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Having Menstrual Bleeding From Very Long. Had Taken Contraceptives. Related?

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Posted on Sun, 22 Sep 2013
Question: Hi,

My menstrual cycle has been going on from over a month now. Someday the bleeding is heavy, someday I only observe spottings. I don't understand what is happening. I had taken contraceptive pill, but that was 4 months ago. Can that be the reason causing this?
I've taken a few pills in the past, but they have never affected me in anyway.
Please help!!

Thanks!
doctor
Answered by Dr. Aarti Abraham (12 minutes later)
Brief Answer:
DETAILED BELOW

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Taking the contraceptive pills 4 months ago would not cause this type of menstrual bleeding, if you have been alright in the interim period.
The commonest reasons that cause such a picture would be - emotional stress, anxiety, hectic travelling, fever, surgery, weight fluctuations that occur rapidly, change of place or altitude, exercise, being on birth control or other medications ( eg. antidepressants etc ).
If these are ruled out, then please consult a gynecologist, as it is not normal to continue spotting and bleeding for over a month.
If you are sexually active, this could indicate a pregnancy related complication like a miscarriage or rarely, ectopic pregnancy.
Thyroid and prolactin hormonal disturbances could cause this.
Polycystic ovaries and endometrial hyperplasia ( thickening of the lining of the uterus ) , as well as polyps in the cervix or uterus also can cause such conditions.
Being on blood thinners could cause such bleeding.
If such a patient comes to me for evaluation, I would firstly conduct a per speculum and per vaginum examination to rule out polyps etc.
Then I would recommend a pelvic ultrasound done transvaginally to check the endometrium and the ovaries and any other pathology.
Also, basic hormonal tests such as FSH, LH, TSH, prolactin, complete blood count, bleeding and clotting profile - should be done.
This workup should point to a diagnosis in your case.
Hope this answer helped you.
I would be happy to address any follow up questions should you have them.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Aarti Abraham (42 minutes later)
Hi XXXXXXX

Thanks for your help!

I am not sexually active from last 4 months. I had visited a gynecologist last week, and she suggested me to observe for another cycle.

Yes, I am on hectic travelling and exercise. But I haven't been exercising since the start of my menstruation.

After considering the above conditions, would you suggest me to wait and observe, or take up the tests like you mentioned?

doctor
Answered by Dr. Aarti Abraham (1 hour later)
Brief Answer:
DETAILED BELOW

Detailed Answer:
Hello
You visited a gynecologist as you mentioned.
Was an XXXXXXX examination or any kind of testing done ?
If it was not done, then yes, in view of the bleeding being continuous for a month,as you said, it is advisable to go for atleast XXXXXXX examination, ultrasound and blood tests.
Take care.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
Answered by
Dr.
Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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Having Menstrual Bleeding From Very Long. Had Taken Contraceptives. Related?

Brief Answer:
DETAILED BELOW

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Taking the contraceptive pills 4 months ago would not cause this type of menstrual bleeding, if you have been alright in the interim period.
The commonest reasons that cause such a picture would be - emotional stress, anxiety, hectic travelling, fever, surgery, weight fluctuations that occur rapidly, change of place or altitude, exercise, being on birth control or other medications ( eg. antidepressants etc ).
If these are ruled out, then please consult a gynecologist, as it is not normal to continue spotting and bleeding for over a month.
If you are sexually active, this could indicate a pregnancy related complication like a miscarriage or rarely, ectopic pregnancy.
Thyroid and prolactin hormonal disturbances could cause this.
Polycystic ovaries and endometrial hyperplasia ( thickening of the lining of the uterus ) , as well as polyps in the cervix or uterus also can cause such conditions.
Being on blood thinners could cause such bleeding.
If such a patient comes to me for evaluation, I would firstly conduct a per speculum and per vaginum examination to rule out polyps etc.
Then I would recommend a pelvic ultrasound done transvaginally to check the endometrium and the ovaries and any other pathology.
Also, basic hormonal tests such as FSH, LH, TSH, prolactin, complete blood count, bleeding and clotting profile - should be done.
This workup should point to a diagnosis in your case.
Hope this answer helped you.
I would be happy to address any follow up questions should you have them.