Looni physician Q&A blog post with photo by @claybanks on https://unsplash.com/photos/e6pK_snssSY?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText

Ask The Experts: 1st Edition

We're excited to have Dr. Stephanie Colantonio, one of Looni's medical advisors, answering some of your questions. Dr. Colantonio is a board-certified physician who specializes in integrative reproductive health, including menstrual health, hormone balance, and mental health. She combines her training in both conventional medicine and herbalism and mindfulness when caring for patients at her private practice in Los Angeles.

NOTE: the responses in this blog are based on verbal responses Dr Colantonio gave on Instagram here. They are not direct transcripts.

If you have any questions you want answered by one of Looni’s experts, just email us or ask away in our Burning Questions room here in Geneva.

I'm 21 and haven't had my period since 2022. My OBGYN has made me feel dismissed and uncomfortable and just recommended birth control. Are there more tests I can request?

👩‍⚕️ First of all, I'm sorry that you have experienced feeling dismissed and uncomfortable with your doctor. The good thing is that I'm glad you are advocating for yourself. It sounds like you're asking the right questions and seeking different pathways than the only option that your doctor is offering. When someone hasn't had a period for that long, typically, we check some blood tests, looking at different hormone levels, as well as checking a pelvic ultrasound to try to get a better idea of what is causing the lack of bleeding.

Is it normal to bleed for ten days after getting off contraceptive injections?

👩‍⚕️ It can be normal to have cycle irregularities for the first few cycles after going off of hormonal contraception. So if a person is bleeding for 10 days, but it only happens one cycle, and then the next time they bleed, let's say it's six or seven days, then they should be okay. We would want to dig a little bit deeper if they're consistently having 10 days of bleeding every period, or anything more than eight days of bleeding consistently for more than three cycles or so. In that case, they should check in with their healthcare provider and talk about checking labs, getting a pelvic ultrasound, among other diagnostic checks.

What causes some people to have heavier flows than others?

👩‍⚕️ There are several reasons why one person might have heavier menstrual bleeding than another. Heavy bleeding is defined as going through more than six pads or tampons in a day and bleeding for longer than about eight days consistently, for more than two or three cycles. In this case, it's recommended to check some blood tests, as well as an ultrasound, to get a better idea of what's causing the heavy bleeding. Causes can include fibroids, endometriosis, adenomyosis, lack of ovulation, infections, thyroid issues, prolactin, and other hormone imbalances. It's important to check in with a healthcare provider to get to the root of what is causing the heavy bleeding.

 My GP has referred me to an OBGYN to remove my IUD as the strings are missing. What does this mean? How will they remove it?

👩‍⚕️ It's common for the strings of an IUD to get lodged or coiled into vaginal tissue or cervical tissue. In this case, we check an ultrasound to make sure that the IUD is still in good positioning, even though you can't feel the strings. If the ultrasound shows the IUD is still in place, the practitioner might first try to grab the strings with something called a cytobrush, which is a little thin brush that you might recognize from when a pap smear is done. If that doesn't work, the next step is using something called an IUD hook, a slender device that can be placed into the uterus through the cervix and used to try to pull the IUD out. If there's any trouble, an ultrasound can be used in addition to the IUD hook to guide finding the IUD.


📌 If you have any questions you want answered by one of Looni’s experts, just email us or ask away in our Burning Questions room here in Geneva.