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What Causes Excessive Vaginal Bleeding Between Periods?

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Posted on Tue, 24 Feb 2015
Question: Dear Doctor
I am a 39 years old female with two children. I have been been having regular periods every month, until September 2014. Since Oct, I had intermittent bleeding between periods which presented as watery bloodied discharge, with clots. In Nov, my periods were 12 days overdue and pregnancy tests negative. I started bleeding on 1st Dec 2014 and have not stopped yet. Following heavy bleeding with clots and severe low back pain, I was put on Noethisterone thrice a day (10 mg thrice a day). This had not helped and I was sent for a Hysteroscopy and Biopsy where they picked up Polypoid Uterus lining and told me that I had Endometrial Hyperplasia. Also a Merina coil was inserted to stop the bleeding. I am still bleeding and in pain. What is the risk of me having endometrial cancer? Should I opt for Hysterectomy to prevent the risk of cancer in the future? I also have hypertension, diabetes and hypothyroidism which are all being treated. Please help and thanks for your time!
doctor
Answered by Dr. Aarti Abraham (16 minutes later)
Brief Answer:
Please provide few more details.

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Please tell me a few more things.
What is your height and weight ?
When was the Mirena inserted ?
Has the bleeding not stopped at all or reduced after Mirena ?
Do you have any family history of significant cancers ?
Please particularly upload the biopsy report , that is most important to tell you your risk of cancer in the future .
Also please upload the ultrasound scan and other reports that might have been carried out.
The information will help me to provide you with a proper diagnosis.
Looking forward to hearing from you.
Take care.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Aarti Abraham (1 hour later)
Dear Doctor

Thanks for your reply! My height is 160 cms and weight is 94kgs. No family history of cancers. I don't have the Hysteroscopy and Biopsy report yet as it was done just yesterday. The only thing that the doctor mentioned was Polypoid Uterus lining and Endometrial Hyperplasia. The Merina coil was also fitted at the same time of hysteroscopy and biopsy, yesterday. Since then, I have been having migraine headache, nausea and cramps - which I was warned was to be expected. The bleeding has been more or less the same after the insertion of the coil since yesterday- still passing large clots. Also, five years back, I was previously on treatment for sero-negative Rheumatoid Arthritis with Methotraxate, Sulphasalazine and Hydrocholoquin. I am currently on remission and not taking the tablets due to terrible side effects for the last two years. The progesterone is making my hands and feet swell up once again and so I am at a loss as to what to do. Even if the results of the biopsy came out as simple endometrial hyperplasis, considering my medical history, would it be advisable to go for hysterectomy? Is is ok to bleed for such prolonged period (nearly two months now)? Thank you, once again, for your time!
doctor
Answered by Dr. Aarti Abraham (2 minutes later)
Brief Answer:
Lets wait for the report before opining.

Detailed Answer:
Thank you for the appreciation.
There are various types of endometrial hyperplasia, differentiated on the basis of biopsy.
The risk of cancers varies with each type.
Only after knowing your biopsy report can I tell you exact risks in percentages.
Give the Mirena a few weeks' time to act.
With simple endometrial hyperplasia, cancer risk is 1 %, so medical management is advisable.
Weight loss is a must.
Obesity and diabetes compound your risks .
It is normal to bleed for so long with endometrial hyperplasia.
I will await the biopsy report from your side, before reassuring you, or scaring you into a hysterectomy.
Take care.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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What Causes Excessive Vaginal Bleeding Between Periods?

Brief Answer: Please provide few more details. Detailed Answer: Hello Thanks for writing to us with your health concern. Please tell me a few more things. What is your height and weight ? When was the Mirena inserted ? Has the bleeding not stopped at all or reduced after Mirena ? Do you have any family history of significant cancers ? Please particularly upload the biopsy report , that is most important to tell you your risk of cancer in the future . Also please upload the ultrasound scan and other reports that might have been carried out. The information will help me to provide you with a proper diagnosis. Looking forward to hearing from you. Take care.