By Dr. Flo
What you need to know:
- There are medications that may be prescribed to stop the bleeding, to manage any pain, and correct low blood levels.
Family planning and senior women’s health are two sensitive but crucial topics in modern medicine. A common issue many women face is abnormal or irregular bleeding when using contraceptives like the three-month birth control injection. At the same time, older women, especially those over 70, may struggle with urinary complications that significantly reduce quality of life.
This article dives into both concerns, offering clarity, guidance, and possible solutions from a medical perspective.
“Why Am I Bleeding So Much?”: Understanding Irregular Bleeding on the 3-Month Injection
The three-month contraceptive injection, commonly known as Depo-Provera, is a popular form of birth control due to its convenience and effectiveness. However, like any medical treatment, it comes with side effects — the most common being irregular vaginal bleeding.
“Many women experience changes in their menstrual cycle during the first several months of using the injection,” explains Dr. Flo. “These changes can include light spotting, continuous bleeding, or even heavy bleeding that lasts for weeks.”
This abnormal bleeding is usually not a sign of danger but can be distressing. In fact, for some women, the spotting may last for up to a year. By the end of the first year, nearly half of all users experience an absence of periods altogether.
So, what should you do if the bleeding becomes excessive or prolonged?
“If the bleeding is heavy, uncomfortable, or accompanied by other symptoms such as dizziness or severe pain, it is advisable to see a gynaecologist,” says Dr. Flo.
The doctor may carry out several investigations, including:
- Pregnancy test (to rule out pregnancy-related causes)
- Pelvic ultrasound scan (to detect fibroids, cysts or any abnormalities)
- Blood tests, including hemoglobin levels and coagulation profile
- Screening for infections, such as sexually transmitted diseases
If no underlying issues are found, the bleeding may be treated symptomatically.
“There are medications that may be prescribed to stop the bleeding, manage pain, or address any anemia caused by blood loss,” says Dr. Flo.
Additionally, women uncomfortable with this side effect may consider switching to another contraceptive method.
“It’s important to wait at least a few months for your body to adjust before making a final decision,” she adds. “Some women experience stabilization of their cycle over time.”
“My Mum Can’t Pee Properly”: Urinary Retention in Older Women
A separate but equally important issue is urinary retention in older women. It may appear suddenly or develop over time and can be life-altering.
“I’ve taken my mother to several hospitals, but doctors keep saying everything is normal. Yet she still has difficulty urinating and sometimes feels pain,” writes one concerned daughter.
Dr. Flo responds: “Your mother may be experiencing a condition called urinary retention, where the bladder doesn’t empty completely, or at all.”
There are two types:
- Acute urinary retention – sudden inability to urinate, often painful and requiring immediate medical attention.
- Chronic urinary retention – develops slowly, with symptoms like a weak urine stream, frequent urination, or feeling the need to urinate even after using the bathroom.
Common symptoms include:
- Lower abdominal discomfort
- Waking multiple times at night to urinate
- Urine leakage
- A persistent feeling of bladder fullness
- Pain or burning sensation before urination
But why does this happen, especially in older women?
“Urinary retention is 13 times more common in men, but it can affect women, particularly elderly ones,” Dr. Flo explains.
Causes may include:
- Obstruction due to pelvic organ prolapse, tumors, or constipation
- Nerve damage from diabetes, stroke, or surgery
- Side effects of medication such as antihistamines or antidepressants
- Inflammation or infection in the urinary tract
- Urethral strictures (narrowing due to scar tissue)
Proper diagnosis is essential and usually involves a series of tests, including:
- Urine analysis and culture
- Pelvic ultrasound
- Post-void residual test (to see how much urine remains in the bladder)
- Cystoscopy (a procedure to look inside the bladder)
- Urodynamic studies (to assess how the bladder and urethra store and release urine)
Treatment depends on the cause.
“If it’s an infection, antibiotics may help. If there’s a prolapse, a pessary or surgery might be needed. Medications can also help relax the muscles to improve urine flow,” Dr. Flo says.
In severe cases, a catheter may be used to drain urine from the bladder.
“Long-term catheter use isn’t ideal, but in some chronic cases, it may be necessary while addressing the root problem,” she adds.
Managing and Preventing Urinary Retention
Preventing and managing urinary retention involves a combination of medical and self-care strategies:
- Pelvic floor exercises (Kegels): Help strengthen the muscles supporting the bladder.
- Scheduled toilet times: Encourage routine bathroom visits to avoid retention buildup.
- Hydration management: Drink fluids during the day but reduce intake in the evening.
- Avoid constipation: A healthy diet with fiber can prevent rectal pressure on the bladder.
From young women navigating the side effects of birth control, to elderly women struggling with urination issues, reproductive and urinary health are essential to overall well-being.
“Don’t suffer in silence,” says Dr. Flo. “Whether it’s bleeding that won’t stop or trouble urinating, your body is trying to tell you something. Listen to it and seek help.”
Understanding the conditions, getting a proper diagnosis, and following through with treatment can make all the difference in restoring comfort and confidence in everyday life.
