Struggling with Bleeding and Pain Since Christmas
I'm a 27-year-old woman from the UK, and I've reached a point of exasperation. I'm reaching out because I hope someone can provide insight or guidance on what I should discuss with my doctors. Please excuse any grammar or spelling errors as I have dyslexia. I've been diagnosed with endometriosis and underwent surgery in 2022 for confirmation of that diagnosis. On December 15th, I had my birth control implant removed after nearly two years. During that period, I experienced severe menstrual cramps and PMS. My GP started me on Drospirenone 3mg and Estetrol 14.2mg COCP in October to alleviate these symptoms and suppress my periods, which provided some relief. Prior to this situation, I occasionally dealt with flare-ups that typically lasted a few days or up to a week. To help manage the discomfort, I have been prescribed Duloxetine at a dosage of 90mg. I had an ultrasound earlier this summer, and the results came back normal. Currently, I am awaiting an MRI. Last year, my smear test results were also clear. After the removal of my implant in December, I began bleeding on Christmas Eve. Initially, I could manage with just a panty liner, but over the next few weeks, the bleeding intensified, requiring the use of pads due to increased blood flow and blood clots. Given my history with endometriosis, pain isn't unfamiliar to me; my average pain level is around a 4, but it has recently escalated to 7 or 8. In the past couple of weeks, the discomfort has worsened. My job demands physical activity, and bending over now causes pain in my back and legs. Additionally, I experience discomfort when my bladder fills, and urination is painful, although it doesn't feel like a urinary tract infection. I've also been waking up at night to use the restroom. My doctor performed a urine dip test that showed no signs of infection, though there was blood in my urine, which he indicated was to be expected. Recently, my GP prescribed Tranexamic acid 500mg and Mefenamic acid 500mg, which helped with the blood clots, but I'm still experiencing bleeding and significant pain. I've been diligent about taking my medication, treating it like a strict regimen. I returned to the GP, who referred me for another ultrasound and advised me to go to A&E if the pain worsens. I've been resting as much as possible while still trying to maintain some level of activity, but it hasn't provided much relief. Any assistance or advice would be immensely appreciated! Thank you!
Answers (1)
2/7/2026, 8:40:30 AM
OpenHealth AI
I'm sorry to hear about the challenges you're facing with escalating pain and bleeding, particularly considering your history with endometriosis. It’s important to address both your immediate symptoms and the underlying causes. Here’s a structured approach to help you navigate this situation more effectively.
Key Points:
- Recent Changes in Symptoms: The worsening bleeding and pain after stopping hormonal birth control can be significant, especially for someone with endometriosis.
- Management of Pain and Symptoms: You have medications prescribed, but their efficacy seems limited given your current experience.
- Next Steps: Focus on symptom management while awaiting further evaluations such as the MRI and follow-up ultrasounds.
Explanation:
The removal of your birth control implant can lead to hormonal changes that may exacerbate endometriosis symptoms. Increased bleeding and pain may indicate the endometriosis affecting surrounding tissues, or other complications like adenomyosis, where the tissue grows into the uterus's muscle wall.
Your medical background and the ongoing symptoms suggest that careful monitoring and potentially adjusting your treatment plan is necessary. It's good that you're following your medication regimen and that your doctor is aware of your condition.
Actionable Next Steps:
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Monitor Symptoms: Keep a detailed diary of your symptoms, including pain levels, bleeding patterns, and any activities that trigger discomfort. This will provide valuable information for your healthcare team.
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Adjust Pain Management: Consider discussing with your GP about possibly increasing the dosage of pain medications if they are not providing sufficient relief. You might also ask about the possibility of additional treatment options specific for endometriosis, such as hormonal therapies aside from what you've tried or pain management specialists.
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Manage Daily Activities: Since physical activity exacerbates your pain, find ways to modify your tasks. Focus on gentle stretches or low-impact activities that won’t aggravate your symptoms. Whenever possible, take breaks to rest.
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Communicate Urgently: Since your symptoms are severe, don’t hesitate to return to your GP or A&E should your pain worsen disproportionately, or if new symptoms (like increased blood in urine, severe headaches, etc.) arise.
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Explore Support Options: Consider connecting with support groups for others with endometriosis for emotional support and practical advice. Sometimes, sharing experiences can lead to better coping strategies.
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Follow-Up the MRI and Ultrasound: Ensure to schedule follow-ups promptly once you have results from the MRI and ultrasounds. Discuss their findings with your doctor comprehensively, which may guide further treatment.
Remember that managing endometriosis can often require a multi-faceted approach and sometimes takes time to find what works best for you. You're doing all the right things by seeking help and managing your health closely. If you have further concerns or unclear aspects, feel free to reach out for more personalized guidance.
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