[21F] Experiencing prolonged heavy menstrual bleeding with clots

Patient Description

A 21-year-old female reports a menstrual period lasting almost 3 weeks with variable flow, including episodes of heavy bleeding where an overnight pad is saturated within an hour. The patient also describes passing a very large blood clot one night, followed by small blood clots daily. She has experienced lower back pain for a week, which worsens with prolonged sitting and is alleviated by a heating pad or lying down. The patient has not reported lightheadedness, dizziness, shortness of breath, changes in weight or hair, or any known allergies or reactions to medications. No medications are currently being taken, and there is no history of recent injuries, surgeries, or chronic illnesses.

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Arora's Assessment

What might be happening

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

  • Menorrhagia: This is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. It can be caused by a number of factors including hormonal imbalances, uterine fibroids, polyps, or, in rare cases, a bleeding disorder.

    • Treatment often involves hormonal therapies such as birth control pills or an intrauterine device (IUD) that releases hormones. In some cases, surgical procedures may be required.
  • Dysfunctional Uterine Bleeding (DUB): This is a condition characterized by abnormal bleeding often due to an imbalance in hormone levels.

    • Treatment often involves hormone therapy or, in severe cases, surgical intervention.
  • Uterine fibroids: These are noncancerous growths of the uterus that often appear during childbearing years. They can cause heavy menstrual bleeding and pain.

    • Treatment can range from medication to manage symptoms to surgical removal of the fibroids.

Please note that these are potential explanations and not a diagnosis. You should consult a healthcare professional for a formal diagnosis.

What you can do

  1. Schedule an appointment with a healthcare provider: They can provide a formal assessment and order relevant tests if necessary. This may include a pelvic exam, ultrasound, or blood tests.

  2. Monitor your symptoms: Keep track of your menstrual cycle, how heavy your bleeding is, and any other symptoms you're experiencing. This information can be helpful for your healthcare provider.

  3. Over-the-counter medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help with menstrual cramps and decrease menstrual blood loss.

  4. Stay hydrated and maintain a healthy diet: Heavy bleeding can lead to iron-deficiency anemia. Eating foods high in iron and taking an over-the-counter iron supplement can help prevent this.

What you should look out for

If you experience any of the following symptoms, seek medical attention immediately:

  • Severe pain or cramping
  • Dizziness, fainting, or a rapid heartbeat
  • Bleeding that soaks through one or more pads or tampons every hour for several hours in a row
  • Signs of shock, such as cold and sweaty skin, irregular heart rate, and rapid breathing

Remember, I'm an AI and this advice is not a substitute for professional medical advice. Please consult with a healthcare provider for an accurate diagnosis.

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11 mo ago

People Also Ask


What causes prolonged menstrual bleeding?

Prolonged menstrual bleeding, also known as menorrhagia, can be caused by hormonal imbalances, uterine fibroids, polyps, or bleeding disorders. It is important to consult a healthcare provider for a proper diagnosis.


How can heavy menstrual bleeding be managed?

Heavy menstrual bleeding can be managed with hormonal therapies such as birth control pills or an IUD that releases hormones. NSAIDs like ibuprofen can help reduce blood loss and alleviate cramps. In some cases, surgical procedures may be necessary.


What are uterine fibroids and how do they affect menstrual cycles?

Uterine fibroids are noncancerous growths in the uterus that can cause heavy menstrual bleeding and pain. They are common during childbearing years and can be managed with medication or surgically removed if necessary.


When should I seek immediate medical attention for menstrual bleeding?

Immediate medical attention should be sought if you experience severe pain, dizziness, fainting, rapid heartbeat, or bleeding that soaks through one or more pads or tampons every hour for several hours. These could be signs of a serious condition.


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