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Mirena removed. Started bleeding with clots. Taking primolut N. Not cured. Effective medication?

Mar 2016
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Practicing since : 2011
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I am 36 years old and had Mirena removed 1 week ago. Saw the GP after 2 days due to extremely heavy withdrawal bleeding,large clots etc. She prescribed Primolut N 5mg but only once a day. The heavy bleeding stops some of the time but then comes back just as bad. Day 5 of primolut and I am still passing massive clots and bleeding too heavily to use tampons.
I understand she has given me a lesser dose than usually prescribed.
I would prefer to stop taking primolut since it is not helping and just ride out the withdrawal bleed but am I making it worse by stopping the medication before 10 days?
I'm worried that I'll keep it up for 10 days still bleeding and then have a withdrawal bleed from finishing primulot too.
I have to go away on a trip in 1 week (flying) and don't want to be in a worse state by then!
Posted Mon, 22 Apr 2013 in Women's Health
Answered by Dr. S Patra 1 hour later

Thanks for writing to us. I am trying to solve your problem.

First of all, heavy bleeding with blood clots following removal of Mirena IUD is quite common in some women and it occurs mostly due to hormonal imbalance.

Other pathology like uterine fibroid/ polyp/ endometrial hyperplasia/ adenomyosis etc are also needed to be ruled out in case of continuous heavy bleeding even after using above medication for 10 days. Some relevant investigations may be required like ultrasound scan of pelvis, endometrial tissue biopsy, hormonal assay including thyroid profile etc. Treatment depends on underlying etiology.

In heavy bleeding, recommended dose of Primolut N (Norethisterone) is 5 mg thrice daily for 7-10 days.

Alternatively, you can take Deviry/ Meprate (Medroxyprogesterone) to arrest this type of bleeding. Please consult with your gynecologist regarding this for dose & duration of therapy.

In addition, you should take healthy diet with iron supplements and maintain genital hygiene properly.

Hope I have answered your query. If you have any further questions I will be happy to help.

For any future query, you can directly ask me by viewing this page WWW.WWWW.WW
Wish your good health & take care yourself.

Dr Soumen
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