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Gynecology

Problems related to prlonged (25 day) periods

04/14/2006

Question:

Dear Doctor, I m asking this qusetion for my younger sister. She is 23 years old, unmarried. Her Menses started at 16 years age. Even since she has following problem with her periods. 1). Her period never come regularly....usually its at gap of two months. 2).Whenever she has period, she has very heavy bleeding and continues for 20-25 days unless she starts taking taking some harmonal tablets named "Primolute N". After taking these tablets bleeding stops. 3).She also hv severe pain during the days of period. 4).This is for informtion that she has got only one kidney....this condition is by birth. 5).When we consulted one gynec, we were told that reason for this is that, opening of her uterus is comparatively bigger. We are also worried, bcos this might affect her married life and wether she can have kids or not ? Do u have any clue on this ? What could be reason for this and whats treatment. Best regards

Answer:

The most common reason for her to have periods that are spaced so far and last so long are that she isn't ovulating. The lining grows until ovulation occurs. Once ovulation occurs (typically 14 days after your period starts) a hormone like the one in Primolute are produced that stop the growth. The hormones are only made for 14 days after which they stop. Once this happens the lining sheds all at once. In someone who isn't ovulating, the hormone isn't produced and the lining grows uninhibited. Once it gets too thick, it starts to breakdown at irregular intervals and patches. It can take days or weeks before the lining completely sheds and stops the bleeding. The process starts again and takes several weeks to months to get too thick again. Taking the Primolute is like copying the last two weeks of the cycle. It will cause the lining to stabilize and then shed. Her doctors need to look for any causes of anovulation (the failure to ovulate). For most women there isn't a specific cause and one needs to make sure the lining is shed every month. When pregnancy is desired, medicine can be used to stimulate the ovary to ovulate. Also, having one kidney could be associated with an abnormal uterus. Possibly one that is missing a half. This could be determined with an ultrasound or MRI scan.

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Response by:

Thomas  A deHoop, MD Thomas A deHoop, MD
Formerly Associate Professor of Clinical Obstetrics and Gynecology
Director, Medical Student Education
No longer associated