Women's Health Community

Dear ladycooper: If any gauze was removed, that would not be the likely culprit for your current bleeding changes. Also, the rapidness of the onset of these changes suggests either a hormonal reason (my best GUESS)--or more distantly, a new infection with chlamydia or gonorrhea.

As you may have read, for women not using hormonal birth control, the most common reason for a menstrual pattern like you have described is not having an ovulation every month. In a normal cycle, estrogen is produced all month. Estrogen is responsible for building up the lining of your uterus so you have something to shed each month.

In a normal cycle, progesterone production increases following ovulation and release of an egg.. Progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining—your period.

So, if you do not ovulate, the estrogen build up of the lining continues, but without the usual ovulation associated progesterone. Thus, the hormone levels don't decline, and the lining stays up inside the uterus—as a missed/late or even too early period. Alternatively, the built up lining can begin to shed under its own weight producing prolonged/erratic bleeding.

There can be many causes for not ovulating: low thyroid, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with boyfriends/girlfriends, money), increased body weight, anorexia, rotating shifts at work, etc.

If the lining of the uterus was very thickened this month that can produce a heavier flow leading to big/frequent clots. A thicker lining can also produce more prostaglandins (substance responsible for uterine cramps).

Bottom line, you should rule an undetected pregnancy by getting a reliable pregnancy test first. If the bleeding lasts longer than seven days, or takes on an erratic pattern, you should see a GYN--or even your local county family planning clinic. The other advantage of seeing a clinic is that they can get your records about the retained gauze after your daughter's birth. Once those details are known they can give you more accurate advice about any role the gauze may have.

In Support,
Jane