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Withdrawl bleed due to Oral contraceptives, hormonal imbalance, fibroids - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Women's Health
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1725 Questions
Doctor :   Hi
Doctor :  
How can I help you?
User :   I am an otherwise healthy 28 year old married women who has had 3 successful non-complicated pregnancys. I have been on birthcontrol for just under a year since the birth of my son in October 2008. I was on AAAAAAA 30 but due to break through bleeding, ovarian cysts, and the discovery of a fibroid tumor I was placed on Ovcon 35. The first day of my last period was on or around September 1 and I just ended the 2nd week of my birth control pill pack last night. With the birth control I have usually regular periods with little to no cramping or pain. So here is my problem/question: Doctor :  
Our Doctors will be here to help you 24/7 and give instant advices
User :   Are we connected?
Doctor :  
Yes
Doctor :  
We are connected
User :   Did you see my previous post?
Doctor :   I just started reading and it disappeared as you moved out of the page

Doctor :  
Can you paste it again?
User :   Yes
User :   I am an otherwise healthy 28 year old married women who has had 3 successful non-complicated pregnancys. I have been on birthcontrol for just under a year since the birth of my son in October 2008. I was on AAAAAAA 30 but due to break through bleeding, ovarian cysts, and the discovery of a fibroid tumor I was placed on Ovcon 35. The first day of my last period was on or around September 1 and I just ended the 2nd week of my birth control pill pack last night. With the birth control I have usually regular periods with little to no cramping or pain. So here is my problem/question: User :   I was 3 days late on starting my pill pack this month, my husband and I had unprotected sex 2 days after my period ended and on the 3rd day I had one time where I had rather heavy bright red spotting and then nothing after. Now 3 days ago my husband and I had sex and the next morning I noticed bloody discharge. I figured it was simply from the sex the night before, but the bloody discharge has now turned into a full fledge period like bleeding that is a little heavier then my normal periods. For the past 48 hours I have also experienced additionial symptoms which may or may not be related: Doctor :  
Now let me read it
User :   * painful yet tolerable cramping that is pretty consistant but can have moments of increased discomfort
* frequent need to have a bowl movement which ends up usually not resulting in anything
* achy, crampy pain in my hamstrings which sometimes travels down to my calfs
* pelvic pain
* low back pain that is pretty consistant
* inguinal pain/discomfort

Most of this pain is pretty consistant & moderate but has moments where it is a little worse. I have to push it aside though as I have an 11 month old & work that requires my attention at the same time. I do not have insurance which is why I am here to get advice. If this is something potentially hormonal then I will deal with it and let it run its course. However if this is something that could be potentially dangerous then I may have no option then to go to an ER or find a way to see a doctor.
User :   ok
Doctor :  
This seems to be a withdrawl period from the Oral Contraceptive pill that you were late in taking it
Doctor :  
Now coming to the pain, what is the severity of the pain on a scale of 1 to 10, 1 being the least
User :   Ok I have been late with this pill other times sometimes later then 3 days where I double up till I am back on track and this kind of thing has never happened before.
User :   As far as pain I would say a 4 on a constant basis and it spikes up to a 7-8
Doctor :  
Are you more worried about the pain or the bleeding?
User :   Both only because the pain is worse then my normal period and the bleeding is slightly heavier
Doctor :   Did the period stop completely or not?

Doctor :  
Sorry the bleed*
Doctor :  
Did the current bleed reduce or stopped?
User :   The period that happened on or around September 1 started and lasted about 6 days which would have been my regular period. It then completely stopped and now I am bleeding again
User :   The main 'pain' that I have constantly is the low back pain & the abdominal/pelvic cramping/pain.
Doctor :   Ok did you take any medicine for the current pain

User :   I have been taking Advil and that takes the edge off the pain
Doctor :  
What dose and how many times?
User :   Also the cramping at times is very similiar to the cramping one would get when they needed to have a bowl movement.
User :   I have been taking 3 tablets about ever 4-6 hours
Doctor :   Is it 200mg or 400mg

User :   200mg
Doctor :  
Please wait I am once again going through your history
User :   ok
Doctor :  
How many pads were you using per day right now because of this bleeding?
User :   I am using tampons and I am having to change it about every 2-3 hours
Doctor :  
Ok after your going through your history and asking you few related questions I have few reasons
Doctor :  
1) Hormonal cause 2) Withdrawl bleeding
Doctor :   Since the flow of the bleed is copious I suggest you to see the ER to stop the bleeding

Doctor :  
Same time ADVIL should help you in relieving the symptoms
Doctor :  
but ADVIL cannot help in control of bleeding moreover it can increase the bleeding
User :   Would you think that any of this would be life threatning if I were to wait to see how long the bleeding lasts?
Doctor :   3) Fibroids can cause severe cramping and bleeding
Doctor :  
So these are the probable reasons I could think of immediately
User :   My thoughts were leaning towards either my ovarian cysts or the fibroid tumor but I do not know enough about them to know if I should be concerned.
Doctor :  
The next step of management is to control the bleeding which is profuse and you had to use the tampons every 3 hours
Doctor :  
The next reason of getting physical examination is the pain
Doctor :  
Now answering to your question, Waiting is not a good idea since it is already more than 48 hrs
Doctor :  
since you are bleeding
Doctor :  
Ovarian cysts are the reason for Hormonal imbalance
Doctor :  
Fibroid are the one of the most common reasons for interrupted vaginal bleeding and cramping
Doctor :  
sorry interrupted*
User :   Can either of those be life threatning?
Doctor :   They are not lifethreatening per se, but bleeding endless can prove so
Doctor :  
It reduces your performance as you go anemic
User :   Would there be any chances of my body throwing a clot?
Doctor :  
and it takes lot of time to recover once you go anemic
Doctor :  
Actually you should pass clots by now since it is been more than 48 hrs
Doctor :  
and you should not be surprised if you do not pass any
Doctor :  
since the fibroids are too vascular to bleed endless
User :   As I said before I have no insurance and no money for an ER bill. My husband wants to make sure this is something that I can't stop on my own before incurring a potentially large medical bill.
Doctor :  
I understand that but you can atleast visit an Urgent clinic nearby
User :   As far as the clots, I meant 'throwing' a clot like to my heart, lung, or brain...
Doctor :  
Which area do you belong to
User :   area?
Doctor :  
Yes
User :   I am in South Florida, Royal Palm Beach
Doctor :  
Your zip code
User :   33412
Doctor :   Do you have any urgent care of Low cost clinics where you can get a GP

User :   There is a urgent care walk in but to be seen without insurance is $175+
Doctor :   Search if there is one in this list where you can get easily
User :   I am able to get full coverage Medicaid but I would have to have a medical bill equaling $2600+ before it would kick in. I am not sure if a visit to an ER would be that expensive...if I thought it would be at least that much then I would go right away to the ER.
Doctor :  
But being a mother of a baby ( infant) getting an medicaid is always recommended
Doctor :  
that too having Fibroids which may bleed at any given time
Doctor :  
They may regress after sometime
Doctor :  
but their potency of bleeding is more during and after pregnancy
User :   I was on Medicaid while I was pregnant but my 'full' coverage ended the end of 2008. Now all I can get is 'Share of Cost/Medically Needy' Medicaid which is where that $2600 limit comes in. Once that limit is at least met then Medicaid covers that cost plus I would have full coverage for the rest of the month. It is just having a medical meet that $2600.
User :   How could the ER stop the bleeding?
Doctor :  
But if these problems set in it may happen time and again
Doctor :  
With coagulants and Uterine Relaxants
User :   There would be no chance that I would be having an ectopic pregnancy right?
Doctor :  
Since you are on Birth control pill the chances are less
User :   If I have a rupturerd ovarian cyst would I bleed or just have the pain?
Doctor :  
Pain is the predominant symptom
User :   I have had a ruptured one before and the pain is similiar but this time there is the bleeding.
User :   ok
Doctor :  
Was it a submucosal or Endometrial type of fibroid, any idea?
User :   When the doctor explained to me I understood it to a fibroid inside the uterus.?.
Doctor :  
ok
Doctor :  
Actually it is tough to interpret without examination in these kind of uninterrupted bleeding
Doctor :  
and pain
User :   Is one worse then the other?
Doctor :  
These kind of fibroids tend to present with bleeding than cramps
Doctor :  
There are others which bother with pain like serosal
User :   ok. I will present this information to my husband. Are there any other symptoms that I should look out for that would indicate my situation getting worse? Are there symptoms for anemia?
Doctor :  
Tiredness, short of breath are long term symptoms of anemia
Doctor :  
Just you can look at the inside of the lower eye lid if it is pale then anemia is a possibility
Doctor :  
If the bleeding keeps worsening you have to rush to ER
Doctor :   My advice is to knock the door of ER before it worsens
User :   Of course you wouldn't be able to answer this potentially but to throw it out there do you think from your experience that I would meet or exceed that $2600 for Medicaid by going to the ER? If I can tell my husband this then he would let me go..otherwise he would insist on my waiting to see if it gets worse or goes away on its own.
Doctor :  
It could be less than 2600 USD
User :   ok. I greatly appreciate your help and advice. I will talk to my husband and see what I can do.
Doctor :  
Ok
Doctor :  
Is there anything else I can help you with?
User :   No I don't believe so. Thank you very much for the link for the clinics hopefully one of those I would be able to go to.
Doctor :   Please fill the feedback form say done when done.

User :   done
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.
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