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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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13 Year Old With Missing Menstrual Cycle. Stopped Birth Control Due To Thickened Uterus. Need To Be Worried?

I have a 13-year-old girl whose menstrual cycle has gone for 8 1/2 weeks now. She has been on birth control 2 per day for a week and still bleeding with abdominal pain. Her doctor told me that she has thickening of the uterus and today stopped birth control and put her on provera for 10 days. Do I need to be concerned about this?
Fri, 17 May 2013
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Pediatrician 's  Response
Hello:
The most common cause of continuous bleeding is due to low estrogens which make the endometrium (uterine lining) atrophic. A small amount of estrogen is needed to make the lining of the uterus repair the open blood vessels that result from a menstrual slough. After menses, estrogen alone in a normally ovulating woman not taking birth control starts the tissue growing again and to seal off the bleeding blood vessels. This makes bleeding stop. With birth control pills that have both estrogen (very small doses) and progestin in each pill, the progestin component works opposite the the estrogen and does not allow the endometrial tissue to grow and repair itself. If a woman is on a progestin only birth control pill, or using DepoProvera® which is pure progestin only, the same effect takes place, i.e., the endometrium may not totally repair its entire surface inside the uterus because of a lack of estrogen or the antagonism of the progestin working against any small amount of estrogen present in the woman's body.
Did she have a pregnancy test done?
I recommend you consult with a gynecologist.
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13 Year Old With Missing Menstrual Cycle. Stopped Birth Control Due To Thickened Uterus. Need To Be Worried?

Hello: The most common cause of continuous bleeding is due to low estrogens which make the endometrium (uterine lining) atrophic. A small amount of estrogen is needed to make the lining of the uterus repair the open blood vessels that result from a menstrual slough. After menses, estrogen alone in a normally ovulating woman not taking birth control starts the tissue growing again and to seal off the bleeding blood vessels. This makes bleeding stop. With birth control pills that have both estrogen (very small doses) and progestin in each pill, the progestin component works opposite the the estrogen and does not allow the endometrial tissue to grow and repair itself. If a woman is on a progestin only birth control pill, or using DepoProvera® which is pure progestin only, the same effect takes place, i.e., the endometrium may not totally repair its entire surface inside the uterus because of a lack of estrogen or the antagonism of the progestin working against any small amount of estrogen present in the woman s body. Did she have a pregnancy test done? I recommend you consult with a gynecologist.