What causes prolonged menstrual bleeding?

Question

Hello doctor,

I am experiencing prolonged bleeding. I am on my eleventh day of my period, but the bleeding is still ongoing, and it is heavy. I have lower abdomen pain and back pain. This is the first time I am having prolonged bleeding; otherwise, I have a normal three to five-day period.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

The possible causes of heavy menstrual bleeding:

A foreign body that can be polyp or IUCD (intrauterine contraceptive device) for the first three to four days after insertion.
Fibroid, the most common type of fibroid that causes heavy bleeding are submucosal fibroid and intramural fibroid (because of distorting the uterine cavity).
Adenomyosis.
PID (pelvic inflammatory disease).
Bleeding disorder.
Thyroid disease.
Ovarian mass.

I have seen the ultrasound report (attachment removed to protect the patient’s identity). There was a small subcentimeter fibroid and evidence of adenomyosis.

CBC (complete blood count).
FT4 (free thyroxine).
TSH (thyroid-stimulating hormone).
Serum prolactin.

I would suggest medical management, as most cases of heavy bleeding should be managed medically for the first 3 months.

Tablet Tranexamic Acid 500 mg (antifibrinolytics), two times a day for five days.
Tablet Mefenamic acid 500 mg (nonsteroidal anti-inflammatory drug), two times a day for five days.
Tablet Norethisterone 5 mg (norethindrone acetate), three times a day for one month.

Consult your doctor and take the medicines accordingly.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.