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Gynecology  (Expert Forum)
 | 
Heavy Periods
Answered by
Elaine Brown, MD - Pregnancy, Gynecology
Elaine Brown, MD - BLOG Billings - MT
This forum is for questions and support regarding gynecology issues such as: Cervical Disorders, Colposcopy, Cramps, Cystitis, Fallopian Tube Disorders, Menstruation, Ovarian Disorders, PAP Test, Pelvic Exam, PID, PMS, Surgery, Tests, Ultrasound, Uterine Disorders, Vaginal Disorders.

Heavy Periods

by BusyMommy613, Jun 22, 2009 06:31AM
Hi-
I am 30 years old, have had two children (vaginal deliveries - a 1 year old and 3 year old). My periods have been very heavy. My cycle is 28 days if I count from the first day of heavy bleeding- however I spot for 3 days before the heavy bleeding begins. Once the heavy bleeding begins I bleed for 7 days (4 of which are very heavy) I use the Diva Cup (menstrual cup) because my periods are so heavy tampons aren't absorbent enough. Because I use the Diva Cup, I know that I bleed over 100 mls each period.  From the time I start spotting to the time I stop bleeding is typically 10 days. I cannot go on hormonal birth control because of other health issues. I had a transvaginal u/s to check for cysts (I also have pain in the area of my right ovary) and it was fine- no cysts, no fibriods.  What could be the cause of the heavy bleeding, and should I be concerned?

Thank you!

by Elaine Brown, MD, Jun 25, 2009 12:54AM
To: BusyMommy613
Hi!
I'm glad that they checked you for fibroids, because that was my first thought.  Another possibility is an endometrial polyp, but that should show up on your ultrasound as a thickening of the lining.  When someone has "mini-hemorrhages" and the work up is negative, we often suspect adenomyosis.  This is a form of endometriosis.  The abnormal endometriosis implants form within the muscle wall of the uterus, and can make it enlarged, and irregular.  Adenomyosis can also cause pain.
I have two thoughts for you:
Have you considered the Mirena IUD?  Those really work, and because the progesterone is only dispersed locally within the uterus, you don't have to worry about systemic side effects ( like blood clots, etc).  The other possiblity is an endometrial ablation.  Since you only have two kids you may not be ready for that yet--you should be finished with your family before having an ablation--but it could really slow down the flow.
One thing you absolutely should do is take a multivitamin with iron.  Anemia could make it very hard to keep up with those litte ones!
Good luck!
Dr B
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