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What Causes Prolonged Menstruation?

Posted on Tue, 14 Oct 2014

Question: hi this question is in regards to my 13 year old godchild, she started her cycles last year she would bleed for 10 days at a time and having 2 in one month.She was hurting so went to hospital then and they told her mom that nothing was wrong, in July of this year she started hurting really bad again so her mom brought her to hospital again at that time they saw her potassium was high so they thought it was appendix and went to do surgery to take it out when they went in they saw a pool of blood at bottom of stomach and told her mom they cleaned it out. They seem to think she had an ovarian cyst rupture and that's what caused the bleeding. her mom took her to ob/gyn because hospital told her that her ovaries didn't look good., ob/gyn put her on birth control last month on the 19th and told her mom that it could take up to three months to start working, Here is the problem: she started on Sept 5 and is still bleeding today so that makes a total of 17days on a cycle or what we think is a cycle.. we really looking for some advice and answers as to what could be causing this and if we are maybe missing something. please help me to be able to help my godchild. thank u

Answered by Dr. Arun (1 hour later)

Brief Answer:
It will settle soon , continue meds

Detailed Answer:
HI
Thanks for writing to us.
This prolonged leeding is Dysfunctional uterine bleeding or menorrhagia which is common between 11 to 14 years.
In the first 2 years after menarche, almost 70% of cycles are anovulatory, and by the fourth and fifth year this decreases to 20 % of cycles being anovulatory. Approximately 95% of dysfunctional uterine bleeding in adolescents is due to anovulation.

Without ovulation, progesterone is not subsequently produced from the corpus luteum of the ovary. This leads to a state of unopposed estrogen. Unopposed estrogen stimulates endometrial growth, which ultimately outgrows its blood supply. The endometrium becomes excessively thickened and unstable, and the lining breaks down irregularly and unpredictably. This leads to heavy bleeding and prolonged menstruation.

Birth control pills are the best way to treat this problem.

But if no improvement on this, other causes like low platelets, coagulation disorders, VWF factor deficiency should also be ruled out.

Regards

Dr Arun

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Arun (35 minutes later)

thank you for response. is this type of birth control safe and would be the best one for her age and problem. I noticed this type says not to take if you have unexplained bleeding from that area can u help me better understand this

Answered by Dr. Arun (21 minutes later)

Brief Answer:
yes it is safe

Detailed Answer:
Hi,
Yes birth control pills are very safe.
Hormonal treatment is the most effective therapy, with more than 90% of adolescents responding to some form of hormonal treatment.Estrogen provides hemostasis and progesterone stabilizes the endometrium. The easiest way to administer these hormones is by use of combined oral contraceptive pills (OCPs).
Regards

Above answer was peer-reviewed by : Dr. Raju A.T