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Having irregular and delayed periods. Having continuous bleeding with clots from very long. Suggested Depo shot. Advise?

Mar 2013
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Practicing since : 1998
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I am 35, F and have had regular periods my whole life up until the past 2 years. The went from 28 days like clockwork to 4-6 months with no period then a very heavy and painful period. I recently started bleeding the 30th of XXXXXXX and it's 9/11 I'm still bleeding. It varies in color from bright red, dark brown/burgundy and light pink. I am passing clots larger than a quarter and just feel run down. My doctor wants me to get the depo provera shot but I'm unsure of this. Any advice would be appreciated. Thank you. I would prefer a gyno but that choice hasn't been given to me.
Posted Tue, 1 Oct 2013 in Women's Health
Answered by Dr. Aarti Abraham 2 hours later
Brief Answer:

Detailed Answer:
Thanks for writing to us with your health concern.

I am a gynaecologist and would be glad to assist you with your concern.
Generally antipsychiatric medications alter your menstrual period, they cause delayed / absent periods.
So the delayed periods ( 4- 6 months without a proper period ) would be explained by the intake of the medications you mentioned.
However, the continuous bleeding from XXXXXXX end till now needs to be investigated.
The most likely cause would be hormonal imbalances, which cause thickening of the lining of the uterus ( endometrial hyperplasia ), and then the lining of the uterus gets shed off erratically and you bleed off and on.
Other equally likely possibilities are a fibroid ( benign tumour ) in the uterus, adenomyosis ( thickening of the wall of the uterus ) and cervical or endometrial polyps.

If a patient with such continuous bleeding comes to me, firstly I would order a complete blood panel (complete blood count, bleeding and coagulation profiles, renal and liver function tests, thyroid function tests , blood sugars ) to check if there is any abnormality there.
Also, a thorough XXXXXXX examination ( per vaginam and per speculum ) would reveal any local causes of the bleeding.
Most important would be to get a transvaginal pelvic ultrasound done - that would help to pinpoint the diagnosis.
Please get this workup done.

Meanwhile, Depo Provera would work for the above mentioned conditions ( endometrial hyperplasia, fibroids, adenomyosis etc ) and reduce the bleeding due to them.
Once you get the ultrasound and work up done, I would be able to tell you if you should go for it.
Please do get back with any further follow up questions.

I would be happy to address them.
All the best.
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