Hello,

Thanks for writing to us. I have gone through your history in detail.

You are in peri-menopausal age group and in this age group, irregular /heavy bleeding occurs in some women. It may be due to hormonal imbalance, caused by dysfunction of ovary without ovulation leads to progesterone deficiency.

We have to rule out other possible causes of heavy bleeding in this context. These are as follows:
1) Uterine fibroid & polyp (body and cervical region)
2) Adenomyosis/ endometrial hyperplasia / Dysfunctional uterine bleeding (DUB)
3) Rarely carcinoma- endometrial/ cervical
4) Use of certain medication etc.

Complete physical examination including pelvic/speculum exam and colposcopy if indicated, 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 (which may be needed).

There is certain treatment protocol with initiation of haemostatic agent combined with oral progesterone tab. 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.

So please consult with your gynecologist. It would definitely be required for suggestive measures.

Until then, the following things should help:
1) Take healthy diet with iron supplements
2) Drink more water and eat leafy vegetables/ fruits.
3) Avoid heavy work or straining
4) Avoid stress/anxiety & maintain personal hygiene.

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

Wish your good health
Regards,
Dr Soumen

---