ask: I have been having 3week-1 month long periods w/ large clots. What could be causing the length and clots? Should I worry?

Thank you so much for your response. I'd be happy to share my gynecologist's opinion and recommendations after I see him (end of August). One thing that I failed to mention in my previous comment is that my 17 year old daughter has recently began experiencing the same symptoms and, she too, had an ovarian cyst removed around the beginning of '09. I do intend to speak with my gynecologist about this as well about hereditary and what she should expect in her adulthood.

Anon,

First of all, welcome to EmpowHer! And thank you so much for your question.

How long have you been having these extremely long periods, Anon?

And do you mean they last two months whether they are light OR heavy?

What you have is called Hypermenorrhea (big name) or Menorrhagia (not quite as big a name), which stands for excessive bleeding during your period. About 10% of all women have this condition.

Here's some information from ourEmpowHer Encyclopedia page on this. It covers a lot of areas that may not apply to you because you are so young, but you may be interested in all of it:

Causes

In some cases the cause of menorrhagia is unknown. However, many conditions have been known to be associated with menorrhagia. These include:

◦Menstrual cycle hormone dysfunction (this means perhaps a hormonal imbalance; easy to test for)
◦Cervical or endometrial polyps
◦Uterine fibroids
◦Infection (pelvic infections)
◦Blood-clotting disorders (you can be tested for this)
◦Anticoagulant medications (blood thinners)
◦Anti-inflammatory medications (large amounts over a long period of time)
◦Liver, kidney, or thyroid disease
◦Problems with an intrauterine device (IUD)
◦Ectopic pregnancy
◦Ovarian cysts
◦Chronic medical conditions
◦Cancer of the uterus or cervix (rare)
◦Vaginal injury from trauma or sexual abuse
◦Complications from pregnancy, such as miscarriage

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. People at greatest risk for menorrhagia include:

◦Adolescent girls who have started menstruation within the last 12 to 18 months
◦Women approaching menopause
◦Women with hereditary bleeding disorders
◦Women who are obese

SymptomsSymptoms of menorrhagia include:

◦Menstrual bleeding lasting more than seven days
◦Unusually heavy bleeding (soaking through a sanitary napkin or tampon every hour)
◦Menstrual flow requiring change of sanitary protection during the night
◦Menstrual flow including large clots
◦Menstrual flow interfering with lifestyle
◦Fatigue and/or shortness of breath (symptoms of anemia )

Diagnosis

Your healthcare provider will ask about your symptoms and medical history. A physical examination including pelvic exam will be done as part of the evaluation. Tests may include:

◦Pap test
◦Blood tests
◦Pregnancy test
◦Ultrasound —a test that uses sound waves to examine your reproductive organs (uterus and ovaries)
◦Endometrial biopsy —removal of a sample of endometrial tissue to look for changes in the lining of the uterus
◦Dilation and curettage (D&C)—scraping of the inner lining of the uterus
◦Hysteroscopy—examination of the cervix and fallopian tubes using a telescope-like viewing device

Treatment

Treatment of menorrhagia will depend on the underlying cause. Women who experience persistent excessive bleeding should discuss with their healthcare provider whether to take iron supplements to prevent anemia.

If there is no medical disorder causing your menorrhagia, your doctor may prescribe the following:

Medications
These may include:

◦Hormone therapy (estrogen and/or progestogen hormones by mouth, skin application, vaginal application, or injection)
◦An IUD that releases a progestogenic drug (Mirena)
◦Nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and mefenamic acid (Ponstel, Ponstan)

Surgical Procedures
Procedures may include:

◦Dilation and curettage (D&C)
◦Operative hysteroscopy—A long, thin instrument is inserted into the uterus that can aid in removal of a polyp or fibroid.
◦Endometrial ablation or resection—The surgical removal of the lining of the uterus using heat, microwave, or surgical tools. After this procedure, you will not be able to carry a pregnancy.
◦Hysterectomy —The surgical removal of the uterus. After this procedure, you will not be able to carry a pregnancy. If the ovaries are also removed, early menopause will follow.

Your age, overall health, and medical history should be considered when choosing treatment. Discuss with your doctor your plans for having children.

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In terms of having children, it's first important to get your cycle balanced and to figure out why it goes so long. Getting pregnant has to do with making sure you are ovulating and that your body is building up the uterus in case a fertilized egg happens by. All of that is a function of hormones such as estrogen and progesterone.

Because you are young and you haven't been having periods for more than a few years, it makes sense that your doctor first tries birth control pills to help regular your cycle. How long ago did you start them, and does it seem to be helping?