Seeking Help and Insights
Greetings, I'm a 39-year-old woman looking for some guidance. My troubles began with a prolonged menstrual period that lasted a month, resulting in my hemoglobin level dropping to 7.8. Due to persistent fatigue, I reached out to my OB-GYN, who subsequently requested some blood tests and a transvaginal ultrasound. Thankfully, the results all returned within normal ranges. My OB informed me that I might experience this issue on a monthly basis without a specific cause. To manage the situation, I was prescribed tranexamic acid for five days, followed by ibuprofen, and later transitioned to birth control pills. However, just two days after discontinuing the tranexamic acid, I experienced an alarming incident. While brushing my teeth, I suddenly noticed blood in my sputum and had an unexpected nosebleed that lasted around 15 to 20 minutes. This incident prompted a visit to the emergency department, where a doctor tested me for clotting deficiencies and von Willebrand's disease. Thankfully, these tests were negative, but by that point, I had already started the birth control pills, leading to a referral to a hematologist. Recently, my OB-GYN changed my contraceptive method from pills to an IUD; however, ever since the onset of my prolonged periods, I've been dealing with new symptoms, including back pain and rib discomfort, which I find puzzling. I have also consulted with my gastroenterologist, who is treating me for GERD, but I’m curious if any of these issues may be related to my anemia. Could these new pains be associated with endometriosis, or are they merely a continuation of my GERD? I appreciate any insights you might have and apologize for the lengthy message.
Answers (1)
4/2/2025, 10:20:46 PM
OpenHealth AI
It sounds like you've been through a challenging time with your health, and it's understandable to seek clarity on these interrelated issues. You’ve been managing a prolonged menstrual period and anemia, undergone various tests, and now have new symptoms causing concern. Let's break this down and focus on what you can do next.
Main Points
- Hemoglobin Level and Menstrual Issues: Your blood test results are crucial; low hemoglobin (anemia) can be linked to heavy periods, and you’ve already begun treatment with tranexamic acid and birth control.
- New Symptoms: The back pain and rib discomfort could stem from various sources, including potential effects linked to your anemia or digestive issues (GERD).
- Follow-up Actions: Prioritize symptom tracking and communicating with your healthcare providers about your concerns moving forward.
Explanation
Your prolonged menstrual bleeding may cause significant fatigue and a drop in hemoglobin, which you've already addressed through medication and hormonal birth control. The bleeding in your sputum and nosebleeds could have been alarming but are less common in the context of anemia unless you have a clotting issue. Since tests for clotting disorders returned normal, it's good news.
As for the new back pain and rib discomfort, these could be associated with several factors:
- Musculoskeletal: Strain or tension can occur due to fatigue or changes in activity.
- Endometriosis: While it’s a possibility considering your menstrual history, pain caused by endometrial tissue outside the uterus is typically more cyclical and not always constant.
- GERD: Your gastrointestinal symptoms may also contribute to discomfort in your ribs or back due to acid reflux or related issues.
Next Steps
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Track Symptom Patterns: Keep a detailed log of your menstrual cycle, pain levels (including back and rib discomfort), and any other related symptoms. Note if they coincide with your menstrual cycle or changes in medication.
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Medications: Continue taking the birth control IUD as prescribed. Monitor how your body responds to this new form of contraception, as it may also influence your bleeding patterns over time.
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Communicate with Your Healthcare Providers:
- Share your symptom log with both your OB-GYN and hematologist to assess any potential correlations between your menstrual health, anemia, and new pains.
- Discuss the ongoing GERD treatment with your gastroenterologist, highlighting any changes in your symptoms since the onset of your period problems.
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Self-Care Strategies:
- Ensure you maintain adequate nutrition, focusing on iron-rich foods to support hemoglobin levels, such as red meat, beans, spinach, and fortified cereals.
- Consider lifestyle adjustments for GERD, like avoiding large meals before bedtime and elevating your head during sleep to reduce acid reflux.
If your symptoms worsen or if the pain intensifies, promptly reach out to your healthcare provider for further evaluation. You are not alone in this—tackling one health concern often leads to better understanding of another, so keep advocating for the answers you need.
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