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Is It Normal To Experience Heavy Bleeding Post Myomectomy?
Question: I had a laproscopic myomectomy to remove two fibriods, one the size of a baseball, the other a plum from my uterus. I am now about 10 weeks post op and having a really bad heavy period that so far has lasted 9 days. These periods almost seem worst than before the surgery, which is one of the reasons I had the procedure. The funny thing is that 3 months before the surgery I had no period, not sure why, before that I was having heavy 10-13 day periods and was miserable. I'm hoping that this is just my body healing from the surgery and that I will have a better period next time. I have read that the first 3-4 periods can be really bad, and that's normal, but I have also read posts from women who say they still have horrible heavy unmanageable bleeding even 5-9 months post op. What should I do?
Brief Answer:
Endometrial status very important
Detailed Answer:
Dear XXXX,
Please pardon me if I have not spelt your name rightly and provide me your correct name in that case.
Please do not ignore this incidence of heavy bleeding. You should report it to your Gynaecologist. It is a myth that after the myomectomy few periods are very heavy.
There are following possibilities:
1. You have developed post operative intrauterine or pelvic infection causing heavy menstruation. This will cause pain also. It can be treated by antibiotics and anti-inflammatory medicines.
2. Your uterine lining (endometrium) may be very thick. This is known to coexist with fibroid uterus as both the conditions are Oestrogen dependant and are due to high Oestrogen levels.
3. About 30% of the fibroids coexist with endometrial cancer. Was your endometrium examined under microscope before removal of fibroids? Had you undergone Hysteroscopy before surgery? Was your uterus specimen subjected to histopathology study? What are the reports?
4. State of high Oestrogen is still existing and hence causing heavy bleeding.
Infection or inflammation can be diagnosed on internal clinical examination. Ultrasonography will reveal any lesion in the uterus and most importantly the thickness of the endometrium. If endometrium is thicker (or even otherwise also) it is good to undergo endometrial study to rule out cancer. Depending upon the endometrial status, further management will have to be managed.
Bleeding due to high Oestrogen can be controlled by use of Progesterone.
5. Please get your blood examined for haemoglobin values. You have a history of heavy bleeding for prolonged time. So it is likely that you are rendered anaemic. Anaemia also can lead to heavy menses.
Please start iron tablets and high protein diet.
This preliminary advice should guide you for further management. I can guide you further when you answer my questions and provide me with more relevant information.
For any more advice and/or information, I am always available for you, Rosetovey.
Dr. Nishikant Shrotri
Endometrial status very important
Detailed Answer:
Dear XXXX,
Please pardon me if I have not spelt your name rightly and provide me your correct name in that case.
Please do not ignore this incidence of heavy bleeding. You should report it to your Gynaecologist. It is a myth that after the myomectomy few periods are very heavy.
There are following possibilities:
1. You have developed post operative intrauterine or pelvic infection causing heavy menstruation. This will cause pain also. It can be treated by antibiotics and anti-inflammatory medicines.
2. Your uterine lining (endometrium) may be very thick. This is known to coexist with fibroid uterus as both the conditions are Oestrogen dependant and are due to high Oestrogen levels.
3. About 30% of the fibroids coexist with endometrial cancer. Was your endometrium examined under microscope before removal of fibroids? Had you undergone Hysteroscopy before surgery? Was your uterus specimen subjected to histopathology study? What are the reports?
4. State of high Oestrogen is still existing and hence causing heavy bleeding.
Infection or inflammation can be diagnosed on internal clinical examination. Ultrasonography will reveal any lesion in the uterus and most importantly the thickness of the endometrium. If endometrium is thicker (or even otherwise also) it is good to undergo endometrial study to rule out cancer. Depending upon the endometrial status, further management will have to be managed.
Bleeding due to high Oestrogen can be controlled by use of Progesterone.
5. Please get your blood examined for haemoglobin values. You have a history of heavy bleeding for prolonged time. So it is likely that you are rendered anaemic. Anaemia also can lead to heavy menses.
Please start iron tablets and high protein diet.
This preliminary advice should guide you for further management. I can guide you further when you answer my questions and provide me with more relevant information.
For any more advice and/or information, I am always available for you, Rosetovey.
Dr. Nishikant Shrotri
Above answer was peer-reviewed by :
Dr. Prasad
As far as I know my edometruim was okay and was never noted as being thick or anything throughout. I thought if I had something my doctor would have been able to see it on the ultrasound, which I have had several of or during the surgery, but perhaps not?
If I do have an infection, I have no fever as of yet..
I have never heard that 30% of fibriods coexsist with cancer, that is terrible. My OBGYN never told me that.
Thank you so much for all of that. I have written this all down and plan to call my doctor right away and ask about edometuim status, infection, estrogen level and test to see if I am anemic. It seems I need a series of tests done right away.
If I do have an infection, I have no fever as of yet..
I have never heard that 30% of fibriods coexsist with cancer, that is terrible. My OBGYN never told me that.
Thank you so much for all of that. I have written this all down and plan to call my doctor right away and ask about edometuim status, infection, estrogen level and test to see if I am anemic. It seems I need a series of tests done right away.
Brief Answer:
Would like to see the reports and opinion of Gynaecologist
Detailed Answer:
Dear XXXX,
I would appreciate if you get the exact findings about the endometrium instead of having just the feeling about it. Endometrial thickness during ultrasonography, its appearance - all carry quite an importance.
If you are not having any fever, the chances of infection are very remote.
Yes, the relation of Fibroid uterus and Cancer of endometrium is proved way back. Both are the result of Hyperoestrinism.
It is a good step to report to your Gynaecologist for the investigations you have mentioned. However, I do not feel Oestrogen levels are required.
Please keep me informed about the reports and upload them for my review. Also, I would be interested in knowing about the Gynaecologist's opinion about your condition.
Please feel free to ask me any information.
Dr. Nishikant Shrotri
Would like to see the reports and opinion of Gynaecologist
Detailed Answer:
Dear XXXX,
I would appreciate if you get the exact findings about the endometrium instead of having just the feeling about it. Endometrial thickness during ultrasonography, its appearance - all carry quite an importance.
If you are not having any fever, the chances of infection are very remote.
Yes, the relation of Fibroid uterus and Cancer of endometrium is proved way back. Both are the result of Hyperoestrinism.
It is a good step to report to your Gynaecologist for the investigations you have mentioned. However, I do not feel Oestrogen levels are required.
Please keep me informed about the reports and upload them for my review. Also, I would be interested in knowing about the Gynaecologist's opinion about your condition.
Please feel free to ask me any information.
Dr. Nishikant Shrotri
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi Dr. Shritri,
I went to the ER because the bleeding was really bad this morning, and then all of a sudden it slowed way down on it's own, so that's a good thing. Hoping it doesn't come back.
They did some blood work and my hemoglobin is 13, so not anemic and I handled the heavy period and blood loss well, as I usually do.
They also performed an ultrasound this afternoon and found some thickening in the edometrial lining. It looked to be like maybe a cm thick, but I can call them to check and be sure.
Last they said that there is some scar tissue from the surgery or possible another fibriod, but they could not tell that clearly on the ultrasound.
No signs of uterine infection, like fever, bleeding that is not cyclical etc.
I have an appointment with my OBGYN who performed the surgery on Wednesday. What specifically should I ask and what test should I have performed.
Thanks,
XXXX
I went to the ER because the bleeding was really bad this morning, and then all of a sudden it slowed way down on it's own, so that's a good thing. Hoping it doesn't come back.
They did some blood work and my hemoglobin is 13, so not anemic and I handled the heavy period and blood loss well, as I usually do.
They also performed an ultrasound this afternoon and found some thickening in the edometrial lining. It looked to be like maybe a cm thick, but I can call them to check and be sure.
Last they said that there is some scar tissue from the surgery or possible another fibriod, but they could not tell that clearly on the ultrasound.
No signs of uterine infection, like fever, bleeding that is not cyclical etc.
I have an appointment with my OBGYN who performed the surgery on Wednesday. What specifically should I ask and what test should I have performed.
Thanks,
XXXX
Brief Answer:
Operating Gynaecologist may enlighten you
Detailed Answer:
Dear XXXXXXX
One optimistic event is that at least your bleeding is declining.
One centimetre thick normal endometrium should not cause such a heavy bleeding; however, we should realise that this thickness is after prolonged heavy bleeding. We just have just to guess what would have been endometrial thickness when you started bleeding. It is a good option to examine this endometrium. Hysteroscopy examination may be of some help.
If there is another remaining fibroid, it may bleed provided it is encroaching in the uterine cavity. A fibroid in the musculature of the uterus or encroaching in the peritoneal cavity need not cause bleeding; however it will obstruct the uterine contractions leading to heavy bleeding after it has started. Would you please inform me the precise site and the size of this fibroid. 'Possible Fibroid' term indicates that this could be a very small fibroid which may be unlikely cause of such a heavy bleeding episode.
If it is an unhealed scar, it may bleed. Get is confirmed please. Hysteroscopy may be of great help for diagnosis.
Your Haemoglobin level is indeed encouraging; however, considering the amount of bleeding you had and are having, please start iron preparations with high protein diet to safeguard against the impending anaemia.
During your visit to the operating Gynaecologist, please get the clarification about the points I have mentioned in my previous communications. Also, I would like to know whether he/she had to open the uterine cavity while removing the fibroid and if so, how was it closed. I would appreciate if you could upload the detailed steps and description of the surgery. Moreover, if the uterine cavity was opened, how was the appearance of endometrium? Was the cavity after the fibroid removal obliterated completely by encircling purse string sutures?
Try to get as much information and as many reports & images available. I would like to go through them if you upload them.
Any number of your queries and doubts are most welcome. I shall definitely be available for you as and when required, XXXXXXX
Dr. Nishikant Shrotri
Operating Gynaecologist may enlighten you
Detailed Answer:
Dear XXXXXXX
One optimistic event is that at least your bleeding is declining.
One centimetre thick normal endometrium should not cause such a heavy bleeding; however, we should realise that this thickness is after prolonged heavy bleeding. We just have just to guess what would have been endometrial thickness when you started bleeding. It is a good option to examine this endometrium. Hysteroscopy examination may be of some help.
If there is another remaining fibroid, it may bleed provided it is encroaching in the uterine cavity. A fibroid in the musculature of the uterus or encroaching in the peritoneal cavity need not cause bleeding; however it will obstruct the uterine contractions leading to heavy bleeding after it has started. Would you please inform me the precise site and the size of this fibroid. 'Possible Fibroid' term indicates that this could be a very small fibroid which may be unlikely cause of such a heavy bleeding episode.
If it is an unhealed scar, it may bleed. Get is confirmed please. Hysteroscopy may be of great help for diagnosis.
Your Haemoglobin level is indeed encouraging; however, considering the amount of bleeding you had and are having, please start iron preparations with high protein diet to safeguard against the impending anaemia.
During your visit to the operating Gynaecologist, please get the clarification about the points I have mentioned in my previous communications. Also, I would like to know whether he/she had to open the uterine cavity while removing the fibroid and if so, how was it closed. I would appreciate if you could upload the detailed steps and description of the surgery. Moreover, if the uterine cavity was opened, how was the appearance of endometrium? Was the cavity after the fibroid removal obliterated completely by encircling purse string sutures?
Try to get as much information and as many reports & images available. I would like to go through them if you upload them.
Any number of your queries and doubts are most welcome. I shall definitely be available for you as and when required, XXXXXXX
Dr. Nishikant Shrotri
Above answer was peer-reviewed by :
Dr. Sonia Raina
Dr. Shrotri,
Thank you again. I just got the report from my ultrasound as to exactly what it states. It says that my uterus is enlarged and very heterogeneous measuring 16.3 x 7.0 x 10.5 cm. I was large obviously before the surgery and I thought that maybe it was still large during the recovery process, but there are multiple heterogeneous nodule that are present throughout the myometruim.
It says that Endometruim is 9.4 mm.
Right ovary 5.0 x 4.3 x 5.1 cm Mildly lobulated cyst within the right ovary measuring 3.0 x 2.5. , Normal color Doppler.
Left ovary: 3.5 x 2.9 x 5.2 . No mass. Normal Doppler
No free fluid
Impression: Enlarged uterus consistent with multiple fibriods, normal endometruim and small right ovariam cyst.
How can I have multiple fibriods just after having a myomectomy? Where they there before and too small to be seen or did my hormone go way out of balance after the surgery and cause them?
What should I do to rule out cancer of the uterus and endometruim? And what can I do to extend out conversation past the 3 days before out discussion closes automatically.
I will ask the doctor on Wednesday for all the information you requested and send it to you Wednesday night.
The bleeding got a little heavy again after IBprofen wore off but still not nearly as bad as it was yesterday and previous.
Will a shot of Depo help stop the bleeding for several months? Something like 500cc? Last time I had heavy bleeding a while back that is what they gave me before I knew I had fibriods and it stopped my period for 9 months. Is natural progesterone shot large dose an option here?
My goal is to prevent having a hysterectomy if I can control the bleeding hormonally and to rule out cancer.
This is so upsetting. I don't to face cancer or having another major surgery, but I am preparing myself for that possibility.
Dr,
Could this be what I have? If so, what are my options? Diffuse uterine leiomyomatosis is a benign and extremely rare condition in which the uterus is symmetrically enlarged as a result of the almost complete replacement of the myometrium by innumerable poorly defined, confluent leiomyomatous nodules.
Thank you again. I just got the report from my ultrasound as to exactly what it states. It says that my uterus is enlarged and very heterogeneous measuring 16.3 x 7.0 x 10.5 cm. I was large obviously before the surgery and I thought that maybe it was still large during the recovery process, but there are multiple heterogeneous nodule that are present throughout the myometruim.
It says that Endometruim is 9.4 mm.
Right ovary 5.0 x 4.3 x 5.1 cm Mildly lobulated cyst within the right ovary measuring 3.0 x 2.5. , Normal color Doppler.
Left ovary: 3.5 x 2.9 x 5.2 . No mass. Normal Doppler
No free fluid
Impression: Enlarged uterus consistent with multiple fibriods, normal endometruim and small right ovariam cyst.
How can I have multiple fibriods just after having a myomectomy? Where they there before and too small to be seen or did my hormone go way out of balance after the surgery and cause them?
What should I do to rule out cancer of the uterus and endometruim? And what can I do to extend out conversation past the 3 days before out discussion closes automatically.
I will ask the doctor on Wednesday for all the information you requested and send it to you Wednesday night.
The bleeding got a little heavy again after IBprofen wore off but still not nearly as bad as it was yesterday and previous.
Will a shot of Depo help stop the bleeding for several months? Something like 500cc? Last time I had heavy bleeding a while back that is what they gave me before I knew I had fibriods and it stopped my period for 9 months. Is natural progesterone shot large dose an option here?
My goal is to prevent having a hysterectomy if I can control the bleeding hormonally and to rule out cancer.
This is so upsetting. I don't to face cancer or having another major surgery, but I am preparing myself for that possibility.
Dr,
Could this be what I have? If so, what are my options? Diffuse uterine leiomyomatosis is a benign and extremely rare condition in which the uterus is symmetrically enlarged as a result of the almost complete replacement of the myometrium by innumerable poorly defined, confluent leiomyomatous nodules.
Brief Answer:
Close monitoring required
Detailed Answer:
Dear XXXXXXX
I must complement you for such an exhaustive report you have forwarded me.
At the outset, let me put forward my impressions:
1. The uterus is quite enlarged, almost double its measurements. It could be due to multiple fibroids you are having. BTW, leiomyoma is another term for Fibroid. In fact it is the most scientific term. Such a large uterus will bleed more, no doubt.
2. The endometrial thickness when more than 5 mm is alarming. Yours is 9.4 mm which demands further work up. I still feel Hysteromicroscopy would be helpful.
3. A cyst on the left ovary needs monitoring.
At this stage, Tranexamic acid might help you to control bleeding. Please avoid aspirin. Depo might control bleeding, however it would not be sustained effect. All these measures to control bleeding would be temporary till the underlying cause is diagnosed.
I do appreciate your attitude to save the uterus; however, till the uterine condition is ascertained, please do not be bent upon your view. Particularly with so many fibroids present in the uterus, I would rather sacrifice the uterus. XXXXXXX Myomectomy is more major surgery than hysterectomy. The fibroid, if left alone in the uterus may undergo many types of degenerations like red degeneration, malignant degeneration, etc.. Sarcomatous changes in fibroid should be kept in mind. So, when it comes to choose between health (or life) and the uterus, I feel you should opt for the former one. At this age, when the function of the uterus is over, what is the advantage in retaining it if it is threatening your health or life?
During myomectomy, very small seedlings are missed; however not the large ones. The diffuse lesion in the uterine musculature indeed needs a thorough work up.
I can understand your keenness to rule out malignancy. The first step would be to have the histopathology report of the removed fibroids. As I have already suggested you, endometrial study should be considered seriously. If needed, the existing uterine lesion(s) may require histopathology study.
Once you are confirmed to have only benign lesions, I may suggest you various option to control the bleeding in forthcoming communications.
Yes XXXXXXX we can have continued discussion on this forum. Even if you close this query, you can again re-open the discussion again; else you may choose to ask me Direct question. Even if you contact Healthcaremagic forum by email or phone, they will direct your messages to me.
Please keep me updated. If you are satisfied with our discussion, you may opt to post your review with 5 star rating for me.
Dr. Nishikant Shrotri
Close monitoring required
Detailed Answer:
Dear XXXXXXX
I must complement you for such an exhaustive report you have forwarded me.
At the outset, let me put forward my impressions:
1. The uterus is quite enlarged, almost double its measurements. It could be due to multiple fibroids you are having. BTW, leiomyoma is another term for Fibroid. In fact it is the most scientific term. Such a large uterus will bleed more, no doubt.
2. The endometrial thickness when more than 5 mm is alarming. Yours is 9.4 mm which demands further work up. I still feel Hysteromicroscopy would be helpful.
3. A cyst on the left ovary needs monitoring.
At this stage, Tranexamic acid might help you to control bleeding. Please avoid aspirin. Depo might control bleeding, however it would not be sustained effect. All these measures to control bleeding would be temporary till the underlying cause is diagnosed.
I do appreciate your attitude to save the uterus; however, till the uterine condition is ascertained, please do not be bent upon your view. Particularly with so many fibroids present in the uterus, I would rather sacrifice the uterus. XXXXXXX Myomectomy is more major surgery than hysterectomy. The fibroid, if left alone in the uterus may undergo many types of degenerations like red degeneration, malignant degeneration, etc.. Sarcomatous changes in fibroid should be kept in mind. So, when it comes to choose between health (or life) and the uterus, I feel you should opt for the former one. At this age, when the function of the uterus is over, what is the advantage in retaining it if it is threatening your health or life?
During myomectomy, very small seedlings are missed; however not the large ones. The diffuse lesion in the uterine musculature indeed needs a thorough work up.
I can understand your keenness to rule out malignancy. The first step would be to have the histopathology report of the removed fibroids. As I have already suggested you, endometrial study should be considered seriously. If needed, the existing uterine lesion(s) may require histopathology study.
Once you are confirmed to have only benign lesions, I may suggest you various option to control the bleeding in forthcoming communications.
Yes XXXXXXX we can have continued discussion on this forum. Even if you close this query, you can again re-open the discussion again; else you may choose to ask me Direct question. Even if you contact Healthcaremagic forum by email or phone, they will direct your messages to me.
Please keep me updated. If you are satisfied with our discussion, you may opt to post your review with 5 star rating for me.
Dr. Nishikant Shrotri
Above answer was peer-reviewed by :
Dr. Sonia Raina
Dr,
I really don't understand what you mean by the first step would be to have the histopathology report of the removed fibroids? Are you referring to the multiple heterogeneous nodules present throughout the myometruim? How would I be able to remove all those? Or do you mean the two large fibriods that were removed during my myomectomy back in February? If so, those were bengin, but I do not know what the hetrogeneous nodule present throughout the myometruim could be. Are you saying these are small fibriods that may have always been there and they were missed on all previous ultrasounds and during the surgery? Could this not me adenomysis instead? Do you think I could have Diffuse uterine leiomyomatosis?
I will certainly give you a great rating, you have been most helpful. And I do want to continue to correspond on here with you until I get through this.
Goodnight
Thanks,
XXXX
I really don't understand what you mean by the first step would be to have the histopathology report of the removed fibroids? Are you referring to the multiple heterogeneous nodules present throughout the myometruim? How would I be able to remove all those? Or do you mean the two large fibriods that were removed during my myomectomy back in February? If so, those were bengin, but I do not know what the hetrogeneous nodule present throughout the myometruim could be. Are you saying these are small fibriods that may have always been there and they were missed on all previous ultrasounds and during the surgery? Could this not me adenomysis instead? Do you think I could have Diffuse uterine leiomyomatosis?
I will certainly give you a great rating, you have been most helpful. And I do want to continue to correspond on here with you until I get through this.
Goodnight
Thanks,
XXXX
Brief Answer:
Further reports awaited
Detailed Answer:
Dear XXXXXXX
Yes, I do mean the histopathology report of the previously removed fibroids. If they were benign, one step is over.
Adenomyosis would have been detected at the time of myomectomy. Though the possibility cannot be set aside, the detailed study is required.
I would be awaiting for more medical investigation reports after you meet your Gynaecologist.
I am thankful to you for the review you have posted about me.
Dr. Nishikant Shrotri
Further reports awaited
Detailed Answer:
Dear XXXXXXX
Yes, I do mean the histopathology report of the previously removed fibroids. If they were benign, one step is over.
Adenomyosis would have been detected at the time of myomectomy. Though the possibility cannot be set aside, the detailed study is required.
I would be awaiting for more medical investigation reports after you meet your Gynaecologist.
I am thankful to you for the review you have posted about me.
Dr. Nishikant Shrotri
Above answer was peer-reviewed by :
Dr. Sonia Raina
Hello Dr. Shrotri,
I hope you are doing well.
I wanted to ask again about the measures to control the bleeding, as I am still bleeding heavily, but controlling it with NSAIDS the best I can until my appointment this Wednesday. They wanted to give me 150 dose of Depo in the ER but I was concerned because it is a synthetic hormone and not natural like a progesterone in oil. Should I ask them if they can provide me with a natural progesterone in oil injection to stop heavy period? And if so, how much should I ask for to stop heavy bleeding that had been going on now for 11 days?
Last, about a month ago I noticed a large lump on the back of my thigh, seems like it was in the mucel. They did an ultrasound on it two separate times and said that it wasn't a blood clot or hemotoma but I am concerned. It has gotten better but it's still very much there and it is a very slow process of healing.
I hope you are doing well.
I wanted to ask again about the measures to control the bleeding, as I am still bleeding heavily, but controlling it with NSAIDS the best I can until my appointment this Wednesday. They wanted to give me 150 dose of Depo in the ER but I was concerned because it is a synthetic hormone and not natural like a progesterone in oil. Should I ask them if they can provide me with a natural progesterone in oil injection to stop heavy period? And if so, how much should I ask for to stop heavy bleeding that had been going on now for 11 days?
Last, about a month ago I noticed a large lump on the back of my thigh, seems like it was in the mucel. They did an ultrasound on it two separate times and said that it wasn't a blood clot or hemotoma but I am concerned. It has gotten better but it's still very much there and it is a very slow process of healing.
Brief Answer:
Get blood profile checked completely
Detailed Answer:
Dear XXXXXXX
I entirely agree with you; some emergency steps have to be taken to control your bleeding. Tranexamic acid would be useful in controlling the bleeding as this bleeding does not appear to be due to hormonal imbalance.
Any injection in oil is a sort of depot and is absorbed gradually. Here, I feel immediately acting medicine is required. A couple of doses of synthetic or natural progesterone will not make much of a difference. If it comes to that, we may have to resolve even to Testosterone injection (male hormone) as an emergency measure. This stops the bleeding immediately. Now your immediate aim should be not only to control but to stop this bleeding.
Please recheck your blood for following:
1. Haemoglobin and complete haemogram with specific attention to platelet count
2. Bleeding and clotting profile
3. Prothrombin time
4. Fibrinogen degradation products
This will reveal whether the cause of bleeding is in the quality and faults in the blood.
If the bleeding remains to be uncontrollable, you might have to opt for surgical intervention to stop the bleeding. Of course, before that I would prefer to have your endometrium and the diffuse tissue in the myometrium evaluated by histopathology along with your bleeding/clotting profile.
If fibrinogen levels indicate, you may have to go for Fibrinogen transfusion.
Unless I know the detailed description of the report of the lump in your thigh, I cannot opine. You have mentioned what it is not, I am more interested in knowing what it could be according to the ultrasonologist. However, if it is not increasing and if it is not blood clot, this problem may be differed.
I hope this will give you some new horizon of management before you see your Gynaecologist; and also will encourage you to post a good review with 5 stars for me.
I am ever available for you, XXXX; however, the clock difference may delay my response by few hours as I am almost 10-12 hours ahead of your time.
Dr. Nishikant Shrotri
Get blood profile checked completely
Detailed Answer:
Dear XXXXXXX
I entirely agree with you; some emergency steps have to be taken to control your bleeding. Tranexamic acid would be useful in controlling the bleeding as this bleeding does not appear to be due to hormonal imbalance.
Any injection in oil is a sort of depot and is absorbed gradually. Here, I feel immediately acting medicine is required. A couple of doses of synthetic or natural progesterone will not make much of a difference. If it comes to that, we may have to resolve even to Testosterone injection (male hormone) as an emergency measure. This stops the bleeding immediately. Now your immediate aim should be not only to control but to stop this bleeding.
Please recheck your blood for following:
1. Haemoglobin and complete haemogram with specific attention to platelet count
2. Bleeding and clotting profile
3. Prothrombin time
4. Fibrinogen degradation products
This will reveal whether the cause of bleeding is in the quality and faults in the blood.
If the bleeding remains to be uncontrollable, you might have to opt for surgical intervention to stop the bleeding. Of course, before that I would prefer to have your endometrium and the diffuse tissue in the myometrium evaluated by histopathology along with your bleeding/clotting profile.
If fibrinogen levels indicate, you may have to go for Fibrinogen transfusion.
Unless I know the detailed description of the report of the lump in your thigh, I cannot opine. You have mentioned what it is not, I am more interested in knowing what it could be according to the ultrasonologist. However, if it is not increasing and if it is not blood clot, this problem may be differed.
I hope this will give you some new horizon of management before you see your Gynaecologist; and also will encourage you to post a good review with 5 stars for me.
I am ever available for you, XXXX; however, the clock difference may delay my response by few hours as I am almost 10-12 hours ahead of your time.
Dr. Nishikant Shrotri
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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