QuestionI have been having changes in my cycle since 2003, I am now 47 years old and am contributing these changes to perimenipause. I have been to my nurse practitioner, a MD who does use alternative, natural methods....had me try iodine, said it was my thyroid (still on Armour), provera and prometrium. Nothing seemed to work. I went to a gyn in July 07 and had the Mirena inserted. It is nine months and still doesn't seem to be working completely. I can say I haven't had any flooding episodes or clotting, but it still isn't to the point where I am comfortable. I am scared to have intercourse because I seem to either spot or bleed afterwards. I have a terrible phobia now of menstrual blood as well. That occurred even before the insertion of the Mirena. I am scheduled for a D&C and ablation in May. I would rather not go under general anesthesia or have the procedure done at all, but I don't know what to do. My fear and anxiety is really high as is my irrational fears of bleeding to death or bleeding after sex. I feel like a basket case, help!
AnswerDear Karen,
Well, the bleeding to death part, you really need not worry about. The normal amount of blood lost during menstruation is about 2 to 8 tablespoons, although I know it seems like more than that. So, even if you have an unusually heavy period one month, it is likely only up to about 12 tablespoons.
If excessive or lengthy bleeding does not respond to medication, doctors may suggest endometrial ablation. Heavy bleeding is most common for women between ages 40 and 50, as they approach menopause. It also can be caused by hormonal changes or certain medical conditions, such as problems with blood clotting. Although there are other causes of heavy bleeding, such as fibroids, ablation is not used to treat these problems. I will assume that fibroids have been ruled out as the cause for your heavy bleeding.
Ablation destroys a thin layer of the lining of the uterus. This stops all menstrual flow in many women. After ablation, some women still have light bleeding or spotting. A few women may have regular periods. This is because the ovaries and uterus are not removed. If ablation does not control heavy bleeding, further treatment or surgery, possibly hysterectomy, may be required. Some women do opt for hysterectomy as a final fix to their problems rather then taking the chance that they will only have to do it in the long run anyway. And most women are not able to get pregnant after ablation, so the fertility effect is essentially the same. With ablation and D&C, you should be able to have sedative and local anesthetic only.
I hope this has helped you and answered your question. I wish you well.
Brenda
