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- Thu Dec 29, 2005 6:12 pm
I am 21 years old and have been having odd cycles for quite some time now. they seem to be normal for a while coming regularly and lasting 5-6 days on average. but then all the sudden they go all out of whack and i get one that last for 2-3 weeks starting out light/moderate then ending extremely heavily with clots sometimes the last few days before it goes away are so heavy i have to stay home. I don't get cramps or pain or anything. then it seems that after that i get long cycle then its back to normal for a bit.
| Dr. Tamer Fouad
- Fri Dec 30, 2005 2:01 pm
It is very difficult to evaluate your case over the internet. You are strongly recommended to refer to your gynecologist as excessive bleeding is always a cause for concern.
Your doctor will first want to know if you do not complain of any other symptoms and do not have a history of any other diseases. Then he will want to rule out any local causes by performing a pelvic examination. He may also want to evaluate the degree of severity of your cycles by performing a CBC (complete blood count).
One common cause of abnormal cycles is called dysfunctional uterine bleeding. Dysfunctional uterine bleeding is a diagnosis of exclusion. In the vast majority of cases, it is secondary to anovulation (lack of ovulation). The fact that you do not experience cramps or other premenstrual symptoms could be a manifestation of anovulation.
Some common causes of hypothalamic anovulation are weight loss or gain, eating disorders, stress, chronic illness, and excessive exercise. Women with chronic anovulation that is not attributable to any of these causes are considered to have idiopathic chronic anovulation.
Anovulatory bleeding can be thought of as estrogen breakthrough bleeding. This type of bleeding is related to the levels of estrogen stimulating the endometrium. For example, high levels of estrogen for prolonged periods result in amenorrhea followed by acute intermittent heavy bleeding, and continually low levels of estrogen availability result in intermittent spotting.
1. Oreil KA, Schrager S. Abnormal uterine bleeding. Am Fam Physician 1999;60(5):1371-82.
2. Speroff L, Glass RH, Kase NG, eds. Dysfunctional uterine bleeding. In: Clinical gynecologic endocrinology and infertility. 5th ed. Baltimore: Williams & Wilkins, 1994:575-93.