OpenHealth Q&A

Seeking Answers for Persistent Health Issues

I’m uncertain if this forum is the right place for my inquiry, but here goes. I’m a 30-year-old woman experiencing ongoing medical challenges. **Summary:** I deal with frequent bleeding that sometimes brings severe discomfort, while doctors have trouble pinpointing the underlying cause. They’ve proposed treatments like ablation or hysterectomy, but I wish to identify a possible reason before proceeding with such options. For many years, I've suffered from prolonged, heavy, and painful menstrual cycles. I began using birth control pills at age 12 and continued until I was 16, when the prescription was discontinued. During that time, I experienced sporadic heavy periods every six months, despite using the pill continuously with the occasional breakthrough bleeding. Despite trying different pill options, I encountered numerous side effects such as acne, weight gain, and mood fluctuations. At 19, I found success with the NuvaRing, which I loved until my insurance stopped covering it when I turned 20. After a few pills I disliked due to similar side effects, I became pregnant and breastfed for a year. I didn’t have my first period until two years postpartum, and when it returned, it was long, heavy, and painful, occurring roughly every three months. Doctors assured me that it would eventually normalize, but that hasn’t happened. In January 2023, I resumed using the NuvaRing on a continuous basis. Unfortunately, at the start of my fourth cycle, I bled for two months straight. After another three ring cycles, I encountered a persistent three-month bleeding episode. My doctors gave varying recommendations, including changing how I use the ring or leaving it in, resulting in confusion. Now, I’ve settled into a troubling routine of using the ring for three months followed by two months of bleeding. Attempts to avoid continuous use result in a pattern of constant bleeding for three out of four weeks, which is hardly manageable. Despite undergoing ultrasounds, all tests have returned with normal results. My blood tests, including thyroid checks, are satisfactory. I have a high iron count, which defies explanation as I’ve adhered to a vegetarian/vegan lifestyle and have made a conscious effort to consume iron-rich foods, especially given my family's history of hemochromatosis. I've also reported issues like painful urination and ovulation discomfort, alongside a history of ovarian cysts. My healthcare providers dismissed the need for laparoscopy due to endometriosis, claiming it won’t address the bleeding concerns. They have hesitated to explore alternative hormone treatments based on my past experiences with them. I’m also not inclined to try the patch, IUD, or Depo shot, as the “most women respond excellently” rhetoric feels dismissive, and I fear being part of the rare exceptions. Recently, my doctors prescribed norethindrone to halt the bleeding after nearly a month of constant flow. While it initially proved effective, it elevated my blood pressure and led to significant mood swings and ongoing fatigue several weeks later. I’m experiencing insatiable hunger, an increase in weight, and persistent acne, all of which contribute to daily emotional distress. To complicate matters, I’ve recently begun bleeding once again. Ultimately, I’ve been presented with the options of undergoing either an ablation or a hysterectomy. Although the likelihood of expanding my family is slim—I have one child aged 8—I feel apprehensive about taking such drastic measures without delving into other avenues. While I don’t suffer from pain or heavy bleeding constantly, I often deal with extended bleeding periods, with occasional severe discomfort. Fatigue is a regular companion for me, alongside typical menstrual cramps and digestive troubles during the initial phase of bleeding. There are times I experience contractions reminiscent of labor pains, with increasing pressure that makes me consider seeking emergency care. Other times, discomfort is localized to one side, giving a sensation akin to having something scraped with a rusty implement. I’ve described the cyclical nature of my bleeding to my doctors: it often starts with dark blood, shifting to bright red after about a week, returning again to darker blood, then transitioning to pink spotting, before reverting to bright red, and finally tapering off to brown or black. These cycles appear to follow a consistent pattern when prolonged beyond four weeks. I’m eager to pursue further testing options beyond just a hormone panel, as the progestin clearly wasn’t the right fit for me, and I’m perplexed by the duration of my symptoms and reactions. I don’t take many vitamins regularly, though I keep some on hand for illness. My diet leans towards healthy, mostly consisting of a massive portion of vegetables at dinner while keeping other meals light. I’m receptive to any suggestions—whether they involve medication, procedures, or dietary adjustments—that might shed light on my puzzling situation, which has proven quite the challenge for my healthcare team.

Answers (1)

3/22/2025, 3:50:54 AM

OpenHealth AI

It sounds like you are experiencing a challenging and frustrating situation with your menstrual health. Persistent bleeding, discomfort, and the side effects from various treatments can understandably cause concerns. Here’s a structured overview of your situation, some possible considerations, and actionable steps you can take.

Main Points:

1. Symptom Pattern and History: Chronic issues with prolonged, heavy, and painful periods, accompanied by other symptoms like painful urination and fatigue.
2. Current Treatment Issues: Discomfort with hormone treatments and their side effects, leading to reluctance for standard options like IUDs or injections.
3. Desire for Further Investigation: A wish to explore underlying causes and alternative treatment options.

Explanation:

Your history of long, painful menstrual cycles combined with the recent confusion regarding treatments suggests that there may be an underlying condition that continues to evade diagnosis. The cyclical nature of your bleeding and associated symptoms could possibly hint at conditions like endometriosis, fibroids, or hormonal imbalances, even if tests so far have returned normal results.

Your inclination to avoid extreme measures such as ablation or hysterectomy is very valid, especially without fully understanding the underlying cause. Seeking further investigation can provide clarity and potentially steer you toward more effective management.

Actionable Steps:

1. Symptom Diary: Start keeping a detailed diary of your menstrual cycles, including the characteristics of your bleeding (color, duration, intensity), any associated pain, dietary habits, and mood changes. This can help identify patterns and correlating factors, and provide valuable insight for your healthcare provider.

2. Seek Specialized Care: Find a healthcare provider or a specialist, such as a gynecologist who focuses on menstrual disorders or reproductive endocrinology. They may approach your case from a different angle, potentially using more advanced diagnostic tools.

3. Discuss Further Testing: In your discussions with your doctor, express your interest in exploring tests such as:

   • Laparoscopy: To check for endometriosis or other abnormalities, if your pain and bleeding patterns support it.
   • Doppler ultrasound: For better imaging of potential vascular issues or to check for fibroids.
   • Comprehensive hormone panel: This could include estrogen, progesterone, and other hormones that might not have been thoroughly explored yet.

4. Diet and Lifestyle Adjustments: Continue focusing on a balanced diet. You might consider:

   • Integrating omega-3 fatty acids (from sources like flaxseeds and walnuts) to help reduce inflammation.
   • Maintaining adequate hydration, which can help with overall health and well-being.
   • Considering a nutritional consultation to ensure you're meeting your dietary needs, especially given your iron concerns.

5. Alternative Therapies: Research and discuss with your healthcare provider the potential benefits of therapies like acupuncture or herbal supplements which some women find helpful with menstrual issues. Make sure any supplements are safe and compatible with your current health status.

6. Emotional Support: It's important to prioritize mental health during this time. Consider speaking with a counselor or joining a support group for women experiencing similar menstrual challenges which can be incredibly validating and helpful.

Final Note:

Your health concerns deserve attention and the effort to explore all potential avenues. Keep an open dialogue with your healthcare provider, be persistent in seeking the right solutions, and know that there are options to explore beyond the treatments you've previously encountered. Your well-being is paramount, and finding a treatment plan that feels empowering and effective is essential. Let me know if you need further details on any specific options!