Brief Answer: Most likely hormonal imbalances. Detailed Answer: Hello XXXXXXX and welcome to health care magic, I understand your queries. You have PCOS and now have heavy irregular bleeding. For similar women in my clinic, the first thing that needs to be ruled out is a pregnancy. So a urine test is the first line investigation as abortions cause irregular heavy bleed. If this is not the case then other causes are hormonal imbalances, even imbalances due to PCOS that lead to excess estrogen and cause heavy bleeding. Ovarian cysts may also lead to irregular bleeding. Fibroids are other common cause of irregular bleeding. They are non cancerous tumors of the uterus, more common in PCOS as they are dependant on estrogen hormone for their growth which is usually increased in PCOS. Similarly cervical polyps and adenomyosis [ enlarged uterus] may cause this. If you are breast feeding and have irregular menses, then periods of absent menses followed by heavy bleed also occur in some women and tend to get corrected after stopping breast feeding. So suggest that you first get a urine pregnancy test using the first morning sample of urine. Then you must visit a gynecologist and get examined. certain conditions like cervical polyp are detected only on gynec examination. An ultrasonography [ USG] must follow to look for fibroids and adenomyosis, ovarian cysts. The endometrial thickness is also important. There is another condition called DUB [dysfunctional uterine bleeding] where no cause is found. A dilatation and curettage procedure helps to correct it most of the time and also provides tissue for biopsy and examination under microscope. If USG is negative, a thyroid function test must be done to look for imbalance in thyroid hormone. For control of bleeding now, you may take tranexamic tablets if the pregnancy test is negative. Further treatment will then depend upon the cause. Continue your diet and exercise schedule if possible but if the bleeding is causing weakness, withold the exercise for a few days. I hope that I have explained the causes to the best of my ability. It is most likely a minor hormonal imbalance which is common at your age. They can be managed using drugs like progesterone or contraceptive pills or injections. So do not worry. Thanks for using HCM. I am always here to answer your questions. Have a good day. Dr Madhuri Bagde Consultant Ob Gynec

---

Brief Answer: Possibility is there Detailed Answer: Hello XXXXXXX I understand that you have earlier had an abortion and are wondering if this is a second episode. The possibility is always there especially if you are not using contraception. Also the initial bleeding may be implantation bleeding during attachment of the baby with the uterus. [ but it is usually slight and not heavy]. A urine test and USG will solve the matter for you as it will help in detecting an incomplete abortion as well as other causes like fibroids etc. I hope this was helpful. Feel free to ask any more queries. Dr Madhuri.

---