such as a transvaginal ultrasound or possibly a hysteroscopy, which allows direct visualization of the uterine cavity.

Treatment Options: Treatment for abnormal bleeding due to uterine masses can vary based on the size, type, and symptoms associated with the masses. If the mass is confirmed to be a fibroid or polyp and is causing significant symptoms, options may include:
- Medications: Hormonal treatments, such as birth control pills or hormonal IUDs, can help regulate menstrual cycles and reduce bleeding.
- Surgical Options: If the mass is causing severe symptoms or if there is a concern about its nature, surgical options such as myomectomy (removal of fibroids) or hysteroscopic polypectomy (removal of polyps) may be considered.

- Monitoring: In some cases, if the mass is not causing significant symptoms, your doctor may recommend a watchful waiting approach with regular follow-ups.

It is essential to maintain open communication with your healthcare provider regarding your symptoms and any changes you experience. If you notice any signs of anemia (such as fatigue, dizziness, or paleness), or if you experience severe pain, it is crucial to seek medical attention promptly.

In summary, while the presence of uterine masses can contribute to prolonged bleeding, effective management is possible through a combination of medical and surgical approaches. Regular follow-ups and monitoring are key to ensuring your health and well-being.

Please feel free to reach out if you have further questions or concerns.

Best regards,
Doctor Q&A Teams

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