Enduring four years of non-stop menstrual bleeding

Her eyes are slightly yellow. Despair is written all over her face. Dressed in a multicoloured gomesi with a red sash and yellow crocs shoes, she carries a yellow and black wrapper (kanga) to the interview. Before she sits down, she wraps herself with it. At 46, Gertrude Kabaseke is a mother of eight. Her oldest child is 20 years old and her youngest is 11. The family resides in Kyabazala Village, Nakifuma Sub-county in Mukono District. 

Four years ago, like any other woman, Kabaseke started her monthly period which never stopped. At the time, she was 42. 

"When my menstruation lasted longer than a week, I started to worry about what might be wrong. After two weeks of prolonged bleeding, I decided to visit a clinic for medical assistance. A nurse gave me some tablets which she said should stop the bleeding within a day," she says. 

The bleeding did not stop; in fact, it became heavier. When Kabaseke returned to the clinic, the nurse asked her if she was experiencing a miscarriage. 

“I was not pregnant. I tried other clinics, but none of them could help. After six months of continuous bleeding, I was referred to Kayunga Regional Referral Hospital, where I received additional medication and was sent home. However, the bleeding did not stop,” she adds. 

Kabaseke describes her menstrual flow as heavy, often accompanied by large dark clots. Each time she goes to the toilet the clots are expelled. Her condition led to anaemia, which resulted in her being admitted to the hospital. 

“I was transported on a bodaboda. When we arrived at the hospital entrance, I suddenly collapsed and fainted. The nurses quickly came to my aid and when I regained consciousness, they asked if I was having a miscarriage. They conducted a scan and informed me that the results indicated a baby was developing in my womb,” she recounts. 

However, Kabaseke was not pregnant. To confirm the scan results, a midwife performed a physical examination on her. When she pushed her hand into Kabaseke’s cervix, she retrieved heavy clots of blood. 

“There was no sign that what she had pulled out were parts of a rotting foetus. It was just dark blood. I was severely anaemic and they gave me a transfusion of four units (packets) of blood,” she says. 

Dr Badru Matovu, an obstetrician and gynaecologist at Kibuli Muslim Hospital in Kampala, says one possible cause of abnormal bleeding could be related to pregnancy. For instance, incomplete abortions, where retained tissue remains in the uterus, can lead to ongoing bleeding. 

He also highlights another common cause of abnormal bleeding associated with pregnancy known as molar pregnancy. This is a rare and abnormal condition that occurs when a fertilised egg implants in the uterus but does not develop into a normal baby. Instead, it grows abnormally. 

Women with molar pregnancy experience heavy vaginal bleeding with clots. Some pass out small pieces of the molar tissue. 

After two weeks in the hospital, Kabaseke’s condition stabilised and she was discharged. The bleeding stopped for a month, and then, returned with a vengeance. Four years down the road, and it has never stopped. 

Abnormal vaginal bleeding

A normal menstrual period should last a minimum of three days and a maximum of seven days. A normal menstrual cycle lasts 28 days on average but can range from 21 to 35 days. Dr Matovu, says if a cycle is beyond those days, it ceases to be menstruation and becomes vaginal bleeding.

“Prolonged vaginal bleeding is a serious issue. When you bleed for a whole year, you can become anaemic and will go into shock. Therefore, you must report the condition to a gynaecologist so that tests can be performed to determine the cause of bleeding,” he says.

Dr Matovu adds that there are several causes of abnormal vaginal bleeding, one of them being hormonal imbalance. These may be reproductive hormones or hormones from other glands, such as the thyroid or pituitary glands.

“Sometimes, abnormalities in the uterus can cause a woman to bleed for months. They come here saying they have ekikulukuto and they have been bewitched. However, when you perform a scan, you find a growth in the endometrium of the uterus. The uterus is designed to push out these growths, hence the bleeding,” he explains.

Other causes of abnormal vaginal bleeding could be an enlarged uterus, female reproductive cancers, abnormal ovaries, and haemophilia, a condition in which the blood does not clot.

"All these conditions need to be evaluated by a specialist. Unfortunately, some women seek help from unqualified health workers who may prescribe medications to temporarily stop abnormal vaginal bleeding without addressing the underlying cause. While these drugs may provide short-term relief, the problem often recurs," cautions Dr Matovu.

Whenever Kabaseke has money, she visits the hospital and gets medication that stops the bleeding for four to five days.

Incapacitated

Kabaseke had to walk up a small hill for this interview in the trading centre. By the time she arrived, she was out of breath and experiencing heart palpitations.

“I feel my heart racing. I cannot walk long distances, and I struggle under the sun. If I try, I have to stop every few minutes to rest under a tree because I feel darkness descending over me. I cannot even do menial work,” she explains.

Kabaseke says her medication costs Shs25,000 per dose. She could only afford the first dose and has since relied on begging from friends. After months of collecting small contributions, she returns to the hospital for another dose.

“The doctors once asked if I had ever used a family planning method. I only did after my last child was born, but I stopped when he turned five. That was six years ago. No one in my family has ever had this problem. I only used to hear about it affecting other people,” she says.

Her husband of 22 years eventually abandoned the marriage in 2023 when she failed to recover. He has since remarried and moved to another village. Initially, he supported her treatment, but over time, he withdrew his help.

“I asked him if he had abandoned me to die. He said no, but he insisted he had done all he could and that my family should take over. He advised me to return to my father’s home. I refused because I could not leave my children to fend for themselves in this village,” she says.

After marrying another woman, her husband stopped providing for the family or paying school fees. Her younger children, who do not attend school, perform menial chores in the village to earn meagre wages, which they use to buy food and soap.

“My son should have completed his Primary Leaving Examinations last year. Now, all the money we make goes to my treatment. How can I afford their school fees? When I was still using sanitary pads, I needed three packets a day. But now, because I cannot afford them, I cut pieces of cloth from my dresses, skirts, and sweaters to use instead,” Kabaseke explains.

She adds that she avoids sitting in large groups, always carrying kangas to wrap around herself.

“I only sit among close friends. I fear standing up and finding blood stains on my gomesi. Some people say I was bewitched and should visit a shrine. But I have not gone to a witch doctor. I do not believe this is supernatural. I just got my period, and it never stopped,” she says.

Despite her suffering, Kabaseke does not blame her co-wife for witchcraft, acknowledging that her husband only remarried after trying to help her in vain. Besides what her children earn, kind neighbours sometimes provide food or milk whenever they can.

Call for help

Kabaseke appeals to Good Samaritans for help in raising transport fare to travel to Mulago National Referral Hospital for specialised medical care.

“I have been receiving treatment and blood transfusions at Kayunga Hospital, but I believe proper medical attention could heal me. I urge professionals who can diagnose my condition to assist me. I would also be grateful to anyone who can help me access them,” she pleads.

Dr Matovu cautions against self-medicating to stop abnormal vaginal bleeding without identifying the root cause. 

He also warns against taking medication based on a friend's recommendation, as what works for one person may not be suitable for another.

FREQUENTLY ASKED QUESTIONS

According to medicalnewstoday.com, below are some commonly asked questions about a period that will stop.

1. When should a person go to the hospital if their period will not stop?

According to the Centers for Disease Control and Prevention, a person should seek medical help if they:

Have menstrual bleeding that soaks through one pad or tampon per hour for several hours.

Pass blood clots that are larger than a quarter.

Are pregnant and experience heavy or prolonged bleeding, as this can signal miscarriage or an ectopic pregnancy.

Experience menstrual bleeding that lasts more than 7 days.

2. Why have I been bleeding for over a month?

Potential reasons why a person has experienced prolonged menstrual bleeding include the following:

They have an intrauterine device (IUD).

They take hormonal birth control.

They have thyroid problems.

They have polycystic ovary syndrome.

3. Why am I light bleeding for two weeks? There are many reasons why a person might experience light menstrual bleeding: l An eating disorder.

Uncontrolled diabetes.

Hormonal birth control pills. l Certain medications. 4. How will a doctor diagnose the underlying cause? There are many causes for a long period, so your doctor will likely begin your appointment by asking you some questions.

These may include:

When your period started.

5. How many pads and tampons you have used in the last day?

Your sexual activity.

Other symptoms you are experiencing.

Your medical and relevant family histories.

Enduring four years of non-stop menstrual bleeding

Other causes of abnormal vaginal bleeding could be an enlarged uterus, female reproductive cancers, abnormal ovaries, and haemophilia, a condition in which the blood does not clot.

"All these conditions need to be evaluated by a specialist. Unfortunately, some women seek help from unqualified health workers who may prescribe medications to temporarily stop abnormal vaginal bleeding without addressing the underlying cause. While these drugs may provide short-term relief, the problem often recurs," cautions Dr Matovu.

Whenever Kabaseke has money, she visits the hospital and gets medication that stops the bleeding for four to five days.

Incapacitated

Kabaseke had to walk up a small hill for this interview in the trading centre. By the time she arrived, she was out of breath and experiencing heart palpitations.

“I feel my heart racing. I cannot walk long distances, and I struggle under the sun. If I try, I have to stop every few minutes to rest under a tree because I feel darkness descending over me. I cannot even do menial work,” she explains.

Kabaseke says her medication costs Shs25,000 per dose. She could only afford the first dose and has since relied on begging from friends. After months of collecting small contributions, she returns to the hospital for another dose.

“The doctors once asked if I had ever used a family planning method. I only did after my last child was born, but I stopped when he turned five. That was six years ago. No one in my family has ever had this problem. I only used to hear about it affecting other people,” she says.

Her husband of 22 years eventually abandoned the marriage in 2023 when she failed to recover. He has since remarried and moved to another village. Initially, he supported her treatment, but over time, he withdrew his help.

“I asked him if he had abandoned me to die. He said no, but he insisted he had done all he could and that my family should take over. He advised me to return to my father’s home. I refused because I could not leave my children to fend for themselves in this village,” she says.

After marrying another woman, her husband stopped providing for the family or paying school fees. Her younger children, who do not attend school, perform menial chores in the village to earn meagre wages, which they use to buy food and soap.

“My son should have completed his Primary Leaving Examinations last year. Now, all the money we make goes to my treatment. How can I afford their school fees? When I was still using sanitary pads, I needed three packets a day. But now, because I cannot afford them, I cut pieces of cloth from my dresses, skirts, and sweaters to use instead,” Kabaseke explains.

She adds that she avoids sitting in large groups, always carrying kangas to wrap around herself.

“I only sit among close friends. I fear standing up and finding blood stains on my gomesi. Some people say I was bewitched and should visit a shrine. But I have not gone to a witch doctor. I do not believe this is supernatural. I just got my period, and it never stopped,” she says.

Despite her suffering, Kabaseke does not blame her co-wife for witchcraft, acknowledging that her husband only remarried after trying to help her in vain. Besides what her children earn, kind neighbours sometimes provide food or milk whenever they can.

Call for help

Kabaseke appeals to Good Samaritans for help in raising transport fare to travel to Mulago National Referral Hospital for specialised medical care.

“I have been receiving treatment and blood transfusions at Kayunga Hospital, but I believe proper medical attention could heal me. I urge professionals who can diagnose my condition to assist me. I would also be grateful to anyone who can help me access them,” she pleads.

Dr Matovu cautions against self-medicating to stop abnormal vaginal bleeding without identifying the root cause. 

He also warns against taking medication based on a friend's recommendation, as what works for one person may not be suitable for another.

FREQUENTLY ASKED QUESTIONS

According to medicalnewstoday.com, below are some commonly asked questions about a period that will stop.

1. When should a person go to the hospital if their period will not stop?

According to the Centers for Disease Control and Prevention, a person should seek medical help if they:

Have menstrual bleeding that soaks through one pad or tampon per hour for several hours.

Pass blood clots that are larger than a quarter.

Are pregnant and experience heavy or prolonged bleeding, as this can signal miscarriage or an ectopic pregnancy.

Experience menstrual bleeding that lasts more than 7 days.

2. Why have I been bleeding for over a month?

Potential reasons why a person has experienced prolonged menstrual bleeding include the following:

They have an intrauterine device (IUD).

They take hormonal birth control.

They have thyroid problems.

They have polycystic ovary syndrome.

3. Why am I light bleeding for two weeks? There are many reasons why a person might experience light menstrual bleeding: l An eating disorder.

Uncontrolled diabetes.

Hormonal birth control pills. l Certain medications. 4. How will a doctor diagnose the underlying cause? There are many causes for a long period, so your doctor will likely begin your appointment by asking you some questions.

These may include:

When your period started.

5. How many pads and tampons you have used in the last day?

Your sexual activity.

Other symptoms you are experiencing.

Your medical and relevant family histories.