strange new kind of periods after c-section

I had a pretty traumatic c-section 6 months ago and since then things are very different for me.  The c-section incolved a lot of adhesions of my bladder, bowel, and the uterine wall was pretty adhered.  I lost a lot of blood and the doc said he used seprafilm on me to help with new adhesions.  It took me 4 months to feel normal again..   But,. my periods started back very heavy and lasted 15 days, then the next one lasted 9 days and since then the last 3 have been about 7 days.  Also, I have no cramping at all, where I did have mild cramps before.  My breasts don't get tender either, so when I start it is a major shock--just seems to start up all of a sudden without warning.  No cramps at ALL.  I keep thinking that eventually they will go back to normal, but it is 6 months and they are still heavier thatn they were before-have to use heavy flow pads now and the no cramps, no warning thing is starting to scare me.  Is this normal sounding, or what should I do?

[Elaine Brown, MD]

Hi!
Congratulations on the birth!  I'm sorry it was so traumatic!  I hope you are not planning too many more deliveries!  Because you are so recently post partum, the unusual bleeding could be due to hormones and may yet regulate itself.  It is quite likely that you have some scar tissue built up in the wall of your uterus too--we refer to this as adenomyosis.  Adenomyosis can cause heavy bleeding too.

If you were my patient, I would recommend an ultrasound to look at your uterus and the lining.  Also, I would suggest birth control pills to regulate and slow down the flow so that you don't become anemic (or more anemic as the case may be ).
Most of the time, birth control pills work fairly well for this, although if the adenomyosis is too severe even they may not work well.

If you have completed your family and want no more children, you may want to give some thought to an endometrial ablation.  This is an out patient procedure that can really reduce the bleeding a lot.  DON"T do it if you want more children.

Good luck!
Dr B