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Suggest Treatment For Heavy Menstrual Bleeding, Abdominal Cramps And Severe Hair Loss

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Posted on Thu, 2 Feb 2017
Question: Hello,

I have heavy bleeding, more cramps, hair falling out and terrible skin all of a sudden in my 40's. I have had my hormones evaluated by a dermatologist and he said they were fine, plus I've had two normal transvaginal ultrasounds. What could be causing this? My gp is suggesting birth control, but I am unsure of the risks at my age of 42. Please advise!
doctor
Answered by Dr. Saul Weinreb (50 minutes later)
Brief Answer:
it sounds like a hormonal problem, possibly PCOS, birth control may work

Detailed Answer:

Hi,

That's kind you so much for asking your question on HCM. I will do my best to help you.

While there are many possible causes for heavy periods, cramping, acne, and the other symptoms you describe, it certainly sounds like a hormonal problem to me. I am not sure what hormones your dermatologist checked, but he/she may have only been checking for menopausal hormone levels, which may indeed be normal in your case. I think that PCOS is likely, even if the ultrasounds didn't show any cysts. I think that birth control pills would be a great idea to stabilize your cycles, and would probably help your skin and hair loss as well.

Of course you have to make sure that birth control pills are safe for you, so your blood pressure has to be normal, and you cannot be a smoker or have a history of blood clots.

PCOS may not be easy to diagnose with ultrasound or a blood test for hormonal levels. so it may be worth using the pills and just assume the diagnosis without further testing, especially since the testing has been normal until now.

I hope this helps, please let me know if you have any more questions.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Saul Weinreb (19 hours later)
Thank you so much for your answer. Is there any way to properly test my hormones before I take birth control, and are there some birth controls that are safer than others? I have had many weird health issues, including throat problems the last two years, and I believe they are related to hormone issues, but I am not positive. I have had negative tests for pretty much everything..but yet, my symptoms continue.

Because I have LPR (throat reflux), I am weary about birth control as it can contribute to reflux? Also, are there any natural ways to fix hormones? I am taking progesterone cream, but it seems to be doing very little.

doctor
Answered by Dr. Saul Weinreb (12 minutes later)
Brief Answer:
there really isn't any useful hormonal test for PCOS

Detailed Answer:
thanks so much for your question. I know this issue seems complicated, but there really aren't any useful tests that can be done to determine if this is a hormonal imbalance. some hormones, such as thyroid hormone and prolactin can be tested and the result can be useful. also, a blood test for testosterone levels should probably be done as well.

however, the main problem in PCOS and other similar disorders that affect your periods is that the hormones that are involved are estrogen, progesterone, and the hormones that are involved on stimulating the production of estrogen and progesterone - such as LH and FSH. These hormones will always be present at some level, and they fluctuate normally throughout the cycle. most hormonal problems are due to the overall imbalance between the hormones over the course of time. so any blood test is not really useful because it only catches the moment that the test is done. some tests that were once thought to be helpful , like an LH/FSH ratio, are no longer considered helpful.

so there really isn't a useful blood test, so we have to rely upon our clinical judgement. as far as natural ways to fix it, the primary and most important is lifestyle, proper diet, exercise, and weight loss has been shown to be the most effective natural way to correct these hormonal disorders. eating a healthy diet with fruits and vegetables, fiber, protein and avoiding fats and sugars cab be very helpful. it may be a good idea to avoid too much soy due to its estrogenic properties.

I hope this answers your question. please let me know if I can be of further help.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Saul Weinreb (2 hours later)
One last question!

Factor V Leiden runs in my family. Does this effect my ability to go on birth control? And are there any brands you would recommend more than others?

Thank you again,

You are so helpful! XXXXXXX
doctor
Answered by Dr. Saul Weinreb (33 minutes later)
Brief Answer:
factor 5 Leiden is only a problem if you have a history of blood clots

Detailed Answer:
you are very welcome, and thank you so.much for your kind words.

Factor 5 Leiden is usually not a problem unless you have a personal history of blood clots. you should also not use birth control pills if you have high blood pressure or if you smoke. as far as which brand or type to use, it really doesn't matter that much though I usually recommend using the lowest dose possible. Also, the monophasic pills which give a consistent dose usually manage bleeding better than the triphasic pills which adjust the dosage differently each week.

there are other very small and subtle differences that usually don't matter much, but you can discuss them with your doctor when he/she prescribes it to you.

please let me know if you need any more information.
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Saul Weinreb

OBGYN

Practicing since :2000

Answered : 562 Questions

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Suggest Treatment For Heavy Menstrual Bleeding, Abdominal Cramps And Severe Hair Loss

Brief Answer: it sounds like a hormonal problem, possibly PCOS, birth control may work Detailed Answer: Hi, That's kind you so much for asking your question on HCM. I will do my best to help you. While there are many possible causes for heavy periods, cramping, acne, and the other symptoms you describe, it certainly sounds like a hormonal problem to me. I am not sure what hormones your dermatologist checked, but he/she may have only been checking for menopausal hormone levels, which may indeed be normal in your case. I think that PCOS is likely, even if the ultrasounds didn't show any cysts. I think that birth control pills would be a great idea to stabilize your cycles, and would probably help your skin and hair loss as well. Of course you have to make sure that birth control pills are safe for you, so your blood pressure has to be normal, and you cannot be a smoker or have a history of blood clots. PCOS may not be easy to diagnose with ultrasound or a blood test for hormonal levels. so it may be worth using the pills and just assume the diagnosis without further testing, especially since the testing has been normal until now. I hope this helps, please let me know if you have any more questions.