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DMPA can affect menstrual bleeding. After a year of use, 55% of women experience amenorrhea (missed periods); after two years, the rate rises to 68%. In the first months of use "irregular or unpredictable bleeding or spotting, or, rarely, heavy or continuous bleeding" was reported. [ 73 ]
In particular, prostaglandins induce abdominal contractions that can cause pain and gastrointestinal symptoms. [8] [9] The use of certain types of birth control pills can prevent the symptoms of dysmenorrhea because they stop ovulation from occurring. Dysmenorrhea is associated with increased pain sensitivity and heavy menstrual bleeding. [10] [11]
The pain can manifest in several ways, per OWH: very painful menstrual cramps, chronic pain in the lower back and pelvis, pain during or after sex, intestinal pain, and pain when you poop or pee.
If the degree of bleeding is mild, all that may be sought is the reassurance that there is no sinister underlying cause. If anemia occurs due to bleeding then iron tablets may be used to help restore normal hemoglobin levels. [1] The treatment choices of those referred to hospital in the UK for heavy menstrual bleeding. [20]
Abnormal uterine bleeding (AUB) is a broad term used to describe any disruption in bleeding that involves the volume, duration, and/or regularity of flow. Bleeding may occur frequently or infrequently, and can occur between periods, after sexual intercourse, and after menopause. Bleeding during pregnancy is excluded. [12]
Estrogen replacement can restore vaginal cells, pH levels, and blood flow to the vagina, all of which tend to deteriorate at the onset of menopause. Pain or discomfort with sex appears to be the most responsive component to estrogen. [22] It also has been shown to have positive effects on the urinary tract. [22]
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