19 and Suffering with Heavy Bleeding

Dear Brianne:

Your condition is called menometrorrhagia, a medical term to describe heavier than normal menstrual periods and bleeding between menstrual periods. Additionally, pain and cramping with menstrual flow is called dysmenorrhea. From your description, it sounds as though you have a severe case. There are many reasons that can cause this condition or be contributing to its development. These include structural, infectious, autoimmune, and hormonal, causes.

Structural causes include polyps and fibroids of the endometrium (lining of the uterus) as well as endometrial hyperplasia where the cells reproduce excessively. Andenomyosis, a condition where the endometrial cells move into the muscle wall of the uterus, is generally not found in your age group. Endometriosis is more likely at your age. It is a condition when endometrial cells are found outside the uterus generally in the pelvis. These spots or blebs can cause severe cramping during menstrual flow. Additonally, prior surgeries or pelvic infections may have left adhesions. These are fibrous bands that bind organs into abnormal positions. Pelvic ultrasound, endometrial biopsy (office procedure to get cells inside the uterus), and laparoscopy (surgical procedure where the doctor looks through a scope to look at the outside of the uterus and pelvic structures) are part of the necessary tools to make a diagnosis.

Infectious causes include infections of the cervix, the uterus, the tubes, and the pelvic cavity. For the most part these are the result of sexually transmitted diseases which are cultured and treated easily. However women can get infections after childbirth, surgical abortions, and bacteria from the rectal area. Women don’t necessarily develop temperatures or other features of infection. Unusual bleeding may be the only presenting symptom though not as severe as what you describe.

Autoimmune reasons are unclear and under investigation. These may be related to genetic and developmental reasons as well. Conditions such as systemic lupus, thrombocytopenia (low platelets), and von Willebrand’s (bleeding disorder) can be associated with your condition.

Hormonal causes have been investigated well. Thyroid disorders always need to be monitored with periodic checks by lab work. Estrogen and progesterone levels as well as other associated hormones need to be evaluated. Estrogen is the main female hormone of the pre-ovulatory phase and progesterone is the main hormone of the post-ovulatory phase. The only meaningful way to check these levels is when you have been taught to chart your cycles by a certified teacher. I prefer the Creighton model charting as it was developed specifically for medical analysis but allows women and couples to understand their fertility. If estrogen and progesterone levels are checked randomly or by calendar date, they don’t have any relevance to where a woman is in her cycle. Of course, it may be quite difficult to determine if you are ovulating at all but the Creighton model charts are extremely helpful in diagnosis because they are medically relevant.

Besides thyroid dysfunction, many women suffer from polycystic ovarian syndrome which causes varying amounts of cycle irregularities. Commonly progesterone levels do not rise or stay elevated when they are supposed to and the woman will experience irregular bleeding. The cyst formation can cause pain. Approximately 8% of women experience it and it has been successfully treated with ovarian wedge resection and or progesterone. It can occur along with all the other conditions I have mentioned above.

Other hormone conditions stemming from the brain section that sends signals to the ovaries exist as well. Again Creighton model charting is extremely helpful. It helps to put you in the driver’s seat of your health and give your physician a great amount of information with which to work.

Birth control pills are sometimes helpful in treating symptoms but are never helpful in diagnosing or curing disease. As you have found, once off the pills, you are back where you started from. I would recommend that you seek a Creighton model natural fertility care provider who will teach you how to chart your bleeding. This teacher will then be able to recommend you to physicians who are trained in using the medical and surgical techniques of the Creighton model including NaPro Technology.

Treating your condition is very important not only for your well being now but for your future health. Statistics show that your fertility and ability to carry a child to full term are reduced at this time. Additionally, if the cause is too little progesterone, you can be at higher risk for uterine cancer in the future.

I hope that this information, though not complete, will be of help. Please let us know how you are doing as I am sure there are other women who would benefit from your feedback.

Sincerely, Gretchen V. Marsh, D.O.