Hello,

Thanks for writing to us. I am trying to give answer according to your concern.

It seems that you are in peri-menopausal age group (your 49 yrs). In this age group, irregular or heavy bleeding occurs in some women. It may be due to hormonal imbalance, caused by dysfunction of ovary without ovulation leads to progesterone deficiency.

But, we have to rule out other possible causes of heavy bleeding (more than 3 weeks) in this context. These are as follows:

1) Uterine/ cervical fibroid & polyp.
2) Endometrial hyperplasia / atrophy.
3) Adenomyosis/ Dysfunctional uterine bleeding (DUB)
4) Others- infection, using certain medication etc.

Complete physical examination including pelvic/ speculum/ colposcopic exam is needed to rule out underlying pathology.

Possibilities can be narrowed by several investigations like blood test for thyroid profile & clotting factor abnormality, Ultrasound scan for pelvis, Pap smear test to detect cancerous changes and endometrial biopsy ( may be needed).

There is certain treatment modalities by the means of haemostatic agent combined with oral progesterone tab for 3-6 months duration. If above medical treatment fails to control bleeding, then approach would be surgical by the means of Dilation and curettage (D&C), Operative hysteroscopy to remove polyp, endometrial ablation in case of hyperplasia.

Lastly, total hysterectomy (removal of uterus, tube & cervix) is the ideal choice in your age group with completed family.

So please consult with your gynecologist for proper guidance through investigation, medication & suggestive measures.

In the interim, the following things should help:

1) Take healthy diet with iron supplements.
2) Drink more water and eat more vegetables/ fruits.
3) Avoid heavy work or strain full activity.
4) Avoid stress/anxiety & maintain genital hygiene.

Hope I have answered your query. If you have any further questions, I will be happy to help.

Wish your good health & take care yourself.

Regards,
Dr Soumen

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