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Dr. Zach
Dr. Zach, OB/GYN (Doctor)
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My 13 year old daughter has a heavy menstrual cycle. She has

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My 13 year old daughter has a heavy menstrual cycle. She has long blood clots that she literally pees out into the toilet. Her period has lasted up to 15 days. She has had all the blood tests and vaginal transverse ultra sound done, that have been negative. She was prescribed norethin for 25 days a month then to go off for 5 days. This has made her period heavier with more large blood clots, cramping(which she did not have before going on norethin), however it did shorten her cycle to 9 days. She at the same time has been out on medical leave for an h. pylori infection which caused gastritis, which she had no past Gi problems. She is a healthy teen. Her infection is no healed and she will return to school in week. She has been out for 8 weeks. I need to know what other options she has, so she can function when she has her period. At this rate when she has her period, with the heavy bleeding, she will not be able to attend school. because she will not get to the bathroom in time to change with all of the heavy bleeding. She is very stressed with her menstrual cycle.
Submitted: 3 years ago.
Category: OB GYN
Expert:  Dr. Zach replied 3 years ago.
Hello! My name isXXXXX and I will be happy to assist you today.

Given this heavy bleeding, she likely needs to be tried on a regular birth control pill with both estrogen and progesterone (the norethin is just a progesterone pill). Given a few cycles, this will slowly cause her periods to lighten and be far more manageable.

Also, if she hasn't already, she needs to be checked for blood disorders that cause easy bleeding (her doctor will know what to look for) -- this always needs to be ruled out before one just assumes it is due to simply 'heavy periods' and birth control is the answer.

The following site has some great information about combination birth control pills for you and her to read after before discussing this with her doctor to come up with an official plan.

http://www.youngwomenshealth.org/femalehormone1.html

Please remember to click the GREEN ACCEPT for my answer. Thank you!

~ Dr. AJ
Customer: replied 3 years ago.
My daughter has already been checked for blood disorders and clotting issues and all of the blood tests have been negative. Since she is still dealing with gastritis from the H. pylori infection, which is being managed with prilosec and gavascon. I think the ob gyn is concerned that low dose birth control may aggravate her stomach. However, from a 13 year old's point of view she wants the knowledge that her period is under control and can go about her daily activities with out any problems. She in the fall, had a very embarrassing large menstrual leak in her math class. It is difficult to concentrate on school, when she is worried about having a flood of blood, at any time during the heavy days of her cycle.

Is low dose birth control in your opinion an option without serious side effects?
Expert:  Dr. Zach replied 3 years ago.
an h. pylori infection and gastritis should not be effected by low dose birth control which I Feel is a great option for a person like her with these symptoms. The thing to always keep in mind is that most birth control pills have a similar side effect profile in GENERAL; however, each person is affected differently by each pill, so it may take some trial and error before the right low dose birth control pill is found for her (about 50% of women are happy with their first pill, others may go through 2, 3, or more before finding one they are happy with)

Please remember to click the GREEN ACCEPT for my answer. Thank you!

~ Dr. AJ
Customer: replied 3 years ago.
What is a common prescription that you professionally tend to prescribe for low dose birth control for a 13 year old, with minimal side effects in your practice? My daughter just got her first menstrual period, last July of 2010, 6 weeks before her 13th birthday.
Expert:  Dr. Zach replied 3 years ago.
Some examples of more popular, modern 'ultra-low dose' birth control pills include Yasmin, Alesse, and Mircette. I encourage you to read about them online and inquire about these from your doctor (EVERY ob/gyn has their favorite pills or go-to intro low dose pills) -- in my experience the three listed above tend to do quite well with my patients and at the very least is a starting point for your daughter.

Please remember to click the GREEN ACCEPT for my answer. Thank you!

Best Wishes,

~ Dr. AJ
Dr. Zach, OB/GYN (Doctor)
Category: OB GYN
Satisfied Customers: 4519
Experience: Accomplished Physician and Educator
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Dr. Zach
Dr. Zach
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