Prolonged Menstrual Bleeding: When to Seek Medical Advice?

Menstrual bleeding has not stopped yet?

Menstruation started on February 9 and has now lasted for over ten days.
From February 9 to February 12, the flow was very light, almost as if it wasn't there or just about to end.
Starting on February 13, the flow has been similar to what is typically experienced on the second or third day of a regular period.
There has been a history of irregular cycles, and medication was taken to regulate it, which was stopped about three to four months ago.
After stopping the medication, the cycles were normal for two months, but there was no period last month.
This month, however, the period has lasted almost half the month.
Is this normal? Should I return to the original clinic, or should I just monitor the situation?

Ru, 20~29 year old female. Ask Date: 2016/02/20

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the causes of abnormal bleeding outside of the menstrual period in women may include hormonal imbalances, emotional factors, diet, age, and others.
However, it is crucial to rule out conditions such as uterine tumors, endometrial hyperplasia, cervical lesions, and vaginal lesions.
If the bleeding persists, it is advisable to consult a physician for further evaluation.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2016/02/20

More Info

Prolonged menstrual bleeding, or menorrhagia, can be a concerning symptom that warrants medical attention, especially when it lasts for an extended period, as in your case. Based on your description, it seems that you have been experiencing abnormal bleeding patterns, including prolonged bleeding that has lasted for over two weeks. This situation can arise from various underlying causes, and it is essential to understand when to seek medical advice.

Firstly, it is important to note that menstrual cycles can vary significantly among individuals, and factors such as hormonal imbalances, stress, changes in weight, and underlying health conditions can influence menstrual patterns. In your case, you mentioned a history of irregular cycles and previous medication adjustments. This could indicate that your menstrual cycle may still be stabilizing after the cessation of medication.

However, prolonged menstrual bleeding can be indicative of several medical conditions, including:
1. Hormonal Imbalances: Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can lead to irregular and prolonged bleeding.

2. Uterine Fibroids or Polyps: These benign growths in the uterus can cause heavy and prolonged menstrual bleeding.

3. Endometrial Hyperplasia: This condition involves the thickening of the uterine lining and can lead to heavy bleeding.

4. Coagulation Disorders: Conditions that affect blood clotting can result in prolonged bleeding.

5. Infections: Pelvic inflammatory disease (PID) or other infections can also cause abnormal bleeding.

Given your symptoms, it is advisable to seek medical advice if you experience any of the following:
- Bleeding that lasts longer than seven days.

- Soaking through one or more sanitary pads or tampons every hour for several consecutive hours.

- Passing large blood clots (larger than a quarter).

- Severe pain or cramping.

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

In your situation, since the bleeding has persisted for over two weeks and you have a history of irregular cycles, it would be prudent to return to your healthcare provider for further evaluation. They may perform a physical examination, order blood tests to check for anemia or hormonal levels, and possibly conduct imaging studies such as an ultrasound to assess for any structural abnormalities in the uterus.

In the meantime, it is essential to monitor your symptoms closely. Keep track of the amount of bleeding, any associated pain, and any other symptoms you may experience. This information will be helpful for your healthcare provider in determining the appropriate course of action.

In summary, while some variations in menstrual cycles can be normal, prolonged bleeding, especially when accompanied by other concerning symptoms, should not be ignored. Seeking medical advice is the best course of action to ensure that any underlying issues are addressed promptly and effectively. Your health and well-being are paramount, and timely intervention can help prevent potential complications.

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