What Causes Heavier Menstruation While Taking Progesterone During Perimenopause?

Posted on Sat, 28 Mar 2015

Question: I am 47. Premenopause. I havent stopped having a period since January 8. I have tried progesterone, but that made the bleeding heavier. I was told that I would have to have a hysterectomy. Should I also have a bladder sling. I was told that removal of the uterus can cause more bladder problems so If some bladder problems already exist then the hystorectomy will make it worse. Is that true.

Answered by Dr. Deepti Verma (35 minutes later)

Brief Answer:
Need endometrial biopsy,can try medicines, sling if needed

Detailed Answer:
Hi XXXX, I have gone through your question. Prolonged menstrual cycles in premepausal period are due hormonal disturbances and decreased progesterone levels in the body, and this is called dysfunctional uterine bleeding (DUB). The bleeding after taking progesterone is heavier because of the thick uterine lining which develops in the absence of menstruation.
You might have been advised hysterectomy in view of DUB, but in my opinion you should get an endometrial biopsy to confirm the diagnosis, and discuss with your OBGYN specialist the treatment of DUB by medical methods. The medical methods are quite effective in treating DUB.
If hysterectomy is still needed, your OBGYN specialist will assess whether you need the bladder sling or not. Removal of uterus does not cause more bladder problems, if there is no pre-existing one. If there is weakness in the bladder support muscles and ligaments, then you may need the bladder sling.
Hope you found the answer helpful. Please do get back to us for further queries.
Wishing you good health.
Regards, Dr Deepti Verma

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Above answer was peer-reviewed by : Dr. Shanthi.E