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What Causes Severe Vaginal Bleeding And Pain Post Endometrial Ablation?
Question: Hi .....
I have a prelong period which lasted about 6 months ( non stop heavey bleeding also passing heavey & large clots )
I was told my lining in my uterus had reached 15 cm and needed the lining removed.
I had a D&C , hytorscopy ( i think i spelt it wrong ) pap smeer and insertion of a mirina ....
Pre op .....
I was taking 6 Primolut N tables daily .... my bleeeding had not stopped but reduded ....
And was taking XXXXXXX folic acid twice a day .... and had serve pain... un controlable pain endone and morphine were not working to ease the pain
Post op
Had my operation .....
Im still bleeding heavily with large clots. ...
I was given primolut n and was told to have 2 table 3 times a day for 1 week then 4 tables 4 times a day for the next week then 3 tablets 3 times aday for a week then i should stop
Problem is when i reduce from 6 tablets a day to 4 tablets a day my bleeding intensify massivly and still have major pains and endone dose not work ....
I have been back to emergency and they have said that there is nothing more that they can doo .....
I went to my LOCAL docter who advised me i had to go back to emergency but all they do is run a blood test and give me pain killers ( which do not help ) and send me home
What am i suppose to do ...
Im constenly shaking
Im consently bleeding
Im consently in pain
I have a prelong period which lasted about 6 months ( non stop heavey bleeding also passing heavey & large clots )
I was told my lining in my uterus had reached 15 cm and needed the lining removed.
I had a D&C , hytorscopy ( i think i spelt it wrong ) pap smeer and insertion of a mirina ....
Pre op .....
I was taking 6 Primolut N tables daily .... my bleeeding had not stopped but reduded ....
And was taking XXXXXXX folic acid twice a day .... and had serve pain... un controlable pain endone and morphine were not working to ease the pain
Post op
Had my operation .....
Im still bleeding heavily with large clots. ...
I was given primolut n and was told to have 2 table 3 times a day for 1 week then 4 tables 4 times a day for the next week then 3 tablets 3 times aday for a week then i should stop
Problem is when i reduce from 6 tablets a day to 4 tablets a day my bleeding intensify massivly and still have major pains and endone dose not work ....
I have been back to emergency and they have said that there is nothing more that they can doo .....
I went to my LOCAL docter who advised me i had to go back to emergency but all they do is run a blood test and give me pain killers ( which do not help ) and send me home
What am i suppose to do ...
Im constenly shaking
Im consently bleeding
Im consently in pain
Brief Answer:
Please furnish some information
Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
I can understand the pain and suffering you are undergoing.
Did you get the histopathological examination of the endometrial tissue after D&C?.If yes, then please upload the reports so that I can review it ?
Moreover, please do mention your age, whether you have children, and have diabetes mellitus or hypertension?
For how many months you have taken primolut?
Is Mirena still there in uterus?
What are your haemoglobin levels?
Please do get back to me with the information so that I can explain the situation clearly.
Regards
Dr Deepti Verma
Please furnish some information
Detailed Answer:
Hi dear, I have gone through your question and understand your concerns.
I can understand the pain and suffering you are undergoing.
Did you get the histopathological examination of the endometrial tissue after D&C?.If yes, then please upload the reports so that I can review it ?
Moreover, please do mention your age, whether you have children, and have diabetes mellitus or hypertension?
For how many months you have taken primolut?
Is Mirena still there in uterus?
What are your haemoglobin levels?
Please do get back to me with the information so that I can explain the situation clearly.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
my hieght us 165 cm
my weight 175kg
no kids (but desprestly want kids )
age 28
i have had an examination of a vaginal ultrasound and was verbally told that my myrina is in a low poisition but its not that low to re operate .... they were concern that my tissue might becancer but they out ruled it while operating ...
i have asthma when it get cold
and my blood levels are normal
but im low on iron and i have iron tablets for that
my weight 175kg
no kids (but desprestly want kids )
age 28
i have had an examination of a vaginal ultrasound and was verbally told that my myrina is in a low poisition but its not that low to re operate .... they were concern that my tissue might becancer but they out ruled it while operating ...
i have asthma when it get cold
and my blood levels are normal
but im low on iron and i have iron tablets for that
Brief Answer:
Histopathological diagnosis is mandatory
Detailed Answer:
Hi dear, so no histopathological examination of the endometrial tissue was done???
Ideally in your case, Histopathological examination of the endometrial tissue is mandatory in order to rule out hyperplasia or carcinoma.
Heavy bleeding during the periods can be due to hormonal disturbances in endometrial lining, endometrial hyperplasia or carcinoma.
If the bleeding is not getting controlled by primolut, then a repeat ultrasound to assess the endometrial thickness and endometrial biopsy for histopathological diagnosis should be necessarily done.
In the meantime, you can take tranexemic acid tablets two to three times a day to decrease the flow of bleeding in the periods.
Hope you found the answer helpful.Please do get back for further queries.
Wishing you good health.
Regards
Dr Deepti Verma
Histopathological diagnosis is mandatory
Detailed Answer:
Hi dear, so no histopathological examination of the endometrial tissue was done???
Ideally in your case, Histopathological examination of the endometrial tissue is mandatory in order to rule out hyperplasia or carcinoma.
Heavy bleeding during the periods can be due to hormonal disturbances in endometrial lining, endometrial hyperplasia or carcinoma.
If the bleeding is not getting controlled by primolut, then a repeat ultrasound to assess the endometrial thickness and endometrial biopsy for histopathological diagnosis should be necessarily done.
In the meantime, you can take tranexemic acid tablets two to three times a day to decrease the flow of bleeding in the periods.
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
i was told not to take that ... as it affects the mirina ?
Brief Answer:
Mirena should ideally be removed if giving no relief
Detailed Answer:
Hi dear, if you are not relieved by Mirena and primolut, then ideally Mirena should be removed, before proceeding to further management.
Mirena contains levonorgestrel which interacts with tranexemic acid and increases the risk of thromboembolism, hence not recommended to be used together.
You should discuss these points with your treating gynecologist, so that appropriate treatment can be done
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Mirena should ideally be removed if giving no relief
Detailed Answer:
Hi dear, if you are not relieved by Mirena and primolut, then ideally Mirena should be removed, before proceeding to further management.
Mirena contains levonorgestrel which interacts with tranexemic acid and increases the risk of thromboembolism, hence not recommended to be used together.
You should discuss these points with your treating gynecologist, so that appropriate treatment can be done
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
ok .... do you know why this is gappening ? . i cant find anything on line
Brief Answer:
Excessive estrogen exposure
Detailed Answer:
Hi dear, Heavy bleeding in periods can be due to hormonal disturbances, endometrial pathologies like dysfunctional uterine bleeding, endometrial hyperplasia or carcinoma.
These conditions arise due to excessive estrogen hormone exposure to the endometrium. Excessive estrogen hormone exposure can occur due to increased hormonal levels in the body in polycystic ovarian disease, chronic anovulation, estrogen secreting ovarian tumours or can be idiopathic( in which no cause is found).
The treatment for dysfunctional uterine bleeding and endometrial hyperplasia is progesterone support by primolut or medroxyprogesterone acetate.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards
Dr Deepti Verma
Excessive estrogen exposure
Detailed Answer:
Hi dear, Heavy bleeding in periods can be due to hormonal disturbances, endometrial pathologies like dysfunctional uterine bleeding, endometrial hyperplasia or carcinoma.
These conditions arise due to excessive estrogen hormone exposure to the endometrium. Excessive estrogen hormone exposure can occur due to increased hormonal levels in the body in polycystic ovarian disease, chronic anovulation, estrogen secreting ovarian tumours or can be idiopathic( in which no cause is found).
The treatment for dysfunctional uterine bleeding and endometrial hyperplasia is progesterone support by primolut or medroxyprogesterone acetate.
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
what happens if i am still bleeding with mirina and primolouts .... what woukd be the next step
Brief Answer:
Removal of Mirena and endometrial biopsy
Detailed Answer:
Hi dear.
The next step in your case should be removal of mirena and doing a endometrial biopsy and sending it for histopathological examination to confirm the diagnosis and take further treatment accordingly.
Regards
Dr Deepti Verma
Removal of Mirena and endometrial biopsy
Detailed Answer:
Hi dear.
The next step in your case should be removal of mirena and doing a endometrial biopsy and sending it for histopathological examination to confirm the diagnosis and take further treatment accordingly.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
how long can i take primolot for
Brief Answer:
Maximum 6 months
Detailed Answer:
Hi dear,
Primolut can be taken for maximum 21 days at a stretch and for maximum 6 months cyclically.
When did you start taking primolut?
Regards
Dr Deepti Verma
Maximum 6 months
Detailed Answer:
Hi dear,
Primolut can be taken for maximum 21 days at a stretch and for maximum 6 months cyclically.
When did you start taking primolut?
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
i have completed 4 boxes of 30 tablets about to start my 5th box
Brief Answer:
Continous or cyclical
Detailed Answer:
Hi dear,
Are you taking primolut cyclically( not taking the pills for few days in between) or taking them continuously.
Regards
Dr Deepti Verma
Continous or cyclical
Detailed Answer:
Hi dear,
Are you taking primolut cyclically( not taking the pills for few days in between) or taking them continuously.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
no its been consently non stop
Brief Answer:
Not recommended
Detailed Answer:
Hi dear,
Giving continuous primolut is not recommended in any endometrial or uterine pathology, and that too for four months at one go.
You should not have any bleeding if you have been on continuous dose of primolut.
Heavy bleeding even on primolut is a very strong indication for doing an endometrial biopsy for accurate diagnosis and appropriate treatment.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Not recommended
Detailed Answer:
Hi dear,
Giving continuous primolut is not recommended in any endometrial or uterine pathology, and that too for four months at one go.
You should not have any bleeding if you have been on continuous dose of primolut.
Heavy bleeding even on primolut is a very strong indication for doing an endometrial biopsy for accurate diagnosis and appropriate treatment.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
i have a menstrual clinic appointment in a couple if weeks ... im pretty sure thats where they will tell me the results of the kinning and operation
Brief Answer:
Whar is kinning?
Detailed Answer:
Hi dear, please tell me what do you mean by ' kinning'.
Regards
Dr Deepti Verma
Whar is kinning?
Detailed Answer:
Hi dear, please tell me what do you mean by ' kinning'.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
sorry i ment linning
Brief Answer:
Discussion of all possibilities
Detailed Answer:
Hi dear, you should discuss all the possibilities like endometrial hyperplasia or carcinoma, and should get appropriate investigations and treatment.
You should also discuss the removal of mirena.
Regards
Dr Deepti Verma
Discussion of all possibilities
Detailed Answer:
Hi dear, you should discuss all the possibilities like endometrial hyperplasia or carcinoma, and should get appropriate investigations and treatment.
You should also discuss the removal of mirena.
Regards
Dr Deepti Verma
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Dr. Deepti Verma
OBGYN, Maternal and Fetal Medicine
Practicing since :2009
Answered : 5064 Questions
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