Unusual Adolescent Bleeding


My neice is 11 years old. She started her period at age 10. She has been bleeding continuously for the last five weeks. Her pediatrician prescribed a low dosage birth control pill to stop the bleeding and regulate her periods. Is this appropriate treatment for such a young girl? Are there other non-contraceptive, natural treatments for such conditions? What are the dangers involved, first of all in the continuous bleeding, and secondly in the prescribed treatment? What could have caused this problem in the first place? Thank you.


Last Updated: June 9, 2013
For teenagers, skipping periods, heavy bleeding, continuous bleeding and other abnormalities are very common. The reason for this is that the cyclical regulation of the ovarian hormones by the pituitary is not well established, and ovulation is not regular. So the lining of the uterus can build up so that it is too thick or disordered. Often the cause is a temporary excess of estrogen effect on the uterus without enough progesterone.

In the case of this young girl, the first thing is to determine the amount of bleeding – whether the bleeding is very heavy, involving clots, several soaked pads a day, etc. going on for a month, and anemia. Very mild cases of abnormal bleeding can just be observed without treatment or treated with just one course of hormones. Severe bleeding would require much closer watching and higher doses of hormones than prolonged, lighter, merely annoying bleeding.

For lighter spotting and bleeding, I would use oral natural micronized progesterone given for ten to twelve days out the cycle, for one or two months at the most. For very heavy bleeding, it might be necessary to use estrogen and progesterone at the same time. Some insurance companies may not cover natural progesterone, which is sold in most pharmacies under the brand name, Prometrium. Natural micronized progesterone can also be obtained from compounding pharmacies. If necessary for financial reasons or because of more severe, heavy bleeding, Provera (an artificial progesterone-like hormone) could be used in addition to estrogen.

If this girl were a bit older, I would definitely recommend learning NFP charting from a certified instructor to help the hormonal therapy. Not only would she learn to appreciate her cycles, but it would also aid in her treatment and help determine when and if the cycles became ovulatory. Cooperative progesterone therapy, given at the proper time in the cycle, is more specific therapy than giving the hormones by the calendar. But in the case of an 11-year old, I would let the mother determine whether the girl were sufficiently mature to learn to chart NFP cycles. Charting would definitely be superior to therapy by the calendar if the bleeding problem were persistent, rather than a one-time event.

About the recommendation for birth control pills: In our training as ob/gyn’s, many of us were taught for both mild and severe bleeding to use high-dose birth control pills (two or three a day for one week), and then for the young women to go off the pills to have an artificial period. We then were instructed to keep the young woman on birth control pills for at least a few cycles. I now think that it would be preferable to just use estrogen and progesterone/Provera in severe bleeding situations formulated as two separate pills. Although birth control pills combine estrogen and progesterone conveniently, there is a lot of baggage associated with their use that can be avoided by using different formulations of similar drugs. Most importantly, even if higher dose hormones are necessary over the short term to deal with a more severe bleeding problem, I absolutely would not KEEP a young woman on birth control pills. If she does not establish regular, normal periods soon and has recurrent abnormal bleeding, she can be given natural progesterone at intervals (minimum every three months) to prevent hemorrhage. For more severe, recurrent bleeding the young woman should be checked for clotting problems and thyroid disorders.

Dr. Mary Davenport

Answered By:

Mary Davenport, MD, MS
Mary Davenport, MD, FACOG, an obstetrician/gynecologist from the Oakland Region of California, offers telehealth services over MyCatholicDoctor.com She graduated from Tufts University School of Medicine and completed her residency at UC San Diego. Dr. Davenport is a Fellow of the American College of Obstetrics and Gynecology, and serves on the Advisory Board of the California Association of Natural Family Planning.

Read more related questions

Long Term Health Issues of Chronic Low Progesterone

Hi—I was diagnosed with low progesterone, after noticing ongoing random (not premenstrual) minor brown spotting a couple times per month. I now take 200 mg…

Anxiety Returning to Cycles Postpartum

I am eight months postpartum and still breastfeeding my child although we supplement with formula and she eats solid foods twice daily. Lately, I’ve been…

What to Expect Stopping Pill at 52

What can you expect coming off the pill at 52 and what are the chances of becoming pregnant? Shuri

Clots, Meds, and Pregnancy

I am 27 and have residual blood clots in my left arm from 2006. They have not dissolved properly and still show up on my…

Worried What this Bleeding Means

I started my period on April 3 and finished on the 6th of April. I started spotting a dark brown sticky discharge (mucus) with little…

Preparing to Use NFP In Future Marriage

My boy friend and I are planning on getting engaged within the next year, and married about a year or so after that. I have…

Can I Use NFP While Taking Tamoxifen

I am 48 and perimenopausal with periods every 26 to 60 days. My husband and I used NFP during most of our married life, but…

Pharmacist Seeks Advice for Inducing a Period Post Pill

I am a pharmacist in Alberta Canada and am hoping you will be able to help me. I have a patient who stopped her Diane…

Want Better Option Than Pill—But it is all I am offered

My name is Jourdan and I am 18, never sexually active, and with no history of breast cancer or cervical cancer in my family (I…

Periods Have Not Returned After Stopping Pill

I have come off the pill because I got so that I was not having a period on my free week. It has been a…

Tick! Tock!

I had my first baby (little boy) on Feb. 16. I still have not had the return of my period. My husband and I want…

What to Expect After 15 Years on Pill?

I was on the pill (Desogestrel 0.15mg and Ethinyl Estradiol 0.03 mg) for 15 years and stopped taking it at the end of March this…

Create An Account

This is not a membership, this is an account for our CANFP website. If you decide you would like to sign up for one of our memberships later, you can do so with or without this account.

First Name *
Last Name *
E-mail *
Username *
Password *
Confirm Password *
Edit Profile
Order History
Shipping and Billing
Login Information
Notification Settings
Notification Subscriptions

CANFP conducts varied outreach programs to the community at large, in addition to serving our members (NFP users, teachers, and advocates).

CANFP provides education programs tailored to the audience, not only on Natural Family Planning, but on the wide variety of topics related to it.

Programs can be continuing education for NFP Professionals, introductory information for a lay audience of youth or adults new to the topic, or specifically tailored to the interests of a professional audience, such as educators, physicians, or clergy. Content is faith based or secular, whichever is suitable for situation.

CANFP offers a variety of resources for those just discovering Natural Family Planning, as well as to meet the varied needs of our CANFP Members. Most resources are available to any visitors to our site. Some resources do ask you to register as a site user in order to access them, others are available only to CANFP Members.

CANFP statewide conferences, regional events offered in collaboration with local partners, events featuring CANFP speakers, or exhbit, as well as other events throughout the state of interest to our NFP community.  Come meet one of our experts at one of these events or book a speaker for your own upcoming event.

CANFP depends on the gifts, talents, and generosity of our members and supporters. The success of our mission depends on the collaboration of our members. Please consider contributing your time treasure and talent through CANFP to share the good news of NFP with the world! Both volunteer and contracted positions available.

Stay informed by joining our email list

* indicates required
Which role(s) best describes you?