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What Causes Heavy Irregular Uterine Bleeding Despite Taking Provera?

Posted on Tue, 27 Oct 2015

Question: I need to find out why I have been bleeding heavy and clotting since 08/21/15 and doctor gave me provera 10mg 1 pill @ day for 10 days then that didn't stop the bleeding so he gave me 7 more days to take that, it stopped for about 3 days then I started back bleeding or as they stated the withdrawal period but I am still bleeding. I am very upset, can't do much of anything, having pain.. He said I may can start taking a shot called depro luth but that would only prolong me to a hysterectomie. First I still dont know why I started bleeding and have not stopped, yes I have a large right side cyst about 5.8 cm..but he said he don't want me to do the hysteretomie because i am too young and it will put me into menapause but at this point what else can be done, I am very confused and angry that I am bleeding and have not clue as to why or how to make it stop.

Answered by Dr. Deepti Verma (14 minutes later)

Brief Answer:
D & C with endometrial sampling and examination should be done

Detailed Answer:
Hi dear, I have gone through your question and understand your concerns. Heavy irregular bleeding at the age of 46 years is usually due to one of the following causes:
1. Dysfunctional uterine bleeding due to the changes in the uterine endometrium due to hormonal disturbances in the body.
2. Endometrial hyperplasia
3. Endometrial cancer.
If you are having heavy bleeding, which is not controlled by provera, you should ideally get a D & C done,which will stop your bleeding in this cycle and also the endometrial tissue which will be obtained during the procedure can be sent for the histopathological diagnosis and exact diagnosis can be made. Further management can be done accordingly.
There is absolutely no indication or recommendation for doing a hysterectomy without making an exact diagnosis of heavy irregular bleeding.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepti Verma (2 hours later)

I already had the endometrial biopsy done and it came back negative for cancer. He told me that the reason I was on provera was too stop the bleeding and it has not helped that. He said my uterus is larger than normal therefore a D n C would not work, the lining of my uterus was very thick so the provera should help thin out the lining....so now he says that it is another type of pill that I can take 3 times a day for 5 days and that should stop the bleeding but I don't know the name of the pill, they are calling it in to my drug store this evening...

Answered by Dr. Deepti Verma (9 minutes later)

Brief Answer:
Norethisterone is given to stop the bleeding

Detailed Answer:
Hi dear, thanks for responding.
If the endometrial lining is thin, then provera for 2-3 months should help you in regularizing the periods.
However, sometimes patients do not respond to provera, then norethisterone tablet is given 2-3 times a day to stop the bleeding.Your doctor must have prescribed you these tablets.
In the meantime, you can also take tranexemic acid tablets to reduce the flow of the bleeding.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards
Dr Deepti Verma

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar