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What Causes Irregular And Heavy Menstrual Bleeding In A 31 Year Old Woman?

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Posted on Mon, 4 Jul 2016
Question: im 31 years old women with two children aged 8 and 3. two months back i had a one day period only and the next month light periods for 10days followed by heavy clots bleeding. im bleeding since then (20days). Had a USG done, showed a small sized intramural fibroid. im having Tsh in normal limit and am on thyronorm 150mg. doctor prescribed crina NCr 10mg for 20 days. what should i do?will i be normal again...i didnt start the medicine prescribed yet.is this danger
doctor
Answered by Dr. Shanti Vennam (38 minutes later)
Brief Answer:
Hormonal imbalance is the likely cause.

Detailed Answer:
Hi,

Thanks for posting your query.

Your recent menstrual history suggests some hormone imbalance. This is often transient and is self-limiting. The fibroid as such cannot be the cause of this bleeding since it is small in size. Yet, if it is nearer to the endometrial surface or if there are associated endometrial polyps, it can be a cause for the bleeding.

Sudden weight disturbances, infections, stress or certain medications can cause this sort of menstrual aberration. I would also suggest a complete hormone profile to look for any other possible hormone deficiencies.

It is good that you are maintaining normal thyroid profile with medication and also there are no ovarian cysts. You can take the progesterone medication prescribed by your doctor. This should arrest the bleeding. If needed, you may also use styptics. You will then see withdrawal bleeding 3-7 days after completing the treatment and can expect normal cycles from then on. This is called a 'kick-back' treatment to the ovaries whenever they deviate from the normal path.

Please maintain a healthy weight, healthy diet and regular exercise.

Hope your query has been clarified. Please feel free to contact for further information. I will be happy to help.

regards,
Shanti.V.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Shanti Vennam (39 minutes later)
thank u ma'am for answering... i just forgot one more medicine prescribed i.e tamik BC. can i take this as well along with CRina NCR10mg. please advise for how many days should i take these medicines. im 80 kgs in weight and height 5feet.7inches. will thse add more weight to me. please tell me how long to take these medicines and when will the bleeding start. do i need to do a Hb test as well. you had mentioned some hormonal tests. kindly ellaborate which tests in particular to be performed.

thanks
doctor
Answered by Dr. Shanti Vennam (3 minutes later)
Brief Answer:
Detailed below.

Detailed Answer:
Hi,

Thanks for writing back.

Tamik BC is Mefenamic acid. This is not necessary with the hormone supplementation, unless you have associated pain. It may be used for a short period, but not prolonged as it tends to cause gastric discomfort. Styptics like Tranexamic acid and Ethamsylate are preferred to arrest the bleeding.

The progesterone supplement should be taken as advised. This ensures arrest of the bleeding.

You have a BMI of 27.68 as of now. Healthy BMI is between 19 and 25. If you can bring your weight down with diet and exercise, your hormone balance will be restored mostly. As you are taking the hormone medication only temporarily, do not worry about putting on weight.

You can get hemoglobin levels also tested. The hormones which need to be tested are FSH, LH, E2, Progesterone, serum Prolactin and serum DHEAS levels.

Hope this helps.

regards,
Shanti.V.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Shanti Vennam (54 minutes later)
maam....one last question before i end....



please advise the duration of the progestrone tablets to be taken....how many days....and whether the hormonal tests are to be performed during medication period or post that,. please advise, when will my bleeding stop finally.

thanks
doctor
Answered by Dr. Shanti Vennam (38 minutes later)
Brief Answer:
Hormone tests should be taken in the non-treatment period.

Detailed Answer:
Hello,

Thanks for writing again.

The progesterone should be taken for 20 days. Arrest of bleeding is usually seen within 2-3 days of initiation of medication if the dosage is sufficient. After completion of the course, withdrawal bleeding occurs after 3-7 days. This bleeding is mostly self-limiting and does not need any further medication.

Hormone essays are to be taken when there is no external hormone supply to the body, i.e., during the non-treatment period. You can wait until you complete the treatment. If your normal menstrual pattern is restored, you can put off these tests for the time being.

Hope all your queries have been answered. Please contact if you need any more help.

Wish you good health.

regards,
Shanti.V.
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. Sonia Raina
doctor
Answered by
Dr.
Dr. Shanti Vennam

OBGYN

Practicing since :1989

Answered : 7667 Questions

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What Causes Irregular And Heavy Menstrual Bleeding In A 31 Year Old Woman?

Brief Answer: Hormonal imbalance is the likely cause. Detailed Answer: Hi, Thanks for posting your query. Your recent menstrual history suggests some hormone imbalance. This is often transient and is self-limiting. The fibroid as such cannot be the cause of this bleeding since it is small in size. Yet, if it is nearer to the endometrial surface or if there are associated endometrial polyps, it can be a cause for the bleeding. Sudden weight disturbances, infections, stress or certain medications can cause this sort of menstrual aberration. I would also suggest a complete hormone profile to look for any other possible hormone deficiencies. It is good that you are maintaining normal thyroid profile with medication and also there are no ovarian cysts. You can take the progesterone medication prescribed by your doctor. This should arrest the bleeding. If needed, you may also use styptics. You will then see withdrawal bleeding 3-7 days after completing the treatment and can expect normal cycles from then on. This is called a 'kick-back' treatment to the ovaries whenever they deviate from the normal path. Please maintain a healthy weight, healthy diet and regular exercise. Hope your query has been clarified. Please feel free to contact for further information. I will be happy to help. regards, Shanti.V.