[18F] Experiencing heavy menstrual bleeding with clots and new onset hot flashes

Patient Description

An 18-year-old female reports experiencing heavy bleeding and abdominal cramps with blood clots for the past two days, despite her period ending two days ago. She finds some relief from the cramps by taking two ibuprofen. Additionally, she has started experiencing sudden waves of hot flashes as of today and has noted significant weight gain recently. The patient also reports feeling unusually tired or fatigued, having increased cravings for sweets, and experiencing mood changes such as increased irritability or mood swings. She began taking ashwagandha four days ago at a dosage of 500mg. There is a family history of diabetes, but no other pre-existing conditions or chronic illnesses. Her menstrual history includes periods that typically last six days with a moderate flow. She is not currently taking any other medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Hormonal Imbalance: Sudden heavy bleeding, hot flashes, and mood swings can be signs of a hormonal imbalance. This can be caused by various factors, including stress, significant weight changes, or starting new supplements like ashwagandha. Hormonal imbalances can affect your menstrual cycle and cause symptoms like heavy bleeding and hot flashes.

    • Treatment: Hormonal imbalances are often treated with lifestyle changes, such as stress management, diet, and exercise. In some cases, hormonal therapy may be recommended by a healthcare provider.
  • Polycystic Ovary Syndrome (PCOS): PCOS is a condition that can cause irregular periods, heavy bleeding, weight gain, and hormonal symptoms like hot flashes and mood swings. It is often associated with insulin resistance, which could be relevant given your family history of diabetes.

    • Treatment: PCOS is typically managed with lifestyle changes, such as diet and exercise, and sometimes medications to regulate menstrual cycles and manage symptoms.
  • Uterine Fibroids: These are non-cancerous growths in the uterus that can cause heavy menstrual bleeding, cramps, and clotting. They can also lead to other symptoms like fatigue due to blood loss.

    • Treatment: Treatment options for fibroids include medications to control symptoms, non-invasive procedures, or surgery in more severe cases.
  • Endometrial Hyperplasia: This is a condition where the lining of the uterus becomes too thick, often due to hormonal imbalances, and can cause heavy bleeding and clotting.

    • Treatment: Treatment may involve hormonal therapy or procedures to remove the excess tissue.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Monitor Your Symptoms: Keep track of your bleeding, cramps, and any other symptoms using a journal or an app like MDandMe. This information can be very helpful for your healthcare provider.
  2. Stay Hydrated: Drink plenty of water to stay hydrated, especially if you are losing a lot of blood.
  3. Iron-Rich Diet: Consider eating foods rich in iron, such as leafy greens, beans, and lean meats, to help counteract any potential blood loss.
  4. Rest: Make sure to get plenty of rest to help your body recover.
  5. Over-the-Counter Pain Relief: Continue using ibuprofen for cramps, but follow the recommended dosage and consult a healthcare provider if you need to take it for an extended period.
  6. Avoid Triggers: If you suspect that ashwagandha or any other new supplement might be contributing to your symptoms, consider stopping it and see if your symptoms improve.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Severe or Uncontrollable Bleeding: If you are soaking through a pad or tampon every hour for several hours.
  • Severe Pain: If your abdominal cramps become severe and unmanageable.
  • Signs of Anemia: Such as extreme fatigue, dizziness, or shortness of breath.
  • Fever or Infection: If you develop a fever or signs of infection.
  • Persistent or Worsening Symptoms: If your symptoms do not improve or continue to worsen.

Remember, while this information can help you understand what might be happening, it is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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6 mo ago

People Also Ask


What could be causing heavy bleeding and abdominal cramps after my period has ended?

Heavy bleeding and abdominal cramps after a period can be caused by hormonal imbalances, uterine fibroids, or conditions like endometrial hyperplasia. It's important to consult a healthcare provider for a proper diagnosis.


How can hormonal imbalances affect my menstrual cycle and overall health?

Hormonal imbalances can lead to irregular menstrual cycles, heavy bleeding, mood swings, hot flashes, and weight changes. They can be caused by stress, weight changes, or new supplements, and are often managed with lifestyle changes or hormonal therapy.


What are the symptoms and treatment options for Polycystic Ovary Syndrome (PCOS)?

PCOS can cause symptoms like irregular periods, heavy bleeding, weight gain, and mood swings. It is often associated with insulin resistance. Treatment typically involves lifestyle changes, such as diet and exercise, and sometimes medications to regulate menstrual cycles.


Can taking supplements like ashwagandha cause changes in my menstrual cycle or symptoms?

Supplements like ashwagandha can potentially affect hormonal balance and cause changes in menstrual cycles or symptoms. If you suspect a supplement is contributing to your symptoms, consider stopping it and consult a healthcare provider.


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