Gynecology / Women's Health Expert Forum
vaginal bleeding for 2 full months
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vaginal bleeding for 2 full months

I have had vag bleeding for 2 months. 1st day of my last period was 2/16/09. Had annual gyno exam 3/09. Urine, pap, breast, thyroid blood test, blood pressure & internal all normal.
2 wks later I had a UTI, doc prescribed macrobid antibiotic. It cleared up. 2 days after completing the antibiotic I had a horrible 24 hour stomach flu. A few days passed and I started to feel like I was suffering from another UTI. My gyno tested my urine. Results were UTI, prescribed amoxycilin. Cleared up again was feeling fine for a few days.
Then I started to lightly spot blood red with tiny clots for about 3 days, which then turned into heavy bleeding with some larger clots about the size of a thick quarter. Saw my gyno after about 17 days of bleeding. She did a pelvic exam, ultrasound and blood count blood test. Didn't find anything to be concerned about. She prescribed Femcon Fe .4mg. a pill every 8 to 12 hrs for 2 days, then 1 pill a day. She told me to take iron supplement daily Slow FE. She said to expect some breakthrough bleeding because I haven't been on bcp's in a long time. I was on Ortho Tri cyclen about 3 yrs ago with no problems.
Bleeding completely stopped after taking the bcp for 2 days/3 times a day. I then proceeded to finish out the pack 1 pill a day. About a day or 2 after the bleeding stopped, I started to spot again. Doc said to expect breakthrough bleeding. After about 2 weeks it got heavier and heavier to the point of a moderate to heavy period. I called the nurse she said that was fine to expect bleeding with this bcp until my body gets used to it. She spoke with the doc said to skip the inactive pills in the pack & move onto the active pills in the next pack. Take 1 pill every 12 hrs for 2 days then 1 pill per day after that.
I am now on the 2nd day of the 2nd pack of pills and bleeding is still fairly moderate. What should I do? Alternative medications or treatments?
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603463_tn?1220630455
Hi!
If you were my patient, I think I would consider an endometrial biopsy about now.  Something is going on in there, and it would be helpful in sorting things out.

I'm going to assume that pregnancy has been ruled out.  It sounds like your MD is thinking that this must be hormonal, which is a very reasonable thought.  I would also wonder about a polyp in the uterus or cervix ( which were probably ruled out by the pap smear and ultrasound ) or chronic endometritis which is a low grade infection of the uterine lining and will respond to antibiotics.  

I am also assuming that fibroids have been ruled out by the ultrasound.

One other option to consider is a 14 day course of progesterone ( I personally like prometrium better than provera ).  This should cause the lining of the uterus to slough down to the basal layer (which may mean a very heavy period--sorry) and then wait to see what happens ( eg. no meds) after that is done.  This is basically like a chemical
D&C.  By the way, that is also an option that I have used and works--a D&C.

Good luck!
Dr B
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