Heavy Bleeding

Question

My wife has two huge problems. She has been to many doctors and her quality of life has gone down the tubes. She is 51 and now bleeds so bad during her period that she has to stay near a bathroom for a week, and when not bleeding she leaks urine and must also stay near a bathroom. Our doctors have no ideas, she has been checked out, no tumors. Is a hysterectomy the only way, aren’t there some drugs, or specialist out there? We are planning a vacation and she is thinking of not going. I am sure she is not the only one? Thanks for any ideas you can send my way.
Jim

Answer

Last Updated: July 11, 2013
Your wife is likely not ovulating–this is very common as one is going through menopause. Assuming that she has had a careful evaluation of her endometrium with a sampling of the endomerial tissue (I assume this was done when you say she has “no tumor”), and assuming that her uterus has been evaluated by ultrasound, then her bleeding is almost certainly the result of the lack of the organizing and stabilize effects of progesterone on the endometrium. Progesterone results from a normal ovulation. If there is no progesterone or not enough, then the uterine lining never stabilizes, and it is nearly impossible to have a normal period. This can be assessed by a targeted hormonal evaluation of your wife’s cycle. I would recommend that a series of progesterone levels be checked during your luteal phase (the time after ovulation would occur). If the progesterone levels are non-existent or inadequate, then cooperative replacement of progesterone may solve this problem. Dr Thomas Hilgers (at the Pope Paul VI Institue) has a nomogram for the expected normal progesterone levels in the luteal phase. If this does not help, then a D&C should be considered. Other options include uterine ablation (where the inner lining of the uterus is cauterized) or hysterectomy. You can discuss these options with your doctor. Good Luck!

John Gisla, MD

Answered By:

John Gisla, MD
Dr. John Gisla, Board Certified by the American Academy of Family Physicians, pracitces in the Sacramento Region.

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