Heavy bleeding is sometimes called “the weeping of the uterus”. The first symptoms of late perimenopause are often cases of sudden very heavy menstrual bleeding (not hot flashes). The “flooding” can be so strong that blood soaks through pads or tampons. Quite often when a woman seeks doctor’s advice because of the heavy period, they recommend endometrial curetage of the uterus. Often in following months is surgical procedure is repeated several times due to heavy bleeding.

Endometrial ablation

It turns out that these repeated surgeries are not only cumbersome but also unnecessary. Furthermore, after having performed several ablation procedures, the doctors often recommend hysterectomy. The essential question is whether it is always necessary and if is it the only solution in this situation. The answer is: “No!”

First time it is good to know that if the results of histologic examinations after ablation do not reveal neoplastic change, conservative treatment may be applied. Transvaginal ultrasound examination is a simple and non-invasive method of monitoring the state of endometrium (the lining of the uterus).

If the ultrasound shows a thickening or irregularity, an invasive examination of the endometrium can be performed (biopsy, hysteroscopy) to exclude the neoplastic lesions.

Progesterone

If the neoplastic lesions have been excluded, in the second phase of the cycle (i.e. from day 12 to 26 or 14 to 28 of the cycle) progesterone should be applied – but it must be bioidentical (its biochemical structure identical to the hormones we make in our bodies). Natural Progesterone can be used vaginally or sublingually or in the form of ointment.  All other available progesterone preparations use synthetic progestin. Synthetic progestin (e.g. orgametril or provera) might be introduced when the periods are extremely heavy.

Administering combined estrogen–progesterone preparation is a serious mistake. Introducing estrogen when periods are very heavy aggravates the problem. Improper hormone therapy may cause the recurrence of heavy menstrual bleeding and in consequence lead to hysterectomy.

Solution for heavy bleeding

In case of very heavy and prolonged menstrual periods the best solution (if the neoplastic lesions have been excluded) is:

1. Natural progesterone cream, lutein 50 or 100 or small doses of orgametril or provera together with natural progesterone;
2. Herbs that have the ability to increase the blood level of progesterone – Agnus castus (Vitex agnus–castus);
3. Herbs that have the ability to decrease the bleeding – Capsella bursa-pastoris, yarrow;
4. Herbs that support the liver function: nettle, dandelion roots, raspberry leaf, milk thistle. The herb infusion can be drunk 3-4 times a day. (Pour 1 glass of boiling water over 1 tablespoon of herbs and allow it to steep for 15-20 minutes. Sieve and drink.)
5. A diet that removes the excess of estrogens from the body and supplies it with phytoestrogens (first of all white sugar, sweets, too much coffee, and food preparations of white flour should be excluded; you should eat 3-4 portions of vegetables, beans, lentils, groats and fish a day; meat must be limited to once a week)
6. Supplements: Spirulina alga, evening primrose oil, big doses of natural vitamin C (2-3g daily, during period 5-10g daily)
7. Relaxation exercise, meditation, yoga or tai-chi.

A fragment of the book: Siła jest w tobie (The Power Is Within You),  dr Preeti Agrawal