Hello XXXXXXX

Thanks for writing to us. I have gone through your history in detail.

Yes, sometimes irregular bleeding may be seen in this age group. But we should take all possible precautions to ensure that we're not missing anything serious.
Causes of heavy bleeding in this age group include
1) Hormonal imbalance, caused by dysfunction of ovary without ovulation leads to progesterone deficiency.
2) Adenomyosis/ endometrial hyperplasia / Dysfunctional uterine bleeding (DUB)
3) Uterine fibroid & polyp (body and cervical region)
4) Rarely carcinoma- endometrial/ cervical
5) Use of certain medication etc.

Complete physical examination including pelvic/speculum exam and colposcopy if indicated, is needed to carry on to rule out underlying pathology.

Possibilities can be narrowed by several investigations like blood test for thyroid profile & clotting factor abnormality, Ultrasound scan for pelvis, pap smear test to detect cancerous changes and endometrial biopsy ( which may or may not be needed)

There are certain treatment protocol with initiation of hemostatic agent combined with oral progesterone tab. If above medical treatment fails to control bleeding, then approach would be surgical by the means of Dilation and curettage (D&C), Operative hysteroscopy to remove polyp, Endometrial ablation in case of hyperplasia. Total hysterecetomy (removal of uterus,tube & cervix) is the ideal choice in your age group.

So please consult with your gynecologist. It would definitely be required.

Till then, the following things should help:
1) Take healthy diet with iron supplements
2) Drink more water and eat leafy vegetables/ fruits.
3) Avoid heavy work or straining
4) Avoid stress/anxiety & maintain personal hygiene.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish your good health
Regards,
Dr Soumen

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