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Suggest Treatment For Irregular Periods With Normal Ultrasound
Question: Hi, I have had my period for almost a month now. Last time this happened the blood tests indicated I was not producing progesterone and was not ovulating. All my other levels were normal and ultrasound was clear. I was given Trinessa last time and it stopped the bleeding. Since then I stopped taking it and didn't have a period for about 5 months. Now my period will not go away. I began to take the Trinessa again and the first week it slowed the bleeding and then stopped it for a day. Now it's back and worse than before. Lots of heavy bleeding and blood clots. Should I continue taking the trinessa and wait for it to work? I'm starting the 3rd week of the pills today. Please help.
Brief Answer:
Dysfunctional Uterine Bleeding, ( DUB ) is possible here
Detailed Answer:
Hello and Welcome
I appreciate your concern
Anovulation and prolonged exposure of endometrium ( inner lining of uterus ) to estrogen without adequate progesterone can cause such abnormal , irregular and heavy bleeding that you are experiencing. Yes you should continue and finish the trinessa.
As part of protocol and accepted guidelines, Pregnancy should be ruled out initially in case of such abnormal vaginal bleeding. Anatomical causes e.g fibroids, adenomyosis, endometrial hyperplasia etc should then be worked up. Endometrial sampling and hysteroscopy in addition to a pelvic exam and saline sonogram would be required in consult with your doctor.
If the above causes are ruled out then Dysfunctional uterine bleeding treatment should be initiated in two ways either cyclic progestins from day 14 to 25 each cycle or by continuing OCPs like Trinessa.
Correctible causes of anovulation such as Hypothyroidism, hyperprolactenemia should also be identified and screened for.
Let me know if you have any query
wishing you best of health
thanks
Dr. M.S. Khalil
Dysfunctional Uterine Bleeding, ( DUB ) is possible here
Detailed Answer:
Hello and Welcome
I appreciate your concern
Anovulation and prolonged exposure of endometrium ( inner lining of uterus ) to estrogen without adequate progesterone can cause such abnormal , irregular and heavy bleeding that you are experiencing. Yes you should continue and finish the trinessa.
As part of protocol and accepted guidelines, Pregnancy should be ruled out initially in case of such abnormal vaginal bleeding. Anatomical causes e.g fibroids, adenomyosis, endometrial hyperplasia etc should then be worked up. Endometrial sampling and hysteroscopy in addition to a pelvic exam and saline sonogram would be required in consult with your doctor.
If the above causes are ruled out then Dysfunctional uterine bleeding treatment should be initiated in two ways either cyclic progestins from day 14 to 25 each cycle or by continuing OCPs like Trinessa.
Correctible causes of anovulation such as Hypothyroidism, hyperprolactenemia should also be identified and screened for.
Let me know if you have any query
wishing you best of health
thanks
Dr. M.S. Khalil
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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