Q. It is difficult to say what the problem is as it could be a number of things. Here are some thoughts. You could have an inflammation of the
uterineDysfunctional uterine bleeding (dub)
Endometrial cancer
Fetal heart and uterine contraction monitor
Intrauterine device
Intrauterine growth restriction
Normal uterine anatomy (cut section)
Uterine anatomy
Uterine fibroids
Uterine prolapse lining from the IUD causing the bleeding. A course of a general antibiotic such as
tetracyclineTetracycline
Tetracycline hydrochloride
Tetracycline topical might stop the bleeding if that is the case. You could remove the IUD and use a diaphragm for the next few years.
Sometimes decreased iron caused by the heavy bleeding can cause spotting. Ask your doctor to check your blood count and a serum iron level and serum iron binding capacity. If they are low, go on an iron supplement for at least 3 months and that will stop the bleeding.
You might just be in perimenopause. That can be controlled hormonally with a three month course of estrogen and progesterone. Talk about these options with your doctor. The option you mention of taking out the IUD and going on the pill is another option and it could work as well.
Machelle M. Seibel, MD