<s>[INST] Hello doctor, My wife is 28 years old. We have a daughter through cesarian and now she is 3 years old. We are using a condom as a safety measure to avoid pregnancy. She uses to have periods more or less normal lasting for five days. This time it came after 40 days with a spot of bleeding and no bleeding for three days after which normal bleeding has lasted for around eight days making it a total eleven days. This has never happened before and is worrying. Should we take this as some of the instance and continue monitoring or should we do some doctor followup? She had a uterus scan some five months back which was normal and a cervical smear test to evaluate cancer risk which was normal as well. [/INST] Hello. This episode of delayed and heavy bleeding might have been due to one of the two reasons. Delayed or absent ovulation. It is normal to have occasional cycle anovulatory and in such a case period will be delayed and heavy. If this is the case, there should be no need to worry as such an episode will not recur frequently. She might have been pregnant and it was early abortion and so heavy bleeding. Condom, used for contraception has a high failure rate and it is better to use some better contraception like oral pills or CuT (copper T). If bleeding has stopped completely, again, there should be no reason to worry. You can confirm whether she was pregnant by doing a simple urine pregnancy test. If it comes positive, you need to consult a gynecologist once for further management. Repeat the ultrasound if such episodes recur. </s>