1. Women’s Health Issues

Menstrual Bleeding Problems

Menstrual bleeding usually lasts from 2 to 7 days. It occurs about every 28 days.



Signs & Symptoms

  1. •Spotting of blood between periods.

  2. •Menstrual periods that occur more often than every 21 days or less often than every 35 days.

  3. •Periods last longer than 7 days.

  4. •Two or more times the average amount of blood is lost during a period.

  5. •A tampon or a sanitary pad is soaked through every hour for 6 hours in a row.



Causes

  1. •It is normal for changes to occur at certain times. This includes: When monthly periods begin; during peri-menopause; and when some birth control methods are started, stopped, and changed.

  2. •Light bleeding can occur for 2 to 3 days when you ovulate. This is usually normal, too.

  3. •Starting or stopping estrogen therapy. Using an IUD for birth control.

  4. •Weight gain or loss. Too much exercise. Anorexia nervosa.

  5. •Vaginal irritation or infection.

  6. •Endometriosis. Fibroids. Ovarian cysts.

  7. •Ectopic pregnancy. Miscarriage.

  8. •Cancer of the cervix or uterus.

  9. •Hypothyroidism. Pituitary and adrenal gland disorders.

  10. •Side effects of blood-thinners or corticosteroids.

  11. •Bleeding or clotting disorders. One example is Von Willebrand disease. This is a genetic bleeding disorder. Often, it is not diagnosed. Bleeding is excessive with menstrual periods and after surgery, dental work, etc. Nosebleeds occur often. Bruises occur easily.

  12. •Polycystic ovarian syndrome (PCOS). This is caused by an excess of a certain hormone. It can result in irregular periods or no periods.



Treatment

  1. •Iron supplements to treat anemia, if present. (See Anemia.)

  2. •Medicines. Examples are birth control pills; GnRH agonists; Danazol (low dose); and a medicine called tranexamic acid.

  3. •Surgery, as needed, for the cause of the problem.

Self-Care / Prevention

  1. •Keep track of how many days and how much you bleed to know what is normal for you.

  2. •Change tampons and sanitary napkins as needed. Note if they are soaked through.

  3. •Avoid stress and physical exertion that lead to increased bleeding.

  4. •Don’t have too much alcohol.

  5. •Take ibuprofen or naproxen sodium as directed. Don’t use aspirin. It can prolong bleeding. Take iron, as advised by your doctor.

  6. •If you have an IUD, check it as advised to make sure the strings can be felt. If Depo-Provera or an IUD cause bleeding problems, change birth control methods.

  7. •Don’t have sex until treatment is done. Follow your doctor’s advice.

  8. •To prevent vaginitis from vaginal dryness, use a prescribed estrogen cream, as needed.

Could you be pregnant? If so, do you have any of these problems?

  1. •Sudden fainting.

  2. •Abnormal vaginal bleeding. This can range from spotting that persists to bursts of bleeding.

  3. •Severe cramping in one side of your lower abdomen.

  4. •Sharp pains in one side of your lower abdomen, rectum, or shoulder.

With irregular menstrual periods, do you have any of these problems?

  1. •Nausea, vomiting, or pain is worse than with normal periods.

  2. •Periods are heavier than normal or last longer than 10 days.

  3. •After taking birth control pills for 3 months, you bleed more or you keep bleeding or spotting between periods.

With irregular menstrual periods, do you have any of these problems?

  1. •Your abdomen is tender and/or bloated.

  2. •Pain in your pelvis or back.

  3. •Pain during sex.

  4. •The skin on your abdomen feels sensitive.

  5. •Vaginal discharge with abnormal color or odor. This occurs when you are not having a period.

  6. •Change in menstrual flow.

  7. •Fever. Chills.

Do periods return after not having one for 6 months?

With menstrual bleeding, do you have any of these problems?

  1. •Pelvic pain is much worse than normal or causes you to double over.

  2. •The bleeding is heavier than normal.

  3. •You feel dizzy, faint, or lightheaded when you sit up.

Questions to Ask