Should I Make Another Trip to the Emergency Room?
A 19-year-old female, measuring 5'8" and of average weight, has not been on hormonal birth control. Her menstruation began on August 18, and she has been experiencing significant blood loss, characterized by large clots and the necessity of changing "night pads" every 3-4 hours—well within the typical capacity, as regular pads last about 2 hours on average. At times, the bleeding temporarily eases to a more moderate level. For relief, she has been using ibuprofen and recently followed a regimen of tranexamic acid, taking 500mg three times daily from August 28 to 30. Previously, she endured an episode of bleeding that persisted for a month (from December 10 to January 8). That situation had become severe enough to cause dizziness, prompting a visit to urgent care. During that visit, tranexamic acid was prescribed, although it did not completely halt the bleeding. This resulted in a referral to the emergency room, where IV tranexamic acid was administered to manage the situation, and she was discharged with additional oral medication in case of recurrence—hence her possession of tranexamic acid for her current episode. Ultimately, the bleeding subsided, but it remains unclear whether this was due to the medication or if it would have ceased on its own. Following the December/January incident, an internal ultrasound was conducted, which revealed no abnormalities. To date, she has not undergone any hormonal evaluations beyond a standard blood test. Since that early episode, her menstrual cycles have become erratic, occurring every other month and lasting longer than 10 days. She was advised that her cycles would likely normalize eventually, but the heavy bleeding and medication may have disrupted her regular pattern. Now, she finds herself in a situation where the bleeding continues unabated for two weeks, leaving her uncertain about whether she should seek emergency care or return to urgent care. Attempts to schedule an appointment with a general practitioner have been unsuccessful, as the university clinic is unavailable until late September, and their sole suggestion was to consider birth control pills. While she is eager to stop the bleeding, she feels it is crucial to ascertain the underlying cause before resorting to potential treatments. Could this be indicative of a more serious condition?
Answers (1)
9/4/2025, 9:50:44 AM
OpenHealth AI
It's understandable to feel unsure about whether to seek emergency care given the significant bleeding you've described. Persistent heavy menstrual bleeding lasting two weeks can be concerning and warrants proper assessment, especially considering your previous episodes.
Explanation: Your symptoms of heavy bleeding, characterized by large clots and the need to change pads every few hours, indicate a condition known as menorrhagia. This can be attributed to various factors, including hormonal imbalances, uterine fibroids, or other underlying issues. Given your history of prolonged bleeding and the need for medications like tranexamic acid, it's crucial to ensure that your condition is monitored closely.
Considering you have already tried medication and the bleeding has persisted for two weeks, here are the prioritized actions you can take:
Next Steps:
-
Evaluate Immediate Symptoms: If you experience dizziness, lightheadedness, severe cramping, or an increase in the amount of bleeding (soaking through pads in an hour or less), you should seek emergency care promptly. These could be signs of significant blood loss requiring urgent evaluation.
-
Keep Track of Your Symptoms: Document the frequency and amount of bleeding, any associated symptoms (like pain or dizziness), and how often you are changing pads. This information will be helpful for any healthcare professional you consult.
-
Consider Over-the-Counter Options: Continue using ibuprofen as you've been doing, but ensure to stay hydrated and rest. If you haven't seen improvement in your bleeding after a few days, consider using tranexamic acid again as directed.
-
Follow Up with a Healthcare Provider: While appointments may be difficult to secure, persist in trying to reach out to your university clinic or look into off-campus clinics that may have availability. Explain your urgency due to ongoing heavy bleeding when requesting an appointment.
-
Explore Hormonal Birth Control: Though you express caution about starting birth control pills without understanding the underlying cause, hormonal contraceptives can often help regulate menstrual cycles and reduce heavy bleeding. Discuss your concerns with a healthcare provider for personalized advice.
Taking these steps can help you monitor your condition and seek appropriate care if necessary. Your health is important, and addressing these symptoms is a positive step toward understanding your situation better. If you notice any alarming changes, please do not hesitate to seek immediate medical attention.
Related Questions
Assessing My Health Concerns: How Anxious Should I Be?
I’m a 32-year-old woman, weighing 124 pounds and standing at 5 feet 6 inches tall. For over a year, I have been experiencing bright red rectal bleeding. Initially, I attributed this issue to hemorrhoids that developed during my pregnancy two years ago. The bleeding occurs with most of my bowel movements, sometimes happens without one, and on a few occasions, has been enough to stain the toilet bowl significantly. The color of the blood is typically darker than what I observe during a hemorrhoid flare-up. There is a notable family history of bowel cancer on both sides; one family member was diagnosed at age 45, and another at 60. In the past six months, I have encountered several episodes of severe abdominal pain—3 to 4 instances—intense enough to consider a trip to the emergency room. However, the pain usually subsides within about an hour. It’s unusual for me to experience such acute pain, given my high tolerance for discomfort; for example, I once played rugby shortly after dislocating and fracturing my finger. Recently, I mustered the courage to consult with my doctor, who recommended a FIT test, which returned a positive result (30.1). Additionally, I underwent a complete blood test, and aside from having low ferritin levels (7 µg/L), all other results were normal. I have since been referred for a colonoscopy on a two-week waiting list to rule out any possible bowel cancer. Given these circumstances, how concerned should I be? Thank you for your input.
Understanding Possible Seizure Triggers and Recurrence Risks
Health Background: I am a 21-year-old female, standing at 169 cm and weighing 65 kg. Over the past three years, I have been using oral contraceptives. As of this morning, I started taking 25 mcg of levothyroxine along with a weekly vitamin D supplement of 0.266 mg. Recently, I was diagnosed with hypothyroidism and found to have a vitamin D deficiency that I suspect has existed for the last three years. I do not consume alcohol or smoke, and I can confirm I am not pregnant. Two years ago, I experienced a mild concussion. I currently reside in Spain. A couple of months back, in mid-December, I blacked out twice. The second occurrence took place while I was at the doctor’s office after seeking urgent medical care for the initial incident. Following the second episode, I underwent a CT scan and an EKG, both of which returned normal results. Further tests, as directed by my physician, revealed a critical vitamin D deficiency and hypothyroidism; however, he expressed doubt that either of these conditions led to my loss of consciousness. I was then referred to a neurologist, and I am presently awaiting an appointment. Although the waiting period is lengthy, my doctor indicated that I should receive priority for scheduling, although the exact timeframe remains uncertain. The referral document summarized my events, labeling the second episode (which the physician witnessed) as a potential seizure devoid of tonic-clonic movements—a revelation that took me by surprise. After regaining consciousness, I felt extremely disoriented and terrified, struggling to process what was happening. I have no prior history of seizures, epilepsy, or any related conditions, and there is no known family history of these issues. If this indeed was a seizure, what might have triggered it? Additionally, what is the likelihood of experiencing another one? Since that time, I have not had any further incidents, but I have experienced moments where I felt a sense of impending doom, which I managed to overcome. I intend to wait for the neurologist's evaluation, but the uncertainty surrounding a possible neurological condition is quite distressing. Thank you for any insight you can provide!
Persistent Pain in Right Shoulder and Arm After Lifting
Hello, everyone! I’m a 23-year-old male and have been engaged in weightlifting for several years now. Recently, I’ve been struggling with ongoing discomfort in my right shoulder and arm, which I haven’t been able to accurately identify. The pain manifests during particular movements, especially with lateral raises or when my arm is raised to shoulder level while rotating my wrist. Certain pressing and pulling activities can also provoke this discomfort. Rather than feeling sharp, it’s a deep, nagging sensation that sometimes seems localized in the front area of the shoulder or at the biceps tendon, and at other times it feels more like it’s situated between the shoulder and upper arm. Fortunately, there’s no numbness or tingling involved. This issue began while I was working out. I decided to take a break for around two months, but when I returned, the pain persisted. After consulting a physician, I was diagnosed with bicipital tendinitis. Since then, I’ve reduced my upper-body workouts, completely steering clear of shoulder exercises and heavy lifting, and have begun a gentle rehabilitation regimen focusing on external rotations, pendulum movements, and scapular exercises. Despite adhering to this routine for about a week, I haven’t experienced any noticeable improvement. Is it typical for this type of tendon injury to require an extended period for recovery? At what point should I consider diagnostic imaging, such as an ultrasound or MRI? Additionally, are there frequent rehabilitation errors that might impede the healing process? I appreciate your insights in advance!
Understanding EEG Results for My 22-Month-Old Son: Insights Needed
Could someone help clarify this for me? My son, who is just 22 months old, hasn’t started walking yet, becomes tired easily, and has been experiencing behavioral outbursts. He had a febrile seizure in February 2025, followed by another unexplained seizure in April 2025, which led us to consult a neurologist. Since he was 3 months old, he has been receiving therapy from a physical therapist for torticollis. At birth, he spent five days in the NICU due to issues with meconium aspiration. A recent MRI showed normal results, and he also had a follow-up EEG after one conducted in July 2025. The results from this recent EEG were abnormal for a pediatric patient in awake, drowsy, and sleeping states. Notably, there were brief episodes of left frontotemporal delta slowing, which occurred mainly when he was awake and drowsy. There were no signs of epileptiform activity detected. In contrast, the EEG performed back on July 3, 2025, was deemed normal for both awake and drowsy states, again with no evidence of epileptiform irregularities, although it did not capture any sleep data. This examination was prompted by the child's existing history of febrile seizures. Importantly, he is not currently on any anti-seizure medications. The EEG procedure used standard electrode placements per the 10-20 system, conducted a single-lead EKG, and included continuous video monitoring. During the analysis, the background activity was symmetric, indicating some anterior-posterior (AP) organization, with a dominant rhythm of 50-80 microvolts at 7 Hz. His drowsy state was marked by a reduced amount of eye blink activity, less breathing motion interference, and a generalized slowing in theta/delta frequencies. Stage II sleep exhibited spindles and vertex waves patterns. Additionally, there were intermittent bursts of 250-300 microvolts in the left frontotemporal region with semi-rhythmic activity of 2-4 Hz, mostly observed during wakefulness and drowsiness. No definitive epileptiform discharge was noted. Photic stimulation during the test did not elicit a strong response, and hyperventilation was not conducted during this session.
Understanding Atrial Fibrillation and Thyroid Issues: Variability in Cardioversion Decisions
Hello everyone, I’m reaching out for guidance regarding my mother’s current health situation, and I’d greatly appreciate any shared experiences or thoughts. **My mother's background:** - **Age**: 55 years - **Weight**: Recently dropped to 116 kg from 118 kg in just two days, likely due to diuretics. - **Health history**: Previously an underactive thyroid, undiagnosed and untreated, now presenting as overactive. - **Medications**: Currently taking thyroid medication and a beta-blocker (Rapiblock). **Current health status:** My mother has been hospitalized since Tuesday, experiencing **atrial fibrillation with heart rates exceeding 200** beats per minute due to her thyroid's hyperactivity. - The plan for cardioversion was initially settled on Tuesday. However, the following day, the medical team advised postponing it until her thyroid levels could be stabilized, believing that her heart rate would return to normal once her thyroid condition was managed. - Her **obesity** precludes her from undergoing a transthoracic echocardiogram, and due to her thyroid concerns, she cannot handle contrast dye (this has been a consistent issue for over four years). Therefore, the only feasible option was a **transesophageal echocardiogram (TEE)**, which has yet to be performed. - She has been prescribed various medications including beta-blockers and thyroid treatments in the past. - On Friday, a doctor proposed proceeding with cardioversion; however, the attending senior physician objected. - Today (Saturday), another clinician has expressed a desire to move forward with cardioversion, having initiated a new medication, as the senior physician is unavailable. - **Communication has been unclear**, as we were notified of developments by a nurse rather than the physician in charge, causing confusion and anxiety. - Currently, only a **chest X-ray** is scheduled, and the TEE remains unaddressed. **My inquiries are as follows:** 1. Is it common for medical professionals to have varying opinions and frequently revise medication or treatment plans like cardioversion? 2. Is it safe to conduct cardioversion in the absence of a TEE? I presumed that this was a standard procedure to exclude the presence of blood clots. 3. Is it usual practice to have only a chest X-ray prior to moving ahead with cardioversion? 4. How typical is it for patients or their families to not be directly informed about treatment changes and learn about them through nursing staff instead? I recognize that this cannot substitute for professional medical advice. I’m simply trying to discern whether these circumstances are typical or if we should express our concerns more assertively with the healthcare facility. Thank you for your insights!