how bad is this?
June 6, 2023 5:36 AM Subscribe
I have already left a message for my doctor but looking for anecdata to quell anxiety while I wait for them to call back.
I take my birth control pills continuously so as not to have periods because periods suck and also during my period I get weepy and ragey. This was okayed by my gynecologist back in 2020.
For a while I would take them for 3 months continuously and then let myself have a period to "clean things out" such as it is. These periods would last longer than my usual period before I started taking the pill continuously and were heavier too but I figured that was because there was a lot of endometrial build up after three months.
Last year at my annual my gyno said there's no real reason to "clean things out" and I could just take the pills continuously forever. I did so and life was grand.
We went on vacation recently and my dumbass forgot to pack my birth control pills. We were on a cruise and I didn't discover I left the pills at home until we were already at sea so I couldn't ask my gyno to call in an emergency prescription for a local pharmacy.
When we came back from vacation I got my period, which I was kind of expecting because I had left the pills behind. I haven't had a period in nearly a year.
TMI time: this period has been a literal blood bath. I use a menstrual cup and it's filling AND overflowing within 3 hours of insertion. I didn't realize they could overflow but here we are. I am also passing giant clots. I have ruined several pairs of underwear and one pair of yoga pants. Last night before bed I emptied, washed, and inserted my cup. I was feeling very dizzy and decided to call my gyno in the morning.
Overnight I bled so much it overflowed the cup to such a degree that I have ruined our bedsheets and a pair of pajama pants. I woke up still dizzy.
I have left a message for my gyno but in the meantime I wanted to know if this is serious enough that I should just head straight to urgent care or the ER before he calls back, or if I should wait. I keep thinking maybe this period is super heavy because it's my first period in a year and I am panicking for no reason. But the huge clots and the dizziness have me concerned.
Should I wait for the call back from my gyno (he's usually pretty prompt) or am I in "do not pass go do not collect $200 go straight to ER" zone?
Anecdata welcome. YANMD and I am well aware YANMD.
I take my birth control pills continuously so as not to have periods because periods suck and also during my period I get weepy and ragey. This was okayed by my gynecologist back in 2020.
For a while I would take them for 3 months continuously and then let myself have a period to "clean things out" such as it is. These periods would last longer than my usual period before I started taking the pill continuously and were heavier too but I figured that was because there was a lot of endometrial build up after three months.
Last year at my annual my gyno said there's no real reason to "clean things out" and I could just take the pills continuously forever. I did so and life was grand.
We went on vacation recently and my dumbass forgot to pack my birth control pills. We were on a cruise and I didn't discover I left the pills at home until we were already at sea so I couldn't ask my gyno to call in an emergency prescription for a local pharmacy.
When we came back from vacation I got my period, which I was kind of expecting because I had left the pills behind. I haven't had a period in nearly a year.
TMI time: this period has been a literal blood bath. I use a menstrual cup and it's filling AND overflowing within 3 hours of insertion. I didn't realize they could overflow but here we are. I am also passing giant clots. I have ruined several pairs of underwear and one pair of yoga pants. Last night before bed I emptied, washed, and inserted my cup. I was feeling very dizzy and decided to call my gyno in the morning.
Overnight I bled so much it overflowed the cup to such a degree that I have ruined our bedsheets and a pair of pajama pants. I woke up still dizzy.
I have left a message for my gyno but in the meantime I wanted to know if this is serious enough that I should just head straight to urgent care or the ER before he calls back, or if I should wait. I keep thinking maybe this period is super heavy because it's my first period in a year and I am panicking for no reason. But the huge clots and the dizziness have me concerned.
Should I wait for the call back from my gyno (he's usually pretty prompt) or am I in "do not pass go do not collect $200 go straight to ER" zone?
Anecdata welcome. YANMD and I am well aware YANMD.
This post was deleted for the following reason: posters request -- frimble
Best answer: You are probably having a super-extra-gnarly period because of travel with all the stress and change in diet and sleep and hydration and such that comes with. Travel has given me rough periods since I was a teen when they were otherwise trouble-free.
If the blood is bright red as if it might be fresh, yes you should call Urgent Care and find out if they're going to just boot you to the ER if you go in.
If the contents are pretty dark as well as gunky as you've described, meaning you are probably just passing a particularly thickened lining, I personally would at least focus for 6-8 hours on serious hydration with electrolytes and probably camping on the loo for a bit to try to let gravity move things along. When I had periods and was having a rough one (which describes the entire 7-8 years leading up to menopause for me), the WORST thing I could do was lay down or even just slouchily recline, as clearly everything would...pool up, I guess, in there. So many mornings I woke up with a sudden "oh no" feeling and hoping I'd dropped a good-sized bath towel beside the bed so I could saddle up before I sat up and made the dash to the bathroom.
The dizziness is more likely anxiety, and exhaustion from worrying.
But, if you're worried, you're worried. If going in will help, and you haven't heard back from your doctor yet, go in.
Should this ever happen in the future, cruise doctors have heard of forgotten meds and they have a stock of the most common and urgent ones. They might have only had the generic version of yours if you were on a name-brand, but they'd also have contact info for pharmacies at all your ports of call.
posted by Lyn Never at 6:06 AM on June 6, 2023 [17 favorites]
If the blood is bright red as if it might be fresh, yes you should call Urgent Care and find out if they're going to just boot you to the ER if you go in.
If the contents are pretty dark as well as gunky as you've described, meaning you are probably just passing a particularly thickened lining, I personally would at least focus for 6-8 hours on serious hydration with electrolytes and probably camping on the loo for a bit to try to let gravity move things along. When I had periods and was having a rough one (which describes the entire 7-8 years leading up to menopause for me), the WORST thing I could do was lay down or even just slouchily recline, as clearly everything would...pool up, I guess, in there. So many mornings I woke up with a sudden "oh no" feeling and hoping I'd dropped a good-sized bath towel beside the bed so I could saddle up before I sat up and made the dash to the bathroom.
The dizziness is more likely anxiety, and exhaustion from worrying.
But, if you're worried, you're worried. If going in will help, and you haven't heard back from your doctor yet, go in.
Should this ever happen in the future, cruise doctors have heard of forgotten meds and they have a stock of the most common and urgent ones. They might have only had the generic version of yours if you were on a name-brand, but they'd also have contact info for pharmacies at all your ports of call.
posted by Lyn Never at 6:06 AM on June 6, 2023 [17 favorites]
Hey, this is only anecdata but I've had tranfusion-level anemia twice from heavy cycles that could best be described as the elevator scene from the Overlook Hotel. The first time this happened his had been going on for some time, mid-February to April. Constant laundry, super overnights flooded in 2-3 hours, clots the size of chicken eggs. Very upsetting. I kept thinking it was stopping (it had always stopped eventually) and I have my own issues re: the gyn, so.
Here's what happened when I went to the ER that April, two months into this: They did bloodwork and vitals, triaged me to lower priority, and after a four-hour wait, they did a pelvic scan. In my case, there was nothing mechanically wrong. I had to do a transfusion (this is not the norm -- my hemoglobin was down to 6.3 and I'd been bleeding like this for a long time and I'm a transplant patient) and then they had me see a gyn in four days. When I saw the gyn, she confided that I was the third person she'd seen that day due to heavy bleeding, and then she eventually put in a Mirena, the bleeding finally stopped.
Gyns seem remarkably unphased by this.
Here's what serious anemia feels like, at least for me: feeling out of breath, feeling weak (like, walking across the house made me wobbly), kind of a heavy pounding/drumming in your ears, mental fogginess/confusion.
If you are not in precarious health, call your gyn's office this morning and get their advice. (ianad etc.)
posted by mochapickle at 6:12 AM on June 6, 2023 [3 favorites]
Here's what happened when I went to the ER that April, two months into this: They did bloodwork and vitals, triaged me to lower priority, and after a four-hour wait, they did a pelvic scan. In my case, there was nothing mechanically wrong. I had to do a transfusion (this is not the norm -- my hemoglobin was down to 6.3 and I'd been bleeding like this for a long time and I'm a transplant patient) and then they had me see a gyn in four days. When I saw the gyn, she confided that I was the third person she'd seen that day due to heavy bleeding, and then she eventually put in a Mirena, the bleeding finally stopped.
Gyns seem remarkably unphased by this.
Here's what serious anemia feels like, at least for me: feeling out of breath, feeling weak (like, walking across the house made me wobbly), kind of a heavy pounding/drumming in your ears, mental fogginess/confusion.
If you are not in precarious health, call your gyn's office this morning and get their advice. (ianad etc.)
posted by mochapickle at 6:12 AM on June 6, 2023 [3 favorites]
A friend of mine had serious anemia (lower than 5) with almost no symptoms - no shortness of breath (which was my primary symptom), so I wouldn't count on being able to tell by the way you feel.
I had extremely heavy periods much like you describe when I was in perimenopause and went to the ER. The PA told me that I absolutely did the right thing with that much blood loss - that I could have had a heart attack.
I don't want to scare you - you'll probably be fine - but I think this warrants an urgent care or ER visit.
posted by FencingGal at 6:17 AM on June 6, 2023
I had extremely heavy periods much like you describe when I was in perimenopause and went to the ER. The PA told me that I absolutely did the right thing with that much blood loss - that I could have had a heart attack.
I don't want to scare you - you'll probably be fine - but I think this warrants an urgent care or ER visit.
posted by FencingGal at 6:17 AM on June 6, 2023
Best answer: honestly, that sounds like a standard heavy period to me. I overflow a cup regularly on heavy days like, an hour to fill, and have to pair them with pads, and the clotting/lumps is just blood doing its thing. I take blood thinners, but even without them, my periods are still very heavy. I kept track and it was close to 1litre over six days. That's not transfusion level quite, but it is wobbly. If my heavy periods went longer than that, I would go to my equivalent of urgent care/gynae because I would want it to stop, and get a quick iron test. I take iron for that and other anemia that can get serious - mochapickle's description is good - regular tiredness is likely to be exhaustion and PMS.
In your case, I would do urgent care or a gynae, not ER. The only hmm is if you think there's a possibility you've been pregnant, in which case it might not be bad to get a proper check-up. A gynae would be my call because they can do something like a mirena or shots, but it depends on how your local medical system is.
posted by dorothyisunderwood at 6:18 AM on June 6, 2023 [3 favorites]
In your case, I would do urgent care or a gynae, not ER. The only hmm is if you think there's a possibility you've been pregnant, in which case it might not be bad to get a proper check-up. A gynae would be my call because they can do something like a mirena or shots, but it depends on how your local medical system is.
posted by dorothyisunderwood at 6:18 AM on June 6, 2023 [3 favorites]
Best answer: As a former period haver, I'd personally say eh, periods are weird. Yours were unpleasant enough before that you accepted certain risks to eliminate them altogether, so it stands to reason that you'd have an unpleasant one now esp. after traveling.
But it's business hours where [your profile says] you are, so I'd skip the waiting-for-a-call-back-anxiety altogether by calling again and asking for a nurse; your doctor's office likely has one triaging calls for them.
posted by headnsouth at 6:22 AM on June 6, 2023
But it's business hours where [your profile says] you are, so I'd skip the waiting-for-a-call-back-anxiety altogether by calling again and asking for a nurse; your doctor's office likely has one triaging calls for them.
posted by headnsouth at 6:22 AM on June 6, 2023
Response by poster: Um here's another thing that just occurred to me - is it possible that I'm leaking everywhere because my cup isn't big enough or it doesn't fit me well? I used a Diva Cup for years but switched to some other brand I cannot recall off the top of my head not long before I started taking my BC pills continuously because I was finding the Diva Cup too stiff to comfortably insert and I wanted a softer, more flexible one.
I guess what I'm asking is is it possible that this isn't a danger zone because I'm getting a false sense of my blood loss because the cup isn't doing what it's supposed to be doing, hence the leakage?
Never occurred to me this could be a factor till just now because again, I haven't had a period in like 10 months.
posted by nayantara at 6:47 AM on June 6, 2023
I guess what I'm asking is is it possible that this isn't a danger zone because I'm getting a false sense of my blood loss because the cup isn't doing what it's supposed to be doing, hence the leakage?
Never occurred to me this could be a factor till just now because again, I haven't had a period in like 10 months.
posted by nayantara at 6:47 AM on June 6, 2023
Response by poster: Ok I just looked it up and I'm using a Lena cup that is soft and flexible but also super large for heavy flow and in theory should be lasting me for like 12 hours. I emptied, washed, and reinserted said cup two hours ago and am already leaking.
Gyno called back and said that if the dizziness doesn't improve by the end of the day to go to the ER.
posted by nayantara at 6:51 AM on June 6, 2023 [7 favorites]
Gyno called back and said that if the dizziness doesn't improve by the end of the day to go to the ER.
posted by nayantara at 6:51 AM on June 6, 2023 [7 favorites]
The change in flow and the clots may be caused by a fibroid on the uterus. You might ask the doctor about that possibility when you see them. Not necessarily a big deal but it would be helpful to know if that is the cause because those can be addressed surgically.
posted by happy_cat at 7:01 AM on June 6, 2023
posted by happy_cat at 7:01 AM on June 6, 2023
Best answer: Just my personal anecdata but when I used to have extra-clotty periods (pre-IUD) the clots especially would be able to sneak around the edge of the cup - I think it's basically a surface tension thing. So the leakage might be more of a quality than quantity issue.
posted by mskyle at 7:03 AM on June 6, 2023 [2 favorites]
posted by mskyle at 7:03 AM on June 6, 2023 [2 favorites]
TW Pregnancy Loss
I am sorry you have to go through this. Just an outlier idea: is it in any scenario possible that you might have become pregnant while on the cruise and are now experiencing an early miscarriage? That would explain the larger amount of, potentially bright red, blood.
Either way, I'd wait for the gyno as ERs are stressful (and sometimes psychologically unhelpful) in their own way, unless you experience fainting, fever or any other serious symptoms. IANYD
posted by Fallbala at 7:23 AM on June 6, 2023 [1 favorite]
I am sorry you have to go through this. Just an outlier idea: is it in any scenario possible that you might have become pregnant while on the cruise and are now experiencing an early miscarriage? That would explain the larger amount of, potentially bright red, blood.
Either way, I'd wait for the gyno as ERs are stressful (and sometimes psychologically unhelpful) in their own way, unless you experience fainting, fever or any other serious symptoms. IANYD
posted by Fallbala at 7:23 AM on June 6, 2023 [1 favorite]
Best answer: Get some pads or use your oldest hand towels. Blood always looks looks like a Lot More than it is, and we are hardwired to pay attention to it. It's unlikely you were pregnant; the timing is specific to stopping BC pills. I had periods this heavy years ago; it's miserable, and I'm sorry you're having such a hard time. I hope you took the day off. Watch something engaging/ read a good book/ listen to music while you wait for a call back. Treat yourself well. Please update when you can.
posted by theora55 at 7:38 AM on June 6, 2023
posted by theora55 at 7:38 AM on June 6, 2023
Best answer: I had a similar extremely heavy period and the doctor prescribed me some medication (Tranexamic Acid IIRC) which stopped it. Might be something to ask your doctor about.
posted by oranger at 8:04 AM on June 6, 2023 [4 favorites]
posted by oranger at 8:04 AM on June 6, 2023 [4 favorites]
Warning, gross discussion of an abnormal menstrual period.
Prior to getting a Mirena IUD, I took birth control pills continuously. I did this for several years with my doctor's approval, to no ill effect. After several years, I had a uterine cast, which is also known as a decidual cast or membranous dysmenorrhea. It happens when the endometrium (uterine lining) thickens as usual, but is shed all at once in a single mass, rather than slowly over the course of several days. It's most common in patients who have used progesterone containing contraceptive pills to skip their periods. Basically, several months' worth of endometrium builds up without being shed, and then it all comes out in one mass. Mine did not cause cramping or pain, and for lack of a less disgusting description, it was pretty "dry" when it came out, with no frank bleeding.
A uterine cast is almost never a sign of a serious problem, but if you look at photos online (warning: images of blood/menstrual fluid), you can see why passing one unexpectedly was an unsettling experience! I actually worked in a pathology lab at the time and that's how I learned that I wasn't a) dying or b) having a miscarriage.
Rarely, a uterine cast can be an indication of a ruptured ectopic pregnancy, so it's definitely worth running by a physician if it happens, but absent other symptoms, it's very likely no big deal. I've only ever had the one, and I've been on some continuous formulation of hormonal contraceptives since adolescence.
If I were in your position, I would wait to hear what my gynecologist recommended. If you develop any new symptoms such as fever, severe pain, vomiting, or uncontrollable bleeding, don't hesitate to go to the emergency room. Otherwise, a heating pad or warm bath, a nice cup of tea, and maybe a nap might make you feel better. Solidarity from another period-hater!
posted by easy, lucky, free at 8:30 AM on June 6, 2023 [4 favorites]
Prior to getting a Mirena IUD, I took birth control pills continuously. I did this for several years with my doctor's approval, to no ill effect. After several years, I had a uterine cast, which is also known as a decidual cast or membranous dysmenorrhea. It happens when the endometrium (uterine lining) thickens as usual, but is shed all at once in a single mass, rather than slowly over the course of several days. It's most common in patients who have used progesterone containing contraceptive pills to skip their periods. Basically, several months' worth of endometrium builds up without being shed, and then it all comes out in one mass. Mine did not cause cramping or pain, and for lack of a less disgusting description, it was pretty "dry" when it came out, with no frank bleeding.
A uterine cast is almost never a sign of a serious problem, but if you look at photos online (warning: images of blood/menstrual fluid), you can see why passing one unexpectedly was an unsettling experience! I actually worked in a pathology lab at the time and that's how I learned that I wasn't a) dying or b) having a miscarriage.
Rarely, a uterine cast can be an indication of a ruptured ectopic pregnancy, so it's definitely worth running by a physician if it happens, but absent other symptoms, it's very likely no big deal. I've only ever had the one, and I've been on some continuous formulation of hormonal contraceptives since adolescence.
If I were in your position, I would wait to hear what my gynecologist recommended. If you develop any new symptoms such as fever, severe pain, vomiting, or uncontrollable bleeding, don't hesitate to go to the emergency room. Otherwise, a heating pad or warm bath, a nice cup of tea, and maybe a nap might make you feel better. Solidarity from another period-hater!
posted by easy, lucky, free at 8:30 AM on June 6, 2023 [4 favorites]
Best answer: I am a person who menstruates and am going on year 30 of this nonsense. I often have clots like that and I have pretty consistent cycles. Add in a giant diaper-like overnight pad. That being said, you know your body better than any of us. Go see your doctor if you are still feeling dizzy in a few hours.
posted by notjustthefish at 9:06 AM on June 6, 2023 [2 favorites]
posted by notjustthefish at 9:06 AM on June 6, 2023 [2 favorites]
It’s time go to the ER if
- you’re filling one pad or tampon per hour, for several hours. (Use pads for now just so you have a metric.)
- clots are bigger than a quarter
- you’re feeling dizzy, or have low blood pressure and/or a rapid pulse
- there’s a risk of pregnancy
- recent birth or miscarriage
At the ER they’ll likely give you tranexamic acid, *maybe* do an internal ultrasound, maybe do some bloodwork and maybe give you an IV if you’ve lost more blood than they think is right.
Follow up with gyno for sure.
posted by cotton dress sock at 12:26 PM on June 6, 2023
- you’re filling one pad or tampon per hour, for several hours. (Use pads for now just so you have a metric.)
- clots are bigger than a quarter
- you’re feeling dizzy, or have low blood pressure and/or a rapid pulse
- there’s a risk of pregnancy
- recent birth or miscarriage
At the ER they’ll likely give you tranexamic acid, *maybe* do an internal ultrasound, maybe do some bloodwork and maybe give you an IV if you’ve lost more blood than they think is right.
Follow up with gyno for sure.
posted by cotton dress sock at 12:26 PM on June 6, 2023
Sorry
You’re dizzy
Do not pass go, go to the ER
posted by cotton dress sock at 12:27 PM on June 6, 2023 [1 favorite]
You’re dizzy
Do not pass go, go to the ER
posted by cotton dress sock at 12:27 PM on June 6, 2023 [1 favorite]
I started to chime in here a bit earlier as this happened to me earlier this year, but something similar also happening to me right now (six months later) except I'm not dizzy and not passing so many large clots. So not really advice as I think others have covered this well above, just unfortunately timely commiseration because when this happened before I was fucking terrified. I ended up going to a doctor (not my primary or an OB GYN, fwiw) who said that she advises at least 4 breaks a year, but that some people may need more in order to prevent these types of... terribleness. It seems I am one of those people, and maybe you are too. I'm glad I panic-invested in period panties because it helps to not feel like I ruining all my underwear at once.
I hope you are doing alright!
posted by sm1tten at 4:17 PM on June 6, 2023
I hope you are doing alright!
posted by sm1tten at 4:17 PM on June 6, 2023
Response by poster: Update: the dizziness dissipated by lunchtime so I opted not to go to the ER and went to get some pads from the drug store. I then had some leakage for the rest of the day but actually felt good enough to go for a long walk in the afternoon and took a hot shower after work which felt good. Overnight there was no bloodbath and I just emptied my cup just now for the first time since the shower and it's only about half full. I'll keep an eye on it today but from my recollection before I took the pills continuously once the cup stopped being completely full when I emptied and cleaned it it was usually a sign that my period was coming to an end. It's been a week since this period started and my period used to range from 3 days when I was in my 20s and then a full week once I hit my early 30s. I'll keep an eye on it today but I don't think I am in the danger zone at this point and I reckon by tomorrow this will all be behind me.
Maybe yesterday's epic overnkght flood was just my body's way of getting the stuff out as fast as possible? Who knows. Bodies are weird.
Thank you all for your advice and your anecdata; it was very comforting to hear that others have experienced this too and helped quell my anxiety considerably.
posted by nayantara at 5:07 AM on June 7, 2023 [6 favorites]
Maybe yesterday's epic overnkght flood was just my body's way of getting the stuff out as fast as possible? Who knows. Bodies are weird.
Thank you all for your advice and your anecdata; it was very comforting to hear that others have experienced this too and helped quell my anxiety considerably.
posted by nayantara at 5:07 AM on June 7, 2023 [6 favorites]
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is there a nurse/triage number at your local hospital you can call?
i hestitate to advise you since I'm a not medical person or period-haver. but if my gf or daughter were worried like you seem to be, i think I'd gently urge an ER visit.
posted by j_curiouser at 5:57 AM on June 6, 2023 [1 favorite]