Brief Answer:
Bleeding from Provera can be stopped with estrogen or more Provera

Detailed Answer:
Hello, and I hope I can help you today.

I am assuming that the reason you were started on Provera was because you hadn't had your period in a long time.

Normally, the first withdrawal bleed from Provera can be a very long and heavy period, lasting even a few weeks. The longer your period had been overdue before taking it, the longer the bleeding will last.

If your healthcare provider suggests it, restarting the progesterone or starting you on combined estrogen/progesterone birth control pills will usually stop the bleeding. But, depending on the reason you were given the provera in the first place, that may not be the appropriate management. Sometimes the point of having a withdrawal bleed is to get all the old blood and tissue out of your uterus that has been built up over time, so stopping the bleeding may not be recommended unless you are losing so much blood that you are dizzy, short of breath or having chest pain. If you do have those symptoms, you really should go to an emergency room for evaluation.

If you want more information, i would be happy to discuss this further, but it would be helpful to know why you were given the Provera in the first place and also the results of any tests you may have had- like ultrasounds or an endometrial biopsy.

Otherwise, I hope I was able to adequately answer your question today and that this information was helpful.

Best wishes,

Dr. Brown

---

Brief Answer:
The bleeding will stop after the GNRH kicks in

Detailed Answer:
Hello again, and sorry for the delayed reply. Thank you for giving me more information about your case and the other medications you are on, it helps to clarify your situation.

You actually are not currently bleeding because of progesterone withdrawal... It is actually from the GNRH injection and your fibroids. If you had DUB that was hormonally related, your endometrial biopsy would have shown proliferation and your endometrial stripe would have been thick.

GNRH agonists are used to reduce levels of estrogen to treat gynecologic conditions that are estrogen-dependent (like Fibroids). Eventually, it gives your body a temporary menopause state, which is reversable after you stop using the injection. But in the beginning, about 2 weeks or so after you get the shot, your estrogen levels actually rise and many women experience worsening bleeding during this time. Taking Provera in addition to the GNRH agonist can sometimes help with this, but the bleeding is unlikely to stop until about a month after the injection.

So in summary, your having increased bleeding at this time is a completely normal side effect of the GNRH injection. The injection will fully kick in at about a month's time and by then your bleeding should stop completely and you should not menstruate anymore after that at all as long as you stay on the injections.
As long as you are not bleeding so much that you are severely anemic, I encourage you just to be patient and the bleeding should significantly slow down or stop in the next week or two. Taking Provera along with the injection is unlikely to help the bleeding, it is just something that needs to run it's course. You can find more information about this if you Google Lupron (one of the most commonly used brands of GNRH agonists).

I hope this additional information is helpful to you and I assure you you should feel better in another week or two. If I can be of any further help, please do not hesitate to contact me again.

Take care,

Dr. Brown

---