Bleeding, weight loss on the pill
Dear Dr Mitchell,
I am on the Minigynon pill. Last month when the pack ended, I began the seven-day break. I had bleeding on the third day after stopping, which was very light. But by the fifth day I had very heavy, bright red bleeding. This went on for a week, then stopped. I have also lost a great deal of weight without trying — 13 pounds since December. This has happened even though I have been eating in excess of my usual diet, and I also supplement with Complan and Peritol so I have an appetite. I fear that I may have some illness like cancer. My only health problem is depression, which I have been grappling with for over a year. But the fact that I’ve tried to maintain a full diet makes me believe that depression isn’t the cause of my weight loss or bleeding. Can you help?
Abnormal vaginal bleeding and significant weight loss of 13 pounds should definitely be investigated.
The oral contraceptive pill usually causes a much lighter flow and decreases period pains significantly. A heavier than normal menstrual period may be due to several factors — inflammation of the lining of the uterus (endometritis), uterine fibroids, polyps in the lining of the uterus, cancer of the uterus, inflammation of the cervix (cervicitis), cervical polyps and cervical cancer — which can all cause abnormal vaginal bleeding.
You will definitely need to get a complete physical examination, an ultrasound and a Pap smear done to determine the exact underlying cause of the bleeding.
If an infection is suspected then treatment with antibiotics should be undertaken. Your partner should also be treated if an infection is suspected to be the cause. An endocervical swab should be done before treatment to rule out a significant sexually transmitted infection such as chlamydia or gonorrhoea. Screening for other sexually transmitted infections such as syphilis and human immunodeficiency virus (HIV) should be done. Other causes of weight loss should be investigated. A complete blood count and screening tests for systemic lupus (SLE) should also be done.
The excessive weight loss may be due to diabetes mellitus or an overactive thyroid gland (hyperthyroidism). Also include a screening test for diabetes mellitus and a thyroid screen in your workup.
If you have not done so you should get the cervical cancer vaccine to reduce your risk of cervical cancer. It is recommended for all women between the ages of 10 to 55 years.
It is given in three doses — the first is followed by a second in one month and a third given six months after the first dose.
Consult your doctor who will advise you further.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver. com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax 968-2025. Dr Mitchell cannot provide personal responses.
DISCLAIMER: The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
