Concerns About Spotting and Clots in a 28-Year-Old on Birth Control
Hello everyone! I’d like to provide some background information upfront. I have a history of health conditions including Bipolar I disorder, Postural Orthostatic Tachycardia Syndrome (POTS), anxiety issues, and anemia (my hemoglobin was normal three weeks ago, but my iron saturation level was low at 11%). I have experienced severe Pelvic Inflammatory Disease (PID) in the past that was not linked to a sexually transmitted infection (STI). I also manage Common Variable Immunodeficiency (CVID) and have undergone surgery for Endometriosis twice, with the last procedure taking place in the spring of 2024. Additionally, I had a left uterine cyst that was excised, in addition to gallbladder removal (cholecystectomy), appendectomy, and thymectomy procedures. Currently, my medication regimen includes Lithium, Buspirone (Buspar), Invega, Abilify, Metoprolol, iron supplements (325 mg), Mili birth control pills, and Gammunex. Typically, I receive Gammunex infusions every four weeks, though I have been delayed for over seven weeks due to issues with new insurance coverage. As a 28-year-old woman with an IUD, I generally do not experience menstrual periods, and I am diligent about taking my medications. My bipolar condition is stable, and I have not had sexual intercourse since June, so I don't suspect that I’m pregnant. In the past three to four days, I noticed an increase in milky white discharge, which has now progressed to spotting clots. Interestingly, these clots resemble gelatin and have not caused my underwear to become excessively stained—they can be easily picked up without leaving much blood. I’ve passed about three or four clots in a span of twelve hours, each around an inch in length. While I experienced no pain initially, I've started to feel sharp sensations in my uterine region, rating a level of 5 out of 10 on the pain scale, with laying flat exacerbating the discomfort. There has been no constipation despite starting iron supplements two weeks ago, yet I feel an overall sense of fatigue and weakness. At the moment, I’m lying down and have been for just over an hour, and my breathing is steady. I hope I’ve covered the necessary details and appreciate any insights or guidance. Thank you!
Answers (1)
8/14/2025, 6:51:11 AM
OpenHealth AI
Thank you for sharing your detailed medical background and current symptoms. It’s important to address your concerns carefully and provide actionable guidance.
Main Points
You are experiencing spotting and passing gelatinous clots while on birth control, along with sharp uterine pain. Given your health history, it’s crucial to monitor these symptoms closely.
Explanation
Spotting while on birth control can occur for various reasons, including hormonal changes, the presence of an IUD, or issues related to your endometriosis. The presence of gelatinous clots and the sharp pain could suggest a few possibilities, such as changes in your menstrual cycle, possible complications from your endometriosis, or even irregularities due to your other health conditions.
Since you have a complex medical history, including PID and endometriosis, any new or worsening symptoms should be approached with caution. Although you haven't had intercourse recently and seem to have ruled out pregnancy, the presence of pain along with your other symptoms warrants careful attention.
Next Steps
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Monitor Symptoms: Keep a detailed record of your symptoms, noting any changes in color, size of clots, and pain levels. This will help track if the symptoms improve, worsen, or remain stable.
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Rest and Hydration: Continue to rest as much as needed and stay hydrated. Dehydration can worsen feelings of fatigue and weakness.
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Avoid Irritants: Refrain from any activities that may irritate your uterus, such as heavy lifting or strenuous exercise.
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Evaluate Pain: If your pain intensifies, becomes sudden, or is accompanied by other concerning symptoms (like fever, severe abdominal pain, or heavy bleeding), it's important to seek help promptly.
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Consider Timing of Next Infusion: Given the potential for your immune support to be delayed, pay attention to how you feel during this waiting period and maintain a dialogue with your healthcare provider about your infusion schedule.
Reassurance
I understand that dealing with complex health issues can be overwhelming, especially when new symptoms arise. Please remember to reach out to a healthcare provider who understands your medical history if you have any concerns, as they can offer personalized guidance. Your awareness of your body and willingness to seek insights into your symptoms is an important step toward maintaining your health. Let me know if you need more information or support!
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