Persistent Menstruation: Exploring Causes Beyond Endometriosis
I am a 21-year-old Brazilian woman, weighing 93 kg and standing 1.71 m tall. My lifestyle is mostly sedentary; I’ve never consumed alcohol or used tobacco. Besides that, I am not currently sexually active, have never experienced pregnancy, and have been relying on birth control pills containing ethinylestradiol and gestodene, which, unfortunately, have not been effective for me. Additionally, I take Venlafaxine to manage my depression and anxiety, Ponstan (Mefenamic acid) for pain relief, and occasionally Transamin (Tranexamic acid). Throughout my menstruating years, I've faced numerous challenges related to my periods, including irregular cycles, heavy blood flow, anemia, severe cramps, nausea, diarrhea, and PMDD among other symptoms. Recently, I underwent an MRI, and the findings indicated that I do not have endometriosis. However, it was revealed that my uterus is retroverted and has a volume of 134.2 cm³. There was also a minor presence of free fluid in my pelvic area. I am quite anxious about my situation as I've been experiencing my period for the past three months, and I had initially suspected that endometriosis would be the cause due to my family history. However, that is not the case and I am left without a clear explanation. What might be going on?
Answers (1)
8/15/2025, 5:41:35 PM
OpenHealth AI
It's understandable to feel anxious when experiencing persistent menstruation and a lack of clear answers, especially with your significant symptoms and family history. Given your situation, it’s important to explore potential causes and management options for your menstrual issues beyond endometriosis.
Main Points:
- Persistent menstruation can result from various factors, such as hormonal imbalances, structural anomalies, or other underlying health conditions.
- Regular monitoring and self-care can help manage symptoms while seeking further clarity on possible causes.
Explanation:
The continued menstrual bleeding for the past three months can stem from several conditions, particularly since your MRI ruled out endometriosis. Possible contributors include:
- Hormonal Imbalances: Birth control pills may not be effectively regulating your hormones. Other hormonal conditions like polycystic ovary syndrome (PCOS) or thyroid issues could also take a role.
- Uterine Structure: Retroverted uterus, and any anomalies in the uterine lining could lead to menstrual irregularities.
- Conditions Impacting Blood Clotting: The use of Tranexamic acid indicates that heavy bleeding is significant for you. Conditions affecting the blood's ability to clot might contribute to prolonged menstruation.
Next Steps:
-
Track Your Symptoms: Maintain a detailed diary of your menstrual cycles, noting the frequency, flow intensity, pain levels, and accompanying symptoms. This information can be helpful in future discussions with healthcare professionals.
-
Review Medication: Consider discussing with your doctor the effectiveness of your current contraceptive method. Alternative birth control options or hormonal treatments may better suit your needs if the current regimen is ineffective.
-
Nutritional Support: Focus on a balanced diet rich in iron (to support anemia from heavy blood flow), fiber, and hydration to help manage gastrointestinal symptoms associated with menstruation.
-
Regular Physical Activity: Gradually incorporating moderate exercise can help regulate menstrual cycles and improve overall well-being. Aim for at least 30 minutes of activity most days.
-
Emotional Support: Ongoing depression and anxiety can intertwine with physical symptoms. Continue managing your mental health with Venlafaxine and consider complementary therapies like mindfulness or therapy if you're not already doing so.
-
Be Alert to Changes: If you notice any worsening symptoms, such as severe pain, a significant increase in bleeding, or new symptoms (e.g., fever), please re-evaluate promptly the need for medical consultation.
While your situation is understandably distressing, tracking and addressing your symptoms proactively can lead to better insight and management strategies. If you have more questions or need further clarification, feel free to ask!
Related Questions
Understanding Abductor Hallucis Muscle Herniation
Greetings everyone, after enduring two months of significant discomfort in my foot, I've finally received the results from my medical tests. It turns out I’m dealing with a herniation of the abductor hallucis muscle in my right foot. I won’t consult with my physician until Thursday of next week, and I'm curious about the typical procedures that follow such a diagnosis. The herniation measures 9mm; is that considered substantial? If surgical intervention is necessary, is there a possibility of remaining awake during the procedure? The thought of general anesthesia frightens me. What should I expect in terms of treatment for my foot? I’ve heard that this condition is relatively uncommon, which adds to my anxiety. I'm prone to overthinking things, and now I worry about the possibility of losing my foot or complications arising, like restricted blood flow while I await treatment. For some context, I’m a 30-year-old woman, standing at 5'9. Any insights would be greatly appreciated!
Concerns Regarding Possible Fungal Infection: Seeking Guidance
Age: 19, Height: 5'3", Weight: 120 lbs. Currently dealing with fibromyalgia and irritable bowel syndrome (IBS). Since my discharge from the mental health facility a few weeks ago, I've encountered a series of distressing and painful symptoms. It all commenced with urinary issues—experiencing cloudy, malodorous urine, difficulty initiating urination, a weak stream, pain during urination, and an increased urge to go. Alongside this, I suffered from significant back and abdominal pain, leading me to suspect I might have a severe urinary tract infection (UTI) that could escalate to a kidney infection. Having had a UTI previously, recent lab results indicated an alarming level of something that suggested an infection, prompting an emergency visit for evaluation. I had also been grappling with intense itchiness but didn't mention it. The ER staff claimed everything was normal and suggested I just "increase my water intake," attributing the pain to my fibromyalgia. Frustratingly dismissive. After resuming my regular medication, I experienced brief relief, only for my conditions to return, intensified. My abdomen throbbed painfully, markedly different from my normal IBS discomfort, and an overwhelming wave of fatigue hit me. I dealt with hot flashes, dizziness, nausea, headaches, coughing, a bout of congestion, and persistent urinary difficulties. It reached a point where I found myself sobbing while trying to schedule a doctor's appointment, only to learn that I first required financial assistance and proof of income (as I'm unemployed and lack insurance). They advised me to visit urgent care instead. During my visit to urgent care, I struggled to walk or stand. While fibromyalgia often causes these challenges, it felt distinctly unusual this time. After assessment, the doctor expressed concern about my symptoms but stated that not much could be done and recommended I go to the ER across the street. I was in such bad shape that a nurse had to wheel me there. At the ER, they conducted evaluations, drawing blood, performing a urinalysis, and swabbing my nose for COVID-19, flu, and RSV—results all came back negative. The wait for a patient room was prolonged, but once I was settled, I learned that my blood pressure and blood sugar were dangerously low. They had me consume juice, eat crackers, and placed me on an IV. The diagnosis indicated a respiratory infection (though they didn't specify which) and they dismissed my other symptoms as being related to my chronic illnesses. Feeling frustrated, I inquired about imaging, but they withheld, claiming there was no indication for it in my charts. Instead, I received allergy medication, nausea relief, and my gabapentin. About ten minutes after being treated, my condition deteriorated—I began to shiver, dizziness escalated, and my throat and chest felt constricted and painfully dry, making breathing laborious. I struggled to catch my breath, wheezing and desperate for assistance, yet the nurse dismissed my concerns as hypochondria. She kept insisting I must "calm down," but I was resolute; my acute chest and throat pain felt genuine, and I was genuinely unable to breathe. Eventually, I received medication to numb the pain and a cough syrup prescription, and I was discharged. Interestingly, two women I met in the mental health facility previously mentioned experiencing similar symptoms, with one even showing me alarming photos of hives she developed. This has led me to fear that we might have contracted a serious or contagious illness, and I wish to identify it. Since leaving the ER, my weakness has escalated; muscle pain has begun radiating to my upper neck, dizziness persists, and I've had additional troubling breathing incidents. There are instances where I suddenly feel an overwhelming drowsiness—not just fatigue—where I can be engaged in conversation or watching TV, and suddenly my head droops as I drift off, reminiscent of narcolepsy. I'm eager to consult with a physician about these ongoing issues, especially since my experiences in hospitals have felt unproductive. Should I request any specific tests or imaging? And should I raise concerns regarding potential exposure to harmful substances like mold or poisoning from my time in the hospital? What steps should I take next?
Concerns About Mid-Cycle Bleeding
Hello everyone, I hope this isn't too personal, but I could really use some guidance. For the past three months, I've been experiencing unexpected bleeding around the middle of my menstrual cycle, which has left me feeling uncertain. Normally, my periods are consistent, and I have never had issues with mid-cycle bleeding prior to this. Typically, my cycle spans from 28 to 33 days, with a duration of about four to six days. Here's a breakdown of what I've noticed: - **June**: I experienced light spotting from cycle days 13 to 15. - **July**: This spotting repeated itself from days 13 to 15 and also occurred on days 21 and 22. - **August**: As of today, I'm on cycle day 11 and have begun to observe some light spotting again. While these episodes are generally accompanied by mild cramps, they’re not severe enough to be considered painful. I'm wondering if anyone has insights on what could be causing this? I intend to reach out to my doctor on Monday to arrange a visit. Any thoughts or hypotheses on this would be greatly appreciated!
Understanding Pulmonary Embolism and Arm Swelling
A male patient, aged 40, stands at 6 feet tall and weighs 175 pounds. His medical history is largely unremarkable, aside from occasional migraines for which he takes 50 mg of Zoloft and sumatriptan as needed. Two days ago, my husband awoke to discover that one of his arms was significantly swollen and exhibited a purplish hue. We rushed to the emergency room where an ultrasound indicated no clotting in the arm itself. However, a cardiac CT scan revealed the presence of multiple small pulmonary embolisms. His D-Dimer level was measured at 4.65 ug/ml, while other blood tests including a complete blood count and metabolic panel returned within normal ranges. The physician who attended to us was rather curt, suggesting that the situation could either be related to a malignancy or potentially an undiscovered clotting disorder. He inquired about any family history of sudden deaths, which left us bewildered, as there are no known instances of unexpected fatalities or clotting diseases in our family. Ultimately, the doctor stated he was free to go but advised starting Eliquis as prescribed and consulting our primary care physician for further guidance. We are left with a couple of pressing questions. What further evaluations should we consider to provide reassurance, especially concerning the possibility of hidden cancer? Additionally, it is worth noting that prior to this incident, he had been sleeping in an atypical posture, with his arm elevated above his head and resting on the side of his face. He had been experiencing difficulties with sleep and had eventually managed to drift off with his ear covered. Could this indicate a condition known as Thoracic Outlet Syndrome? Is there a reliable method to diagnose this?
Persistent Symptoms After Negative Strep Tests?
Hello, I'm a 25-year-old assigned female at birth, living in Canada. I currently take medications including Vyvanse, Wellbutrin, testosterone, and finasteride, and I've recently undergone multiple rounds of antibiotics (details below). I've been consulting various physicians at walk-in clinics regarding my health concerns. In early July, I fell ill, experiencing what I believed to be strep throat. Significant symptoms included white patches on my tonsils, swollen lymph nodes, difficulty swallowing, a decrease in appetite, fatigue, and fever. Given my job, where I'm frequently around children, I suspect I might have contracted something there. After a week without improvement, I visited a doctor who noted all the classic signs associated with strep throat and prescribed a 10-day course of amoxicillin. Since I tend to experience yeast infections following antibiotic treatment, I was also given fluconazole for a few days afterward. After a couple of days on the amoxicillin, I began to feel better and completed the full course of medication. Additionally, I started taking a probiotic with bacillus coagulans to mitigate digestive issues, and I’ve been diligent with that. However, just three days after finishing the antibiotics, my symptoms resurfaced—white patches appeared on my tonsils, lymph nodes swelled again, swallowing became painful, my appetite diminished, and I felt fatigued. I consulted another doctor who suspected strep once more; they conducted a throat culture and prescribed 10 days of clavulin and fluconazole again. When the results came back, they indicated "No Streptococcus pyogenes (Group A) isolated." By that time, I was already well into the antibiotics and my symptoms were diminishing, so I didn't think much about it. Three days after completing the clavulin, the white patches returned, accompanied by mild discomfort when swallowing, swollen lymph nodes, lack of appetite, fatigue, and some muscle soreness. I visited a third physician who explained that, in some instances, strep bacteria can hide in areas of the tonsils that might be unreachable by antibiotics. They performed another culture and initiated treatment with azithromycin (500 mg daily for three days, without fluconazole). I've begun to feel a bit better—no difficulty swallowing, reduced fatigue, and visible improvement in my tonsils, although I've been experiencing some nausea, possibly from the azithromycin. I just received the throat culture results again, indicating "No Streptococcus pyogenes (Group A) isolated." I'm worried about what could be causing my recurring symptoms. What are the odds that it isn’t strep? If it isn’t, what else might be responsible? The last doctor I consulted expressed confidence that it was strep and mentioned that if the issue persists, they might refer me to an ENT specialist to discuss the possibility of tonsillectomy. I really want to avoid that if I can! I'm anxious about the potential for these symptoms to return after the azithromycin, and I'm growing increasingly frustrated with missing out on school and work due to illness. Any thoughts or advice would be greatly appreciated! Thank you!