21F Experiencing Heavier Than Normal Menstrual Bleeding for Three Months Without Clear Diagnosis
I’m a 21-year-old female, standing at 1.71 meters tall and weighing 93 kilograms. I do not consume alcohol or cigarettes, I’m not currently sexually active, and I have no history of pregnancy. I take birth control pills containing Ethinylestradiol and gestodene for contraception. In addition to these, my medication regimen includes Venlafaxine and Ponstan. As indicated in the title, I have been experiencing a continuous menstrual period for the past three months. Despite undergoing MRI scans, ultrasounds, and consultations with several healthcare professionals including gynecologists, my hematologist, and emergency room doctors, I have not received an explanation for my symptoms. The only finding regarding my uterus is that it is tilted, but that doesn’t seem to be related to my current issue. Today, I had an appointment with my hematologist, who recommended further blood tests. However, she doubts that I have a coagulation issue, as I do not exhibit bleeding in other areas or show bruising. I find myself in a state of confusion, unsure of the next steps to take in addressing my situation.
Answers (1)
8/22/2025, 12:52:29 PM
OpenHealth AI
It sounds like you're understandably concerned about your prolonged and heavy menstrual bleeding, especially after extensive medical evaluations. While it’s positive that you've seen multiple specialists, it’s important to consider the various factors that may be contributing to your situation.
Main Points:
- Prolonged Bleeding Causes: Potential causes of heavy menstrual bleeding (menorrhagia) can include hormonal imbalances (especially with birth control), uterine abnormalities, or side effects of your current medications.
- Next Steps: Focus on closely monitoring your symptoms for patterns and consider consulting further on the hormonal aspect of your treatment.
Explanation:
Heavy menstrual bleeding can stem from various issues, including hormonal imbalances, structural uterine changes, and even medication effects. Since you've been taking birth control pills, hormonal factors might be influencing your cycle. Certain medications, including nonsteroidal anti-inflammatory drugs (like Ponstan), can also impact bleeding patterns.
Given that your MRI and ultrasounds have not indicated significant anatomical issues, and your hematologist has suggested blood tests to rule out clotting disorders, it indicates that the problem might be hormonal or medication-related.
Actionable Steps:
-
Symptom Diary: Start keeping a detailed diary of your menstrual cycle. Record dates, flow intensity, associated symptoms (pain, fatigue), and any changes in medication or stress levels. This can help identify patterns.
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Assess Birth Control Use: Talk to your healthcare provider about your current birth control method—consider whether it might be contributing to the problem. Sometimes, switching to a different formulation or method can help balance hormones.
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Nutritional Considerations: Ensure you're maintaining a balanced diet rich in iron and other nutrients to counteract any potential anemia from heavy bleeding. If you are not getting sufficient nutrition, consider consulting a registered dietitian.
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Follow-Up on Blood Tests: Make sure to stay on top of any blood tests your hematologist recommended. They can provide critical information relevant to your bleeding.
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Explore Further Specialty Care: If you don't find answers soon, consider seeking a second opinion from a reproductive endocrinologist or a specialist in menstrual disorders.
While this is a challenging time, taking proactive steps can help guide you toward a resolution. Please update me on your progress or if you have specific questions about any of these suggestions.
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