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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Heavy Continuous Bleeding, Long Lasting Periods, Dizziness, Headaches, Leg Cramps, Intense Weakness. Serious?

hi i am 36 female. for about 6 months i have had my period and they last for 25 days each month. i have every heavy bleeding with big blood clots. Lately i been very dizzy, been very cold , headaches , eating ice all day, leg cramps , pale, and very tired and weak. what should i do? do i go to er, urgent care or just doctors office? is this bad?
Fri, 18 Oct 2013
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General & Family Physician 's  Response
Hello mam!
25 days are very much to bleed for. this condition is called menorrhagia. As you stated it has been for the past 6 months. at this age of yours with previous healthy and regular periods it is suspected to be fibroids by me and all your symptoms are because you are losing blood. As eating ice( PICA) is the hallmark of iron deficiency anemia.dizzines fatigue etc all explained. there are a hell lot of causes for menorrhagia. to rule them out and finding for your cause i will advise these pattern of investigations.
A. Investigations
1. complete blood count
2.iron studies ( TIBC-total iron binding capacity, serum ferritin, serum transferin)
3.coagulation factors( expensive one to be used sparingly if needed)
4.HCG levels
5.Thyroid function tests
6.Lier Function tests
7.Renal function tests
8.Hormonal assay ( LH FSH) to rule out PCOS-poly cystic oarian syndrome
9.pelvic ultrasound
10.Sono hysterography ( saline infusion hyesterography)
11.hysteroscopy
(9-10- and 11 will help my suspected diagnosis of for your menorrhagia that is uterine fibroids)
12.Pap smear
13.Hysteroscopy
14.Endometrial biopsy

your problem will be dignosed with above 14 investigations. you can skip some amongst them.

Now lets start you on some treatment until you get diagnosed. that is treating you empirically

Tretment
1.Start Nsaids for your pain ASAP
2.Start using Oral contraceptive pills ( they will help your heavy bleeding stop)
3.GnRH Agonists like leuperolides
4.DAnazol
5, Conjugated estrogens
6. Tranexamic acids and vitamin k

If these medicines didnot help then next step will be surgery
1.Endometrial ablation techniques
2.Part of your uterus ( muscle in it) removed MYOMECTOMY
3. Complete removal of uterus last resort ( HYSTERECTOMY)

I will pray for you and will be here for you if you need me
Regards
Dr Shafi Ullah Khan
My Patient is my family
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Heavy Continuous Bleeding, Long Lasting Periods, Dizziness, Headaches, Leg Cramps, Intense Weakness. Serious?

Hello mam! 25 days are very much to bleed for. this condition is called menorrhagia. As you stated it has been for the past 6 months. at this age of yours with previous healthy and regular periods it is suspected to be fibroids by me and all your symptoms are because you are losing blood. As eating ice( PICA) is the hallmark of iron deficiency anemia.dizzines fatigue etc all explained. there are a hell lot of causes for menorrhagia. to rule them out and finding for your cause i will advise these pattern of investigations. A. Investigations 1. complete blood count 2.iron studies ( TIBC-total iron binding capacity, serum ferritin, serum transferin) 3.coagulation factors( expensive one to be used sparingly if needed) 4.HCG levels 5.Thyroid function tests 6.Lier Function tests 7.Renal function tests 8.Hormonal assay ( LH FSH) to rule out PCOS-poly cystic oarian syndrome 9.pelvic ultrasound 10.Sono hysterography ( saline infusion hyesterography) 11.hysteroscopy (9-10- and 11 will help my suspected diagnosis of for your menorrhagia that is uterine fibroids) 12.Pap smear 13.Hysteroscopy 14.Endometrial biopsy your problem will be dignosed with above 14 investigations. you can skip some amongst them. Now lets start you on some treatment until you get diagnosed. that is treating you empirically Tretment 1.Start Nsaids for your pain ASAP 2.Start using Oral contraceptive pills ( they will help your heavy bleeding stop) 3.GnRH Agonists like leuperolides 4.DAnazol 5, Conjugated estrogens 6. Tranexamic acids and vitamin k If these medicines didnot help then next step will be surgery 1.Endometrial ablation techniques 2.Part of your uterus ( muscle in it) removed MYOMECTOMY 3. Complete removal of uterus last resort ( HYSTERECTOMY) I will pray for you and will be here for you if you need me Regards Dr Shafi Ullah Khan My Patient is my family