[29F] Experiencing prolonged heavy vaginal bleeding and associated symptoms

Patient Description

A 29-year-old female presents with a 23-day history of heavy vaginal bleeding with clots, occurring unexpectedly and not associated with her normal menstrual cycle. The bleeding is described as a consistent heavy flow. Accompanying symptoms include dizziness, particularly lightheadedness upon standing, which has been present for approximately 4 weeks and is rated as a 5 on a severity scale of 1-10. The dizziness does not improve with exercise and is alleviated by remaining still. The patient also reports loss of appetite, general aches and pains, and fatigue. No further details about the aches, pains, and fatigue were provided. The patient denies being currently pregnant.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Menorrhagia: This is heavy or prolonged menstrual bleeding. It can cause blood clots and can lead to anemia, which might explain your fatigue and dizziness.

    • Treatment may include iron supplements to treat anemia, and hormonal therapies or surgery to manage the bleeding.
  • Endometrial Polyps: These are growths in the lining of the uterus that can cause heavy or prolonged bleeding.

    • Treatment usually involves surgical removal.
  • Uterine Fibroids: These are noncancerous growths in the uterus that can cause heavy bleeding and clots.

    • Treatment can range from medication to manage symptoms to surgery to remove the fibroids.
  • Miscarriage: If there's a chance you could be pregnant, heavy bleeding could be a sign of a miscarriage.

    • Treatment involves monitoring by a healthcare professional to ensure your health and safety.

What you can do

Given the severity and duration of your symptoms, it's important to seek immediate medical attention. In the meantime:

  1. Try to stay hydrated and eat nutritious foods, even if you're not feeling hungry. This can help prevent further dizziness and fatigue.
  2. Rest as much as possible to conserve energy.
  3. Use sanitary pads rather than tampons to monitor the amount and type of bleeding.

What you should look out for

Seek immediate medical attention if:

  • Your bleeding gets heavier or you pass larger clots.
  • You experience severe pain.
  • Your dizziness worsens or you faint.
  • You develop a fever or chills.

Remember, I'm an AI and while I strive to provide accurate information, it's always best to consult with a healthcare professional for a formal diagnosis and treatment.

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1 yr ago

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People Also Ask


What are the common causes of heavy vaginal bleeding with clots?

Common causes of heavy vaginal bleeding with clots include menorrhagia, endometrial polyps, uterine fibroids, and in some cases, a miscarriage. Each of these conditions can cause significant bleeding and may require medical evaluation.


How can heavy menstrual bleeding lead to dizziness and fatigue?

Heavy menstrual bleeding can lead to anemia, a condition where there is a deficiency of red blood cells or hemoglobin in the blood. Anemia can cause symptoms like dizziness, fatigue, and lightheadedness, especially when standing up.


What are the treatment options for menorrhagia?

Treatment options for menorrhagia include iron supplements to address anemia, hormonal therapies such as birth control pills to regulate the menstrual cycle, and in some cases, surgical interventions like endometrial ablation or hysterectomy to control bleeding.


When should someone seek immediate medical attention for heavy bleeding?

Immediate medical attention should be sought if the bleeding becomes significantly heavier, if larger clots are passed, if severe pain is experienced, if dizziness worsens or fainting occurs, or if there are signs of infection such as fever or chills.


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