Extended Menstrual Issues
**Age**: 26 **Gender**: Female **Height**: 5 feet 4 inches **Weight**: 180 pounds **Ethnicity**: White **Duration of Symptoms**: Approximately 1 year **Country**: United States **Current Medications**: Sertraline (for roughly 13 years), Claritin as needed, Mirena IUD (inserted on 02/06/2025) **Medical History**: Left ovarian dermoid cyst (2.8 cm) and simple cyst (3.1 cm). **Primary Concern**: Extended menstrual cycles and new premenstrual syndrome (PMS) symptoms In November 2022, I had the Kyleena IUD placed, which effectively halted my menstrual cycle for over 18 months. However, starting July 1, 2024, I experienced light spotting that persisted for 2 weeks. I attributed this to some stress I was experiencing at that time. Following that, I spotted again from August 1 through August 11, 2024. Then, I faced significant bleeding lasting almost two months from August 25 to October 19, 2024; it felt like I endured two separate menstrual periods rather than just light spotting. During September 2024, I also encountered severe breast pain about a week prior to my expected period; this pain recurred consistently for the last ten months, fading a few days after my cycle began. Additionally, I experienced two yeast infections, which was unusual for me, occurring after unprotected intercourse with a previous partner. All sexually transmitted infection tests returned negative results. I opted for the Kyleena IUD initially to eliminate my periods, as they severely impacted my mental well-being, and it worked wonderfully for over a year and a half. To regain that benefit, I switched to the Mirena IUD in February 2025, yet I have seen no improvement. On May 26, 2025, following penetrative sex with my partner, I noticed bright red bleeding with clots, reminiscent of a period. This irregular bleeding occurred two weeks earlier than anticipated, followed by a week of spotting, breast discomfort, and yet another cycle soon after. We had intercourse two days ago, which led to similar bleeding afterward. This situation is exhausting, and I am seeking clarity on the underlying cause, as my doctor and I are both puzzled. While she asserts that breakthrough bleeding can happen with an IUD, I am eager for a resolution as I can no longer manage these symptoms. An ultrasound confirmed the IUD’s proper placement, with the cysts remaining unchanged; however, a previous cyst on my right ovary seems to have resolved. An MRI suggested possible focal adenomyosis—what implications might this have? Recently, I detected a slightly fishy odor without experiencing itching or unusual discharge. I would greatly appreciate any insights, recommendations, or suggested tests regarding my condition.
Answers (1)
6/16/2025, 8:01:37 PM
OpenHealth AI
It sounds like you're going through a challenging time with your menstrual health, especially with the variations in your cycles and the accompanying symptoms. The situation you've described, including breakthrough bleeding with the IUD, breast pain, and concerns about potential adenomyosis, can indeed be complex.
Key Points:
- Extended menstrual cycles and breakthrough bleeding can occur with IUD use.
- Possible adenomyosis could contribute to your symptoms.
- A fishy odor may indicate a possible infection, even without accompanying discharge.
Explanation:
Your anxiety over these changes is completely understandable, especially since the IUD was initially successful in managing your periods. IUDs, such as Mirena and Kyleena, may occasionally lead to irregular bleeding or spotting, particularly in the initial months after placement or following significant hormonal changes.
The possibility of adenomyosis, which is when the tissue lining the uterus grows into the uterine muscle, might explain increased menstrual pain and heavier bleeding, especially if it’s focal (localized) rather than widespread. It's worth discussing if this diagnosis affects your management options.
The fishy odor you're experiencing, despite the absence of itching or unusual discharge, could suggest a bacterial infection or another type of imbalance. It’s important to address this, especially since it’s a new symptom.
Next Steps:
-
Track symptoms: Maintain a detailed log of your menstrual cycle, symptoms, and any changes. Include dates of spotting, bleeding intensity, breast pain, and any other relevant notes.
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Contact your healthcare provider: Share your symptom diary. It's vital to revisit your doctor, especially regarding the possible fishy odor, adenomyosis, and ongoing bleeding. This information can help your doctor determine if further tests (like a hysteroscopy to evaluate the lining of the uterus) are needed.
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Consider dietary and lifestyle adjustments: Ensure a balanced diet and stay hydrated. Some women find relief from menstrual symptoms and PMS with specific dietary changes, such as reducing caffeine and sugar, or incorporating more omega-3 fatty acids (found in fish, walnuts, and flaxseeds).
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Discuss treatment options: Based on your doctor’s review of your symptoms and any tests, discuss potential treatment pathways, which may involve medication adjustments or further evaluation of your IUD option, assess your pain management strategies, and explore alternatives if necessary.
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Seek support: Talking to a mental health professional can be beneficial, especially considering the mental toll these physical symptoms have taken previously.
Your symptoms deserve thorough investigation, and taking proactive steps can lead to better management and relief. You’re not alone in this, and with the right support, you can find a path forward.
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