Persistent Postpartum Bleeding: Causes, Diagnosis & Treatment

Question
I was wondering what is going on. I had a flow after my daughter was born for 8 months. The doctors checked my thyroid and that was normal. I had an ultra-sound to see if there were any abnormalities and there was none. They put me on Ortho-Tri-Cyclen to see if it was my hormones. The birth control helped initially, but I spot all the time. I take my pills same time every day, but I will bleed for 2 days and stop and go for 2 days again. My daughter is 10 months now and my body does not feel like it is back to normal yet. What else could it be?

Answer
Dear Valerie

Age is an important aspect in the diagnosis. If you are over 35, you may need to have a diagnostic hysteroscope, a scope that looks inside your uterus to check for any local lesions. If this is normal, you may need to go for some progesterone hormone therapy for up to 3 months. If bleeding occurs, the dose of the progesterone should be increased gradually till bleeding stops and the effective dose is maintained for 3-6 months. Unfortunately, the contraceptive pills, such as the one you are taking, contains estrogen in addition to progesterone; and this can be the cause of your intermittent bleeding.