How to manage prolonged periods in a 25-year-old?

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

Continuous bleeding for three months is not normal and requires urgent evaluation. Such prolonged bleeding can lead to severe anemia, weakness, and even fainting.

At 25 years old, the most common causes include hormonal imbalances (such as PCOS - polycystic ovary syndrome or thyroid issues) or structural problems like fibroids (uterine fibroids), polyps (endometrial polyps), or a thickened endometrium. Occasionally, it may be due to improper shedding of the uterine lining, leading to instability. This situation should no longer be ignored.

Probable causes can be:

1. Chronic anovulation results in unopposed estrogen effects on the uterine lining.

2. Structural lesions in the uterus, such as polyps or fibroids.

3. Less likely to have coagulation disorders.

Investigations to be done are as below:

1. Complete blood count (CBC) and hemoglobin levels to assess blood count.

2. Pelvic ultrasound to examine the uterus, ovaries, and lining.

3. Thyroid-stimulating hormone (TSH), prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and androgen profile.

4. Coagulation profile if there is a history suggesting easy bruising or bleeding.

Differential diagnosis is:

1. PCOS with chronic anovulation.

2. Thyroid dysfunction.

3. Endometrial polyp or fibroid.

4. Endometrial hyperplasia.

The treatment plan is as below:

1. Immediate consultation with a gynecologist is essential. Prolonged bleeding for three months typically requires active medical management, including hormonal tablets (such as progesterone or combined oral contraceptives), and occasionally higher-dose therapy initially to halt bleeding.

2. Iron supplementation is likely necessary.

3. If hemoglobin levels are very low, hospitalization and intravenous iron or transfusion may be considered.

4. Ultrasound findings will determine if surgical intervention, such as uterine polyp removal or curettage, is required.

Once stabilized, cycle regulation with hormonal therapy, weight management, and lifestyle modifications (including diet and exercise) will be beneficial. Do not delay further. Schedule an urgent appointment with a gynecologist, undergo an ultrasound and basic laboratory tests, and provide updates on the reports.

Follow-up is crucial because untreated continuous bleeding can lead to dangerously low hemoglobin levels and may affect the uterine lining in the long term.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.