What causes irregular, heavy periods while trying to conceive?

Question

Hello doctor,

I am a 27-year-old married woman weighing 161.68 pounds. My menstrual cycle has been irregular since last year after I gave birth. I was on Levofem tablets last year, and since I stopped taking them, I have been trying to conceive again. This month, I had a heavy flow, which then stopped. Now, I am experiencing backache and abdominal cramps. What could be the cause of this? Please help.

Thank you in advance.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Here is a breakdown of what could be going on based on your situation:

Hormonal imbalance (post-Levofem effect):

Levofem containing Levonorgestrel and Ethinyleestradiol (a type of progestin-only contraceptive pill) can sometimes cause lingering effects on your menstrual cycle, even after you stop taking it. These effects may include:

Irregular cycles.
Delayed return to ovulation.
Occasional heavy or short periods.

Since you stopped a year before, your body might still be regulating hormone levels. Especially if your periods were irregular before starting Levofem.

Possible early miscarriage (occurs when a pregnancy ends early) or implantation bleeding (light spotting that happens when a fertilized egg attaches to the uterine lining):

Heavy bleeding for two days followed by cramping and backache could indicate:

A very early miscarriage (chemical pregnancy).
Or, less commonly, implantation bleeding, though this is usually lighter and shorter.

However, implantation bleeding typically does not come with heavy flow or strong cramps.

Ovulation pain or mittelschmerz:

In some women, mid-cycle pain and spotting can happen during ovulation, especially if cycles are still a bit irregular. It usually presents with:

Cramping on one side of the lower abdomen.
Backache.
Light spotting (not heavy flow).

However, your bleeding sounds heavier than what is typical for ovulation spotting.

Other possible causes

Polycystic ovary syndrome (PCOS): It is a hormonal disorder that causes irregular periods. It can cause irregular periods and trouble conceiving.
Uterine fibroids or endometriosis: Uterine fibroids are non-cancerous growths in the uterus, while endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. They can cause heavy bleeding, cramps, and backache.
Infection (like pelvic inflammatory disease): Might also come with unusual discharge, fever, or pain.

What you can do:

Track your cycle: Use a fertility or period tracker to monitor bleeding, ovulation signs, and symptoms.
Ovulation testing: Try ovulation predictor kits to see if you are ovulating.
Pregnancy test: If your next period does not come, take a test about 2 weeks after the bleeding.
See a doctor: A gynecologist can perform:
1. Hormone blood tests (like follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin).
2. Pelvic ultrasound (to check the uterus and ovaries).
3. STI (sexually transmitted diseases) screening or other diagnostics, if needed.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.