[22F] Experiencing prolonged vaginal bleeding on birth control implant

Patient Description

A 22-year-old female has been experiencing continuous medium-flow vaginal bleeding for more than a month. She is currently using a birth control implant, which she has had for nearly three years and is set to expire in January 2025. The patient reports no cervix pain and has tested negative for sexually transmitted diseases. She was previously diagnosed with chlamydia in January, prior to the implant insertion, and was treated with antibiotics followed by retesting. The patient has no known allergies or adverse reactions to medications, although she experienced initial itching from the implant, which has since resolved. She is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your continuous vaginal bleeding:

  1. Birth Control Implant Side Effects: It's not uncommon for hormonal birth control methods, like the implant, to cause irregular bleeding or spotting. This can sometimes manifest as prolonged bleeding, especially as the implant nears its expiration date.

    • Treatment typically involves monitoring the symptoms, but if the bleeding is bothersome, a healthcare provider might suggest additional hormonal treatments to help regulate your cycle.
  2. Hormonal Imbalance: Even with birth control, hormonal fluctuations can occur, leading to irregular bleeding. This might be more noticeable as the implant's effectiveness wanes.

    • Treatment may include hormonal supplements or adjustments to your current birth control method.
  3. Endometrial Changes: Prolonged use of hormonal birth control can sometimes lead to changes in the uterine lining, which might cause irregular bleeding.

    • A healthcare provider might recommend an ultrasound or other diagnostic tests to assess the uterine lining.

What you can do

  1. Consult Your Healthcare Provider: It's important to discuss your symptoms with a healthcare provider, especially since your implant is nearing expiration. They can assess whether the implant needs to be replaced or if another form of birth control might be more suitable for you.

  2. Track Your Symptoms: Use MDandMe to journal your bleeding patterns, any associated symptoms, and any potential triggers. This information can be valuable for your healthcare provider in determining the cause and best course of action.

  3. Maintain a Healthy Lifestyle: Ensure you're eating a balanced diet, staying hydrated, and managing stress, as these can all impact your menstrual cycle.

What you should look out for

  • Seek Immediate Medical Attention If:
    • You experience very heavy bleeding (soaking through a pad or tampon every hour for several hours).
    • You feel dizzy, faint, or weak, which could indicate significant blood loss.
    • You develop new symptoms, such as severe abdominal pain or fever.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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2 mo ago

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People Also Ask


Can a birth control implant cause prolonged vaginal bleeding?

Yes, a birth control implant can cause irregular bleeding or spotting, which may sometimes result in prolonged bleeding. This is a known side effect of hormonal birth control methods.


What are the signs that a birth control implant is losing its effectiveness?

Signs that a birth control implant may be losing its effectiveness include changes in bleeding patterns, such as irregular or prolonged bleeding. It's important to consult with a healthcare provider if you notice these changes.


How can hormonal imbalances affect menstrual cycles?

Hormonal imbalances can lead to irregular menstrual cycles, including prolonged or heavy bleeding. These imbalances can occur even when using hormonal birth control, especially as the effectiveness of the method wanes.


What should I do if I experience heavy bleeding while using a birth control implant?

If you experience heavy bleeding while using a birth control implant, it's important to seek medical attention, especially if you are soaking through a pad or tampon every hour for several hours, or if you feel dizzy or weak. A healthcare provider can assess your symptoms and recommend appropriate treatment.


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