QuestionI am 45 and have been infertile for years (have one 19 yr old). I have always been irregular (have had thyroid issues), but w/in the last 2 or 3 yrs have become much more so. I can skip 4 months, then have a heavy period with a lot of clotting etc. Well everything came to a head when after another 4 month "dry spell" I had a very light 4 day period. Then a month later another just like it. THEN a week later I started what turned into a 5 WEEK period of heavy bleeding and huge clots. I have also been experiencing mood swings for some time but thay were more like phases in that they would last for days or even weeks. A few weeks of depression...a few weeks of irritability...of giddiness...etc. I finally started taking black cohosh, dong qui, and a blend of milk thistle, false unicorn, and other herbs and this all helped stabilize the moods, but the heavy bleeding continued.
During the 4th week, I had blood work done (normal) and a biopsy, which showed an excess of NORMAL cells. Also had an ultrasound which showed a small fibroid on the stem (obgyn says not a prob). Meanwhile I had started using wild yam cream which slowed the flow considerably but didn't stop it. During the 5th week, she put me on provera because she said i need to completely empty out (how can there be any more there?) and be regulated so that the cells don't turn abnormal. The bleeding became on and off for the 6th week and finally stopped last night (I hope). I'm on the 6th pill and have already gained 3 pounds and feel irritable and PMS - y. I'm also tired (sleeping like the dead). She said that by next week, I'm to expect the flow to begin again and be very heavy, as this is supposedly going to empty me out, but she wants me to take the pills from now on. I'm not comfortable with that and worry about side effects, etc.
I'm wondering about the natural progesterone pills - ? I'm also considering the cream (perhaps wild yam cream was not strong enough?). I'm supposed to have another biopsy in 3 months, but I really don't want to take these pills even that long.
Any thoughts...feedback? Thanks for listening.
AnswerIn the decade between 40 and 50, you will sometimes develop a condition called "Dysfunctional Uterine Bleeding". In addition, in preparation for menopause (around age 50-52) you will start missing your period. First you will miss one month, then maybe a few months, then 5-6 months, until you have missed a full 12 months of periods. When that occurs, we look back at the first day of your last period and say that on that date, you reached menopause. Before than you were "premenopausal" and after that date you are considered "Postmenopausal". When you miss several periods, the endometrium (the wall of the uterus) grows, and when you get your next period it can be very, very heavy. The symptoms that you are feeling can initially be helped by all the holistic remedies you tried (Black Cohosh, milk thistle, Dong qui, etc) but within a few months, even they will not have any effectiveness. The first thing that should be done is Provera 10mg twice a day for 5 days. You should bleed heavily for a few days, and then completely stop bleeding shortly after that. If that does not work, and you are hemorrhaging, Estrogen pills will definitely stop the bleeding. The best method of regulating your cycle at this time are birth control pills or hormone therapy. I know that you would rether not take any hormones, but that may be the only course that helps. If you have continued irregular cycles or bleed for more than 14 days, at your age, the recommended diagnostic therapy is D&C (not merely an office biopsy). A D&C will assess the entire endometrium and a hysteroscopy will allow the gynecologist to visualize the uterine cavity to see if there are any submucus fibroids or polyps that are causing the bleeding. If the bleeding can be brought under control, you may be able to avoid any HRT and wait for menopause, where all the bleeding will stop. However, HRT is helpful in preventing osteoporosis, mood swings, flushes, flashes, night sweats, cognitive ability, and colon and rectal cancer. The risk of breast cancer is minima, as long as you keep up with mammograms. Good Luck.
