What are the causes of heavy menstruation in a 24-year-old girl?

Question

Hello doctor,

My 24-year-old cousin has been having issues with her menstrual cycle for a long period of time. Recently she had menstrual bleeding for one month, after which she started feeling weak. Recently she underwent laboratory tests for liquid profile and surgical profile tests. The tests concluded that her hemoglobin level is 7.5 %. She is currently taking hormonal medicine and one tablet of Zincovit. What could be the issue?

Please suggest appropriate treatment and diet protocol for her to follow.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern. Based on the information you provided, Menorrhagia could be the diagnosis. However, the cause for it needs to be identified as it can be caused by various causes such as the followings:

Fibroid uterus.
Ovarian problems like cysts.
Adenomyosis.
Endometriosis.
Endometrial hyperplasia.
Dysfunctional uterine bleeding if no specific organic cause is present.
Coagulation disorder.

According to the causative factor, further specific treatment can be given. This type of bleeding also can be from hormonal imbalance or it could be estrogen-induced, hence I suggest you take progesterone-containing pills containing Norethisterone for it. An antifibrinolytic agent like Tranexamic acid can also be beneficial. And for iron deficiency anemia, I suggest you take a parenteral iron injection by iron sucrose, and after that take a tablet of iron daily. In addition, I suggest you undergo the below-mentioned investigations:

Pelvic examination.
Pelvic ultrasonography scan by a trained radiologist.
Platelet count.
Partial thromboplastin time (PTT).
Activated partial thromboplastin time (APTT).
Blood hormones level test.
If the diagnosis is not clear from an ultrasonography scan, I suggest you undergo endometrial sampling by dilation and curettage.

I suggest you consult a specialist, talk with them, and take medications with their consent. I hope this has helped you. Please follow up if you have more doubts.

Thank you.