Brief Answer: DETAILS ARE GIVEN BELOW. Detailed Answer: Hello, Thanks for writing to us. At Peri-menopausal age (48 years), heavy bleeding or irregular cycle may occur among some percentage women. It occurs mainly due to hormonal imbalance, caused by dysfunction of ovary and improper ovulation, leads to progesterone deficiency. However, we need to rule out other possible causes of heavy or prolonged bleeding in this context. These are as follows: 1) Uterine fibroid/ polyp/ Endometriosis 2) Adenomyosis or endometrial hyperplasia 3) Dysfunctional uterine bleeding (DUB) 4) Use of certain medicine/ contraceptive etc. I suggest to undergo one clinical and pelvic examination to your GYNECOLOGIST and undergo some investigations like pelvic ultrasound scan, Pap smear test and complete hormone profile. It will help to confirm the diagnosis. TREATMENT: Treatment can be initiated with haemostatic agent like Tranexamic Acid group of drug, combined with Oral Progesterone tab. Medroxyprogesterone acetate or Norethisterone is usually given to reduce or control bleeding. If above medical treatment fails to control bleeding, then approach would be surgical by the means of Dilation and curettage (D&C), Operative hysteroscopy to remove polyp, endometrial ablation in case of hyperplasia. Hope, I have answered your query. If you don't have any other query, you can close the discussion. Wish your good health and take care yourself. Take healthy diet with IRON supplement. Regards, Dr Soumen

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