Q. What can cause irregular menstrual bleeding?

Answered by
Dr. Shruti Kainth Kaushal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 17, 2018 and last reviewed on: Oct 09, 2018

Hi doctor,

I am suffering from irregular bleeding for the past six weeks. I have been using Mirena for the past 10 years for birth control and PCOD. After Mirena my periods had stopped and I would get them once in six months for a day. In six weeks, I have got this bleeding for the third time. It lasts for a maximum for a couple of days. I am diabetic too, and it is under control.



Welcome to

As per your history, it appears that you are having abnormal uterine bleeding and the cause can be many.

As you told that you are diabetic, I would advise you to get a transvaginal scan first and followed by endometrial sampling to rule out the cause.

In your case of irregular bleeding my suspicion goes for hormonal disturbance.

Please revert back after ultrasound for endometrial thickness.

Investigations to be done:

1. Transvaginal scan and endometrial sampling.
2. Fasting blood sugar.

Regarding follow up:

Revert back with the investigation report to an obstetrician and gynaecologist online.--->

Thank you doctor,

I got a pap smear and HPV done as a routine. Please see my report. Also, the bleeding is not there for the past 10 days. I have attached my TVS report too. Can you please let me know that all is fine? The doctor gave me Pause-MF (Tranexamic acid) to have if I have bleeding.



Welcome back to

I have seen your reports (attachment removed to protect patient identity).

  • The endometrial thickness is normal. The pap smear and HPV (human papilloma virus) is also fine.
  • Mirena - intrauterine device is there. So, I think there is no need to worry.
  • Pause-MF (Tranexamic acid) is fine and you can take it whenever you have bleeding. But, if another episode happens then get endometrial sampling done.

For further information consult an obstetrician and gynaecologist online -->

Thank you doctor,

Thank you very much for your reply. I just wanted to understand the cervical smear report. Could you please explain? Is there any cause for concern?



Welcome back to

  • This is the cytology report of cervical smear and it is normal. No malignancy or any infection seen.
  • You need not worry and it is absolutely fine.

For further information consult an obstetrician and gynaecologist online -->

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