[21F] With prolonged menstrual bleeding and associated symptoms

What might be happening

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

• Hormonal Imbalance: Given your history of Polycystic Ovary Syndrome (PCOS) and menstrual irregularities, it's possible that your prolonged bleeding is due to a hormonal imbalance. PCOS can cause irregular periods, and sometimes prolonged bleeding can occur. Hormonal imbalances can also lead to symptoms like fatigue, lightheadedness, and unusual cravings.

  • Treatment: Hormonal treatments, such as birth control pills or other hormone-regulating medications, are often used to manage PCOS symptoms. Your doctor may also recommend lifestyle changes, such as diet and exercise, to help manage your condition.

• Endometrial Hyperplasia: This condition involves the thickening of the uterine lining and can cause prolonged or heavy menstrual bleeding. It is more common in women with PCOS.

  • Treatment: Treatment may include hormonal therapy or, in some cases, a procedure to remove the excess tissue. Your doctor may recommend an ultrasound or biopsy to diagnose this condition.

• Anemia: Prolonged bleeding can lead to anemia, which can cause fatigue, lightheadedness, and dizziness. Although your recent blood tests were normal, ongoing bleeding could still lead to anemia over time.

  • Treatment: Iron supplements and dietary changes can help manage anemia. Your doctor may recommend additional blood tests to monitor your iron levels.

• Medication Withdrawal: Stopping your medications (Abilify and Escitalopram) suddenly can lead to withdrawal symptoms, which might include dizziness, fatigue, and mood changes.

  • Treatment: It's important to consult your doctor before stopping any medications. They can help you taper off safely or find alternative treatments.

What you can do

While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

1. Track Your Symptoms: Use MDandMe to journal your symptoms, track your menstrual cycle, and note any changes in your bleeding, fatigue, or other symptoms. This information will be helpful for your doctor.
2. Stay Hydrated and Eat Nutritiously: Ensure you are drinking plenty of water and eating a balanced diet rich in iron to help manage fatigue and prevent anemia.
3. Rest and Manage Stress: Try to get adequate rest and find ways to manage stress, such as through relaxation techniques, exercise, or talking to a mental health professional.
4. Avoid Sudden Medication Changes: Consult your doctor before making any changes to your medications. They can help you manage any potential withdrawal symptoms safely.
5. Monitor Your Weight and Diet: Continue to follow a healthy diet and monitor any unusual cravings or sensitivities to food. This can help you manage your weight and overall health.

What you should look out for

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

• Severe Abdominal Pain: If you develop severe abdominal pain, it could indicate a more serious condition that requires immediate attention.
• Heavy Bleeding: If your bleeding becomes very heavy (soaking through a pad every hour) or you pass large clots, seek medical help.
• Signs of Severe Anemia: If you experience extreme fatigue, shortness of breath, or a rapid heartbeat, these could be signs of severe anemia.
• Fever or Infection: If you develop a fever (temperature over 100.4°F) or signs of infection, such as unusual discharge or foul-smelling bleeding, seek medical care.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. If you have any more questions or need further assistance, feel free to reach out.