Long periods with no discernible cause

[wombat]

Hi Lara,

I'm wondering if you can help me. No one else has been able to!!

I'm in my early 30s. I was put on the pill (Yasmin) when I was about 15, for very heavy periods and a short cycle (21 days). Blood tests at the time were normal, except for anaemia. The pill worked great until my early 20s - I went off it to see if it was causing my chronic migraines. It wasn't, but when I tried to go back on it, I was getting spotting throughout the entire month. When I went off the pill again, I gradually went back to having 21 day cycles, and long periods of 14 days - mostly light, with a few super heavy days in the middle.

Since then, I've tried everything that's been suggested - seen multiple gynos and an endocrinologist. I've tried multiple pills, including Diane 23, Microgynon 50, Qlaira and Zoely, as well as the Nuvaring. I've given them each at least 6 months but have breakthrough bleeding the entire time. I had a Kyleena for a year, and bled the whole time. I also tried taking estrogen while I had the Kyleena, that didn't help either. I had the Kyleena out about a year ago, and haven't taken the pill or anything else in that time, either. My cycles are now about 25-28 days, but I still bleed for about two weeks at a time. It's almost like two periods, back to back - the first one is light but the blood is dark, then I have a very heavy bleed that's bright red. They're not typically very painful (sometimes a little crampy on the heavy days, but ibuprofen/naproxen fixes it).

My hormone levels are normal (I have hypothyroidism, but that's well managed with thyroxine) - though I have acne when I'm not on the pill. Blood tests also showed I had ovulated (at least, when I had the test I did). Multiple ultrasounds haven't shown up anything unusual, aside from borderline polycystic ovaries, they showed I had ovulated as well. I had a hysteroscopy and a D&C, which didn't show anything unusual and also didn't change anything at all.

No one seems to know what to do with me, and neither do I. The jury is still out on whether I have PCOS, but other than that, there doesn't seem to be anything actually 'wrong' to fix - but it doesn't seem right to me. After reading articles on your website, I'm going to trial cutting out A1 dairy. Are there any other tests or treatments I should be trying? I seem to be at a dead end.

[Lara]

One next step is to track temperatures to see if you are indeed ovulating every cycle. Because long bleeds can be a sign of anovulatory cycles.

Then treatment will depend on the cause of anovulation. If it's PCOS, cyclic progesterone therapy (using oral micronised progesterone, or natural progesterone) can be helpful.

[wombat]

Thanks Lara, I'll try tracking my temperature and see how that goes. I really appreciate your reply!