Talk to Gynecologist on Irregular Bleeding

Dr. Mahwish Choudhry - Gynecologist

MBBS, FCPS (Obstetrics & Gynaecology) | Islamabad

111 Positive Reviews

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You must consult your own dr again, once you start any hormonal preparation then continue it for 3 months ,, without reviewing any reports we cannot give opinion ,

Dr. Mahwish Choudhry - Gynecologist

MBBS, FCPS (Obstetrics & Gynaecology) | Islamabad | Book Appointment

26 Positive Reviews

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How r u feeling now ?

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2 weeks ago

Dr. Tasnim Zahid Hussain - Gynecologist

MBBS, MRCOG, DFSRH | Islamabad

154 Positive Reviews

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Assalam o Alaikum
Pills are not take when pregnancy is tried. Take progesterone for spotting or ignore them till pregnancy is over. Hope you've worked up spotting already

Patient

Post Owner

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i m not pregnant

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2 weeks ago

Dr. Tasnim Zahid Hussain - Gynecologist

MBBS, MRCOG, DFSRH | Islamabad | Book Appointment

7 Positive Reviews

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I know but you are trying for it, which is why I've said that

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2 weeks ago

Dr. Bushra Imtiaz - Gynecologist

MBBS,FCPS Obstetrics & Gynaecology, UKMLA1, UK(PLAB1), Registered Practitioner in Irish Medical Council | Islamabad

49 Positive Reviews

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consult online for complete treatment discussion

Dear Madam,

I understand how concerning and frustrating irregular bleeding can be, especially when you are also trying to conceive. It's a common dilemma with conditions like adenomyosis.

Let's break down your situation:

1. **Diffuse Adenomyosis and Bleeding:** Adenomyosis is a condition where the endometrial tissue (lining of the uterus) grows into the muscular wall of the uterus. This often leads to heavier, more painful periods, and irregular bleeding or spotting, as the misplaced tissue is subject to hormonal fluctuations.

2. **Yasmin and its Effect:** Yasmin, like other combined oral contraceptive pills, works by suppressing your natural hormonal cycle. It makes the uterine lining thinner, which effectively reduces bleeding and often pain associated with adenomyosis. You experienced this benefit when you were taking it.

3. **Bleeding Pattern After Stopping Yasmin:**
* **Initial Bleeding after stopping (Jan 2nd):** This was a withdrawal bleed, which is normal when you stop hormonal pills.
* **Periods on Feb 4th and March 5th:** These seem to be your natural cycles resuming, though perhaps with some lingering effect of the Yasmin.
* **Spotting from March 23rd, stopping, and then restarting April 5th to till date:** This prolonged and irregular spotting is highly likely due to the underlying diffuse adenomyosis becoming active again now that the hormonal suppression from Yasmin has ceased. Your body is trying to re-establish its natural cycle, and without hormonal support, the adenomyosis is manifesting with irregular bleeding. Other factors like hormonal fluctuations common after stopping the pill can also contribute.

4. **Should you take Yasmin pills again to stop spotting?**
**My direct advice is NO, you should NOT restart Yasmin or any hormonal medication without consulting your gynecologist first.**

Here's why:
* **Desire for Pregnancy:** You clearly stated you want to try for a baby. Taking Yasmin will prevent ovulation and therefore prevent pregnancy. If your goal is to conceive, taking Yasmin contradicts this.
* **Diagnosis of Current Bleeding:** While adenomyosis is a strong suspect, it's crucial for your doctor to rule out other potential causes for the prolonged spotting, especially since you are trying to conceive. These could include:
* Early pregnancy bleeding (implantation bleeding, threatened miscarriage).
* Cervical issues (polyp, infection, ectropion).
* Uterine polyps or fibroids (less likely if you had a recent ultrasound that confirmed only adenomyosis, but worth re-evaluating).
* Other hormonal imbalances (e.g., thyroid issues, high prolactin).
* **Personalized Plan:** Your gynecologist needs to assess your current situation, including your desire for pregnancy, and create a tailored plan that addresses both your bleeding and your fertility goals.

**What you should do now:**

1. **Schedule an urgent appointment with your gynecologist in Dubai.** Explain your symptoms and that you are trying to conceive.
2. **Be prepared for a thorough evaluation, which may include:**
* **Detailed history:** Your doctor will ask about your bleeding pattern, any associated pain, and your fertility attempts.
* **Physical examination:** Including a speculum exam to check your cervix.
* **Transvaginal Ultrasound:** To assess your uterus for the extent of adenomyosis, rule out polyps or fibroids, and check your ovarian status.
* **Blood tests:** This will likely include a pregnancy test (hCG), and potentially hormone levels (estrogen, progesterone, thyroid, prolactin) to understand your current hormonal status.

**Discussion points with your gynecologist:**

* **Balancing Adenomyosis Management and Fertility:** This is the core challenge.
* **If actively trying to conceive:** Your doctor may suggest strategies to manage the bleeding that are compatible with conception, such as observation, or short courses of non-hormonal medications (e.g., tranexamic acid for heavy flow, though less effective for spotting). They might also discuss fertility assessments and options, considering your age (39) and adenomyosis, which can sometimes impact fertility and increase the risk of miscarriage. Referral to a fertility specialist might be considered if you don't conceive within a few months.
* **If managing the bleeding becomes the priority for a period:** If the bleeding is significantly impacting your quality of life, you might need to temporarily put conception on hold to effectively manage the adenomyosis with hormonal therapies (like Yasmin or other progestins). This would be a shared decision with your doctor.

Please prioritize seeing your doctor. They are best equipped to guide you based on your specific medical history and current goals.

I hope this helps, and I wish you all the best.

**Disclaimer:** This information is for educational purposes only and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for diagnosis and treatment of any medical condition.