What causes irregular and heavy bleeding after an abortion?

Question

Hello doctor,

I have been bleeding heavily for the past two days. I had large blood clots, and I soak through a sanitary pad every one to two hours. My last normal period was before five months. After that, I did not get a period for the next two months. I got a period on the third month but it only lasted for one day, and it was light. In the fourth month, my period was strange. It was a mixture of spotting, light bleeding, and moderate to heavy bleeding which lasted for 11 days. It stopped because I took a Plan B emergency contraceptive pill not because I had unprotected sex but because I read that it will stop the period. My period ended after that for three days. I had spotting before seven days which continued as a normal period after two days. From the next day of my normal period and till now, I have been bleeding very heavily and passing large clots.

I had a surgical abortion last year at 13 weeks. My period came back on the very next month of my abortion. After three months, my gynecologist did a transvaginal ultrasound to check me for PCOS. The ultrasound showed that I had polycystic ovaries, but blood work showed normal hormones, so PCOS diagnosis was not confirmed. The ultrasound was otherwise normal. Before three months, my endocrinologist wanted to do a scan because she still believed I had PCOS. The scan was normal, and It just showed polycystic ovaries. She did another round of hormone testing, and my hormones were normal after which PCOS diagnosis was not confirmed. I am 5’9 in height and 270 lbs in weight. I gained over 50 lbs since last year due to depression from abortion. Now I have been reading a lot about uterine (womb or endometrial cancer), and I am worried that I might have cancer. Can uterine cancer develop that quickly?

Answer 1

Hello,

Welcome to icliniq.com.

I doubt that you have polycystic ovary syndrome (PCOS) which is the most common cause of irregular cycle in young age like you. Secondly, it is not necessary that hormonal levels become abnormal always to make a diagnosis of PCOS. It could be a clinical diagnosis as well as based on the presence of irregular cycles and ultrasound evidence of polycystic ovaries. The main cause of heavy bleeding is that when one does not get periods regularly the lining of the womb becomes thicker and when it sheds it causes heavier and prolonged bleeding. And the thick endometrial lining is one of the risk factors for the development of endometrial cancer in later life. But it does not develop at early ages commonly. It is usually a problem of menopausal women, but PCOS is one of the risk factors for development. So it has been recommended to regularise your cycle with the help of pills to avoid heavier bleeding and regular shedding of the lining of the womb. I hope it has helped you. If you require any further queries, please do not hesitate to contact me.

Answer 2

Hello,

Welcome back to icliniq.com.

You do not have endometrial cancer. You have a problem of irregular cycles mainly due to PCOS, and it has been advised in PCOS that in every three months there must be shedding of lining to avoid the development of endometrial cancer in later life as endometrial cancer takes time to develop. Your heavy bleeding is due to the thicker lining which develops due to infrequent menstruation. I hope it was helpful.

What causes irregular and heavy bleeding after an abortion?

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