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How Can Abnormal Uterine Bleeding In A 41 Year Old Be Treated?

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Posted on Mon, 21 Aug 2017
Question: I have had MaNY complications and have changed GYnecologists in an attempt to stop the persistent bleeding and the dysmenorrhea my PCP has diagnosed me with. I need to know how I, can advocate to just Have the operation without the hundreds of additional tests? I have been excessively bleeding and getting my menses at least three times a month. What are your thoughts? I am desperate. I suffer from severe anemia and am constantly getting Iron infusions.
doctor
Answered by Dr. Deepti Verma (38 minutes later)
Brief Answer:
Diagnosis needs to be confirmed

Detailed Answer:
Hi dear,
I have gone through your question and understand the concerns.
Excessive and irregular bleeding between the age 40-45 years is mostly due to the endometrial or uterine lining dysfunction, due to hormonal disturbances.
However, an endometrial biopsy should be done to confirm the diagnosis.
Effective medical treatment in the form of progesterone hormones is available for this dysfunctional uterine bleeding.
Endometrial biopsy is also advocated to rule out any chances of endometrial carcinoma.
Removal of uterus is advocated if the medical management do not work or the patient is not willing for it.
You can consult your OBGYN specialist and discuss these issues so that a informed decision can be taken.
Hope you found the answer helpful.
Regards
Dr Deepti Verma
OBGYN
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Deepti Verma (26 minutes later)
Medical oral treatments have not worked due to my gastric bypass en route y. I have Iron infusions, all the time. I have a ferret in deficiency, which causes so many other issues. I even had an ablation two years ago. I really am just exhausted from all the other forms thus far. I have a new GYN specialist and wants to do a hysteroscopy, and a new barrage of tests both outpatient and in office. I am constantly weak, due to my severe anemia, and my PCP referred me with Dysmenorrhea as the cause of my constant need for iron infusions, which lead to constant respiratory infections, etc... I understand that, for legal reasons, we must try everything, I just want to know if I firmly require to just end, this entire cycle, with the surgery, can I? I will be seeing my GYN next week and just wanted to be prepared, as I am very tired. No birth control pills work, no oral meds work, unless doubled or tripled in dosage, which obviously poses another concern. I just want to feel like there is a permanent fix to this matter which has been ongoing for over 4 years.
doctor
Answered by Dr. Deepti Verma (13 hours later)
Brief Answer:
Hysterectomy should be done

Detailed Answer:
Hi dear,
If all the medical management is failed, and you are constantly bleeding, then the removal of the uterus or hysterectomy is the only resort.
You can discuss with your OBGYN to prepare you for hysterectomy if the report of the hysteroscopy is negative for malignancy.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Deepti Verma (10 hours later)
Thank you so much Doctor! I just wanted to be reasonable and not contentious with my OBGYN! You have put my mind at ease.
doctor
Answered by Dr. Deepti Verma (5 hours later)
Brief Answer:
Happy to help

Detailed Answer:
Hi dear,
I am happy to have helped you.
You can get back to me anytime for further health queries by asking a direct question to me on this site by using ' Ask this doctor' facility.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Deepti Verma

OBGYN, Maternal and Fetal Medicine

Practicing since :2009

Answered : 5067 Questions

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How Can Abnormal Uterine Bleeding In A 41 Year Old Be Treated?

Brief Answer: Diagnosis needs to be confirmed Detailed Answer: Hi dear, I have gone through your question and understand the concerns. Excessive and irregular bleeding between the age 40-45 years is mostly due to the endometrial or uterine lining dysfunction, due to hormonal disturbances. However, an endometrial biopsy should be done to confirm the diagnosis. Effective medical treatment in the form of progesterone hormones is available for this dysfunctional uterine bleeding. Endometrial biopsy is also advocated to rule out any chances of endometrial carcinoma. Removal of uterus is advocated if the medical management do not work or the patient is not willing for it. You can consult your OBGYN specialist and discuss these issues so that a informed decision can be taken. Hope you found the answer helpful. Regards Dr Deepti Verma OBGYN