Why am I bleeding for the past 16 days?

Question

Hello doctor,

I have been bleeding for 16 days. I have had blood tests done and an ultrasound done, which both came back normal. My last PAP test was about 16 months ago, which was also normal. I am 26 years old and currently taking Femme-Tab ED 20/100.

Kindly advise.

Answer 1

Hi,

Welcome to icliniq.com.

You have not mentioned current and previous menstrual, obstetrics, gynecology, and drug history.

Please answer the following questions:

Have you been on any medications or being treated for any disease?
How long have you been on Femme-Tab ED 20/100?
Have you been told about the side effects of hormonal contraceptives?

Femme-Tab ED 20/100 is Ethinylestradiol and levonorgestrel-containing contraceptive having few side effects and contraindications as well. Most of the side effects appear, but severity and presentation differ from person to person. Irregular vaginal bleeding is a side effect of OCP (oral contraceptives), but duration and pattern differ from person to person; some get affected after years of use, and some respond immediately.

I do not know how long you have been on this. Could have chances of stroke, high BP (blood pressure), cardiovascular accidents like VTE (venous thromboembolism), breast cancer, and endometrial cancer (post endometrial hyperplasia). Femme-Tab ED 20/100 is contraindicated in SLE (systemic lupus erythematosus), migraine with aura, etc. A few drugs, like antiepileptics and a few antidepressants, also reduce the efficacy of contraceptives.

Bleeding could be a side effect of hormonal contraceptives and their interactions to disturb the cycle. To reduce or stop bleeding, you can have Ponstan (mefenamic acid) for three days, eight hours, and Tranexamic acid 500 mg every eight hours for three days. You can change contraceptives to reduce their long-term effects after discussion. Start iron supplements to reduce the risk of anemia.

If bleeding does not stop even after the above treatment, it is better to have a detailed checkupwith a gynecologist. Any local cause of polyps, trauma, endometrial hyperplasia (you need the endometrial biopsy to exclude pathology), adenomyomas, or fibroid uterus (although you have done the scan, blood, and smear, and all are normal). Is the thyroid function test done? If not, it is better to have it along with the serum beta hCG (human chorionic gonadotropin) level (blood pregnancy test) to be on the safe side.

I hope this helps.