Concerned About Change in Bleeding Pattern
Question
I am 31 yrs. of age and have been trying to get pregnant for the last two years. My husband and I have children from previous relationships. I had a surgery for endo and fibroid cysts Sept. 04. My husband has also been checked by a urologist and everything is fine with him. I have pre-menstrual spotting several days before my cycle begins and my bleeding has gotten worse in the last few months. I bleed so much that I have to change my pads every hour and when I do change the pads I notice that I bleed big chunks of tissue along with the blood. What is going on with me? Am I miscarrying? When do I start the count for the first day of my menstrual cycle? Please advise!
Veronica
Answer
Last Updated: October 11, 2013
You have dysfunctional uterine bleeding. This is likely due to hormonal dysfunction, such as an ovulatory defect (e.g. lack of ovulation) or inadequate production of progesterone following ovulation. You must be sure, though, that you have evaluation of your uterus to rule out more dangerous causes of abnormal bleeding, such as endometrial cancer. Often an endometrial biopsy is indicated in situations such as yours, if you don’t respond to hormonal treatment. Many physicians will prescribe birth control pills in your situation. I do not recommend this; though OCP’s may, in fact, normalize your bleeding, this “treatment” would not address the root cause of the bleeding, and it would obviously be counterproductive for you in your quest to get pregnant. I would recommend that you chart your menstrual cycles using the Creighton Model NFP charting system (you can find an instructor in your area by contacting the California Association of Natural Family Planning at this web site). After charting for 3 months, you should be seen by a physician trained to interpret your charting. A targeted hormonal assessment of your menstrual cycle would then be ordered to assess the hormonal health of your cycle. Depending on the results, cooperative hormonal supplementation may be recommended. This may not only normalize your bleeding, but also assist you in getting pregnant. Good luck.
John Gisla, M.D.
John Gisla, M.D.
Answered By:
John Gisla, MD
Dr. John Gisla, Board Certified by the American Academy of Family Physicians, pracitces in the Sacramento Region.
