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Menopause (Expert Forum)
Why doesn't Prometrium work with me?
Answered by
Machelle Seibel, MD - Women's Health, menopause, ReproductiveMedicine
University of Massachusetts Medical School
MA
Questions in the Menopause forum are answered by Dr. Machelle Seibel. Topics covered include menopause issues, depression, hormone replacement therapy , hot flashes, joint or muscle problems, memory problems, mood swings, osteoporosis , sexual problems, skin changes, sleeping problems, vaginal problems, and weight problems.
Why doesn't Prometrium work with me?
by heart2heart, Jul 31, 2006 12:00AM
To make a long story short, I'm a 54 yo perimenopausal female with a long hx of DUB. I had my third D&C 2 months ago and I'm trying Prometrium AGAIN to regulate my periods. I finished Prometrium 4 weeks ago but did not experience any withdrawal bleeding. Then 8 days ago the bleeding started and has not quit yet...here we go again. This pattern has happened before and the bleeding drags on and on and can get quite heavy. I do not have any hyperplasia or polyps. I have a few fibroids but they are the size of little marbles (and who doesn't have fibroids?) What would my options be right now? I don't want anything with estrogen (I have a hx of a TIA)
Doctor's Answer
by Machelle Seibel, MD, Aug 07, 2006 12:00AM
, Aug 07, 2006 12:00AM
A. Perimenopausal bleeding can be a real nuisance for women and it sounds like your situation is no exception. And nobody wants to have multiple D&C’s. The good news is that you do not have any hyperplasia or polyps. Sometimes doing a hysteroscopy where a small telescope is placed into the uterus, will identify an area that is causing the problem but is missed by the “blind” scraping that takes place with a D&C.
Estrogen combined with progesterone would likely solve the problem but you are uncomfortable with the risk of taking estrogen which is understandable.
Another possible treatment is with a progesterone IUD such is Mirena. It goes into the uterus and secretes progesterone locally. That can often be helpful in such cases as yours. Also, taking a different progesterone that is stronger either as a higher dosage of Prometrium, or another progestin such as megace 20 to 40 mg daily can often help.
Machelle M. Seibel, MD
Estrogen combined with progesterone would likely solve the problem but you are uncomfortable with the risk of taking estrogen which is understandable.
Another possible treatment is with a progesterone IUD such is Mirena. It goes into the uterus and secretes progesterone locally. That can often be helpful in such cases as yours. Also, taking a different progesterone that is stronger either as a higher dosage of Prometrium, or another progestin such as megace 20 to 40 mg daily can often help.
Machelle M. Seibel, MD
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