Should I return to the hospital again for my heavy bleeding?

Question

Hello doctor,

I have excessive bleeding from my vagina. I was in the emergency room yesterday, got a prescription, and was sent home. The medications did not work. I had another episode, a heavy one with a lot of clots.

It happens every few hours that I get flooded with blood and clots. In between, I have period -like bleeding or spotting. The episode usually lasts 20-30 minutes, but sometimes longer (three to four hours). I need to change tampons and pads every 30 to 45 minutes, yet I still get soaked. The episodes occur a few times a day.

Yesterday I went to A&E (accident and emergency), but during the examination, there was almost no blood, so they sent me home. I got tablets to stop bleeding, but they did not help. Today I was bleeding like during a period and just recently got soaked.

I went to the bathroom to clean myself. Even before using a shower, a few clots dropped. Then even more while showering. I just want to know if I need to go back to the hospital. If so, how to speak with the doctor?

My hemoglobin level yesterday was 14, and ferritin was just slightly under the normal range.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Yes, you need to go back to the hospital now.

What you are describing is emergency-level heavy vaginal bleeding (acute abnormal uterine bleeding or possible hemorrhage), especially because you are:

Soaking tampons and pads every 30 to 45 minutes.
Having repeated gushes or flooding.
Passing large clots.
Bleeding in episodes that last hours.
Soaking through clothes.

This meets emergency criteria. Guidance says to seek urgent care if you are soaking one pad or tampon per hour for two hours or more, and you are bleeding even more heavily than that.

Even though your hemoglobin was 14 yesterday, it can drop quickly with ongoing bleeding. A “normal” result yesterday does not make today safe.

Please go to the emergency room immediately, especially if you have any of these:

Dizziness or feeling faint.
Fast heartbeat.
Weakness.
Shortness of breath.
Pale skin.
Severe pelvic pain.

If you feel lightheaded when standing, do not go alone.

When speaking to the doctor, it’s important to be clear and direct about your symptoms. You can say that I need urgent reassessment for severe vaginal bleeding. I am soaking through a tampon and pad every 30 to 45 minutes and passing large clots, with repeated flooding episodes lasting 20 minutes to several hours. The medication prescribed yesterday is not working, and the bleeding is continuing through my clothes. I need repeat blood tests, an urgent gynecology review, and an assessment for treatment to stop the bleeding.

That wording clearly tells them this is ongoing despite treatment.

At the hospital, they may need to:

Repeat hemoglobin or CBC (complete blood count).
Check blood pressure and pulse.
Perform a pregnancy test (important even at 39).
Arrange a pelvic ultrasound.
Consider stronger treatment (for example, tranexamic acid, hormone treatment, IV (intravenous)fluids, and in severe cases, transfusion).

Common causes include:

Fibroids (noncancerous uterine muscle growths).
Polyps (small uterine lining growths).
Hormonal imbalance or perimenopause.
Adenomyosis (uterine lining grows into muscle, causing pain or bleeding).
Less commonly, miscarriage or other gynecologic causes.

Please do not wait to “see if it settles” tonight; this amount of blood loss deserves urgent reassessment.

If you want, tell me the name of the tablets they prescribed, and I can help you explain to the doctor that they are not working.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.

Answer 2

Hello,

Welcome back to icliniq.com.

I am really glad you took the photo, that picture is very helpful evidence, and yes, you should go back today, even if they told you to wait until three days. The key point is that your condition has changed or continued despite treatment.

Bleeding heavily enough to soak pads or tampons every 30 to 45 minutes and pass large clots is considered severe vaginal bleeding and should be reassessed urgently, even if yesterday’s blood test was okay.

A normal hemoglobin level yesterday does not guarantee it is still normal today if this has continued overnight and through today.

Please be firm and specific. You can show them the photo. Honestly, the photo will likely help them understand the severity much better than when the bleeding slowed during the exam. You are absolutely justified in going back.

I hope this helps you.

Take care.

Answer 3

Hello,

Welcome back to icliniq.com.

Thank you for telling me you feel safer checking in here.

I am really glad that this chat is helping you through the scary part. You are not overreacting at all. This is exactly the kind of thing the ER (emergency room) should assess quickly.

Take care.

Regards.