I'm 33 old female. Why do I bleed heavily after my periods?

Question

Hello doctor,

I have a pituitary tumor that secretes growth hormone, and I forgot to ask my endocrinologist during my last visit whether this could be affecting my menstrual cycle. I am 33 years old, female, and weigh 198.95 pounds.

Over the past two cycles, I have noticed a change as I have my regular four-day period, but then two to three days later, I experience another episode of very heavy bleeding. This is unusual for me. Could elevated IGF-1 levels be contributing to this pattern? Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

A pituitary tumor that produces excess growth hormone (GH) can impact the menstrual cycle in various ways. Elevated GH levels lead to increased production of insulin-like growth factor 1 (IGF-1), which can interfere with the normal regulation of reproductive hormones, including LH (luteinizing hormone, which helps the release of an egg from the ovary), FSH (follicle-stimulating hormone, which promotes egg-producing ovarian follicle growth and estrogen regulation), and estrogen.

This occurs because high IGF-1 levels (Insulin-like growth factor 1, growth hormone or GH) serve as a reliable marker of overall GH activity in the body. It may suppress the release of gonadotropin-releasing hormone (GnRH) from the hypothalamus, resulting in reduced secretion of LH and FSH by the pituitary gland, two key hormones essential for menstrual regulation.

As a result, women with a GH-secreting tumor may experience oligomenorrhea (infrequent periods), amenorrhea (absence of periods), or heavy and irregular bleeding, particularly when there is an imbalance between estrogen and progesterone. In your case, the heavy bleeding is likely related to this underlying hormonal imbalance.

Recommended investigations:

Please follow up with your endocrinologist to repeat IGF-1 levels and obtain a comprehensive hormone panel including LH, FSH, estradiol, prolactin, and TSH.
A pelvic ultrasound is also recommended to rule out any structural abnormalities in the uterus.

Follow-up:

Once your updated hormone results are available, we can review them together and determine the most appropriate next steps in your care and treatment plan.

Please do not hesitate to reach out if you have any questions or need assistance at any point.

I hope this helps.

Thank you.