Hi Ms. XXXXX,

Thanks for writing to us.

After delivery, any uterus remains bulky and this bulkiness increases with the number of deliveries. This in itself causes excessive blood loss during periods. Any hormonal imbalance may lead to abnormal bleeding; increased endometrial thickness as a result of hyper-estrogenic states can lead to menorrhagic cycles. Anemia and thyroid disorders are the other causes of heavy periods.

As you do not have any fibroids as the cause of the menorrhagia, you may have to exclude the other causes. Treatment is symptomatic and supportive. For intractable menorrhagia, endometrial ablation may be considered.

Excessive wetness is usually caused by increased Bartholin secretion and is psychogenic. You may use an anti-histamine to decrease the secretion or try to reduce the estrogen production through exercise, reduction of beverage intake etc. Smoking and drinking also cause such discomfort. Use of birth control pills also may help. You may also need to get investigated for pelvic infections if this does not help.

Hope I have answered your query. Please feel free to contact if you need further clarifications. I will be happy to help.

regards,
Shanti.V.

---

Hi,

Thanks for writing back.

Intractable menorrhagia is nothing but heavy bleeding during periods that does not respond to any form of medical management and hence becomes an indication for surgical mode of management. Endometrial ablation is the process of hysteroscopic removal of the endometrial layer of the uterus, thus resulting in control of periods. Novasure and Thermachoice balloon ablation are the other available methods. The endometrium heals by scarring and bleeding is reduced. In some patients, the bleeding may stop altogether.

Low-dose birth control pills may be taken. XXXXXXX contains Drosperinone which should be used with caution in view of the adverse effects on circulation. You may consult your specialist for the choice of drug that suits you after an evaluation.

Hope your query is clarified. Please get back if you need any more clarifications. I will be ready to help.

regards,
Shanti.V.

---

Hi,

Thanks for writing again.

You may use progesterone creams as a local application; you may try the progestogen-only pills or low-dose combination pills. The exact schedule may be determined by your consultant after examination as it cannot be done online. You may try simple remedies like mopping the area before intercourse and adapting posture changes.

Hope all your queries are clarified. Please feel free to contact whenever you need help.

Wish you good health.

regards,
Shanti.V.

---