HEAVY bleeding, Cramps, Irregular spotting ???????????

I have been having heavy periods for about 10 years now.They are getting worse each month.They last about 6 days, Heavy bleeding usually just 2 days. I can actually feel myself passing blood clots. When I am not mensturating occasionally I will get a sharp stabbing pain in my lower abdomin (abdomen) on one side or the other the with in the hour I will spot. Sometimes I will have a heavy mucus discharge for several days. I have been to emergency when the pain would get worse, maybe once a year & am told I have one small ovarian cyst and very small fibroids. I have been to the Dr. who says when the pain lasts I had a cyst rupture because he will do Uultra sound & it shows free fluid in the cul du sac.Was told the pain will stop with time. Which it does. They want to do a biopsy of my uterus which I am scarred to have done. I am tilted & even hard to get a pap on.I have too many other health problems, 1 kidney, heat, lungs, etc. to worry about an infection or puncturing my bowls from a biopsy. Isnt there a mendication I can take for this to get me somewhat regular & stop the cramping?? My tubes are tied.I am not sexually active. I am 40 years old one child.

[Machelle Seibel, MD]

A. Some women who bleed a lot get a low iron level and the low iron level causes them to bleed more.  Your doctor can measure your iron level and another test called Serum Iron Binding capacity.  If they are low, just take iron pills or you can try doing that anyway for 3 to 6 months.  Taking a multivitamin also is helpful because all that bleeding can cause you to become anemic. Some women have less cramps if they try taking an antiprostaglandin medication such as naprosyn or Motrin or ibuprofen a few days before they expect a period and continue for about one week.  

A biopsy of the uterus is very low risk. Puncturing the bowel is very rare with this procedure. The pap smear is on the outside of the cervix, the biopsy places a very thin instrument inside the uterus and a small amount of tissue is removed.  This can make it much easier to know what the problem is.  The ultrasound can sometimes tell if the uterine lining is thick or if there is a polyp. It should also be able to tell if the fibroids are contributing to the bleeding. Sometimes doctors do a D&C and scrape the entire lining out of the uterus to both diagnose the problem and help to treat the symptoms.

Your doctor could try you on a birth control pill for 3 months and see if that stops the problem. But many doctors might not feel comfortable doing that because they want to make sure they do not miss a problem by treating a person without a diagnosis.  
Machelle M. Seibel, MD