[47F] Experiencing heavy menstrual bleeding with systemic symptoms

Patient Description

A 47-year-old female has been experiencing heavy menstrual bleeding for 8 days, with the passage of large blood clots and the need for frequent pad changes. She reports associated symptoms of dizziness, fatigue, pallor, and occasional vomiting, which she manages with prescribed Zofran. The patient also describes intermittent chest pain related to anxiety, for which she has a history. She has been on estrogen patches (Estradiol 25mg weekly) for 18 months but missed a dose 5 days ago due to insurance issues. Her medical history includes a non-cancerous ovarian cyst, mental illness diagnosed 30 years ago, and she has been on stomach medication for 15 years. She does not take psychiatric medications due to adverse reactions. Current medications include Estradiol patches, Famotidine, Zofran, and Ibuprofen 800mg as needed. She has a family history of uterine cancer on her father's side.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Hormonal Imbalance: Missing a dose of your estrogen patches could have triggered a hormonal imbalance, leading to your heavy bleeding.

  • Endometrial Hyperplasia: This is a condition where the lining of the uterus becomes too thick, which can cause heavy or prolonged menstrual bleeding. It's often caused by excess estrogen without progesterone.

  • Uterine Fibroids: These are noncancerous growths of the uterus that can cause heavy bleeding.

  • Polyps: Small, benign growths on the lining of the uterine wall, which may cause heavy or prolonged menstrual bleeding.

  • Adenomyosis: This condition occurs when glands from the endometrium become embedded in the uterine muscle, often resulting in heavy or prolonged menstrual bleeding.

  • Cancer: Uterine and cervical cancer can cause heavy vaginal bleeding, but it's less likely given your age and the sudden onset of your symptoms.

What you can do

Given the severity of your symptoms, it's important to seek medical attention immediately. You should go to the emergency room, especially if you're feeling dizzy and pale, as these symptoms can indicate significant blood loss.

What you should look out for

  • If your bleeding becomes even heavier or doesn't stop
  • If you start feeling more dizzy or faint
  • If you develop a fever or severe abdominal pain

Please remember that while I strive to provide accurate information, I'm an AI and not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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8 mo ago

People Also Ask

What are the potential causes of heavy menstrual bleeding with large blood clots?

Heavy menstrual bleeding with large blood clots can be caused by hormonal imbalances, uterine fibroids, endometrial hyperplasia, polyps, adenomyosis, or, less commonly, uterine or cervical cancer.

How can missing a dose of estrogen patches affect menstrual bleeding?

Missing a dose of estrogen patches can lead to a hormonal imbalance, which may result in heavier or prolonged menstrual bleeding due to the sudden change in hormone levels.

What are the symptoms of significant blood loss due to heavy menstrual bleeding?

Symptoms of significant blood loss include dizziness, fatigue, pallor, shortness of breath, and in severe cases, fainting. These symptoms occur because the body is not getting enough oxygen due to reduced blood volume.

What should I do if I experience severe symptoms like dizziness and pallor during heavy menstrual bleeding?

If you experience severe symptoms like dizziness and pallor during heavy menstrual bleeding, it is important to seek medical attention immediately, as these could indicate significant blood loss. Visiting the emergency room is advisable to receive appropriate care.

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