[20F] Experiencing continuous light vaginal bleeding on birth control

Patient Description

A 29-year-old female has been experiencing continuous light vaginal bleeding for approximately two weeks, following a three-day break after her period. The patient conducted a pregnancy test, which returned negative. The bleeding began as spotting and then slightly intensified, with a cessation yesterday before resuming this morning. The patient has noticed changes in the color and consistency of the blood but reports no severe abdominal pain, dizziness, severe headaches, or changes in vision. She mentions a slight increase in fatigue, potentially attributed to poor sleep rather than the bleeding itself. There is no known family history of bleeding disorders or other gynecological issues, and the patient does not have any pre-existing conditions. The only medication being taken is YAZ, a birth control pill, for almost a year without any noted side effects. No other medications, including over-the-counter drugs, supplements, or herbal remedies, are being used.

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Arora's Assessment

What might be happening

Based on the information you've provided, you're experiencing a condition known as breakthrough bleeding, which is vaginal bleeding or spotting that occurs between menstrual periods or while you're on birth control. This can be a common side effect of hormonal contraceptives like YAZ, especially during the first few months of use. However, since you've been on YAZ for almost a year, it's less likely that this is the cause.

Other possible causes could include:

  • Hormonal Imbalances: These can occur naturally or as a result of certain medications, stress, significant weight changes, or underlying conditions.
  • Uterine Fibroids or Polyps: These are non-cancerous growths in the uterus that can cause irregular bleeding.
  • Infection: Infections of the vagina, cervix, or uterus can sometimes cause bleeding.
  • Pregnancy Complications: Although you've taken a pregnancy test and it was negative, it's still possible that this could be a sign of an ectopic pregnancy or miscarriage.

What you can do

Please consult with a healthcare provider as soon as possible. They can perform a physical examination and may order tests such as a pelvic ultrasound or endometrial biopsy to determine the cause of your bleeding.

In the meantime, keep track of your symptoms and any changes, as this information can be helpful to your healthcare provider.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe abdominal pain
  • Heavy bleeding (soaking through one or more pads or tampons every hour)
  • Dizziness or fainting
  • Fever or chills

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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7 mo ago

People Also Ask

What is breakthrough bleeding and why does it occur?

Breakthrough bleeding is vaginal bleeding or spotting that occurs between menstrual periods or while on hormonal contraceptives. It can be a common side effect of birth control, especially during the initial months of use, due to the body adjusting to the hormones.

Can hormonal birth control like YAZ cause irregular bleeding after long-term use?

While breakthrough bleeding is more common in the first few months of using hormonal birth control, it can still occur after long-term use due to factors like hormonal imbalances, missed pills, or interactions with other medications.

What are uterine fibroids or polyps, and how do they affect menstrual bleeding?

Uterine fibroids are non-cancerous growths in the uterus, and polyps are small, benign growths on the lining of the uterus. Both can cause irregular bleeding, heavier periods, or spotting between periods.

When should I seek immediate medical attention for abnormal vaginal bleeding?

Immediate medical attention should be sought if you experience severe abdominal pain, heavy bleeding (soaking through pads or tampons every hour), dizziness or fainting, or fever and chills, as these could indicate a more serious condition.

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