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What does heavy periods and continues spotting suggest?

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Posted on Thu, 28 May 2015
Question: Hi, I had a very heavy period first of april started normal and got very heavy with clots the second week. Then I stopped for a week, and started again for 4 days really light just spotting. I had a vaginal ultrasound on tuesday and was still spotting. The doctor said my lining was 1.6 is this normal? She wants me on medroxyprogesterone 10mg for the next 3 months which I am very apprehensive about. Last year I had a byopsy and it was negative. Where do I go from here?
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Answered by Dr. Ramadevi Wani (26 minutes later)
Brief Answer:
Have hysteroscopy and biopsy first.

Detailed Answer:
Hi,
Welcome to Healthcare magic.
I am Dr Ramadevi Wani. I will be answering your concerns today.
Do you have regular periods.
I presume that the uterine lining thickness you have mentioned is 1.6 cm. This is not normal. From your notes it appears that you probably may be having an endometrial polyp.
I suggest you have hysteroscopy and biopsy first. If polyp is seen during hysteroscopic examination it can be removed and sent for microscopic examination. Based on the biopsy report treatment can be palnned. If the biopsy shows simple endometrial hyperplasia you can use medroxyprogesterone as mentioned by your doctor.
Please get thyroid hormones and Haemoglobin tested. Thyroid hormone deficiency can also cause such bleeding although in that case lining will not be thick. With the severe bleeding you had you may have developed anaemia. Start taking iron and Calcium tablets along with multi vitamin.

I hope this helps.
If you have further queries, do write to me through Healthcare Magic. I will be happy to answer.

Regards,
Dr Ramadevi wani
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Ramadevi Wani (10 minutes later)
I had blood work and I am not anemic, and my thyroid is borderline but not out of rage. I had a biopsy done last fall and it was negative and it was after heavy bleeding also. I have been told by friends not to have a hysterectomy and it seems like a D and C is not safe either.

I would also like to know what other progesterone is there to take besides provera, and one with less side affects?
doctor
Answered by Dr. Ramadevi Wani (9 hours later)
Brief Answer:
A progesterone intrauterine devise can be used instead of Provera

Detailed Answer:
Hi,
Welcome back.
As of now you definitely do not need hysterectomy.

Hysteroscopy is a procedure in which a small telescope is passed through the cervix ( neck of the womb) to look into the uterine cavity. If polyp is seen it can be removed. If no polyp is seen you need to have curettage. This is a minor procedure. So do not worry.
If polyp is found and removed, you do not need to take any progesterone.
If the biopsy report comes as simple hyperplasia, then you need to take progesterone.
If you do not like this provera tablet there is a progesterone intrauterine devise which can be inserted into the uterus. It releases progesterone in micrograms which acts locally on the uterine lining with less side effects.
I hope this helps.
If you have further queries, do write to me.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Dr. Ramadevi Wani

OBGYN

Practicing since :1985

Answered : 1444 Questions

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What does heavy periods and continues spotting suggest?

Brief Answer: Have hysteroscopy and biopsy first. Detailed Answer: Hi, Welcome to Healthcare magic. I am Dr Ramadevi Wani. I will be answering your concerns today. Do you have regular periods. I presume that the uterine lining thickness you have mentioned is 1.6 cm. This is not normal. From your notes it appears that you probably may be having an endometrial polyp. I suggest you have hysteroscopy and biopsy first. If polyp is seen during hysteroscopic examination it can be removed and sent for microscopic examination. Based on the biopsy report treatment can be palnned. If the biopsy shows simple endometrial hyperplasia you can use medroxyprogesterone as mentioned by your doctor. Please get thyroid hormones and Haemoglobin tested. Thyroid hormone deficiency can also cause such bleeding although in that case lining will not be thick. With the severe bleeding you had you may have developed anaemia. Start taking iron and Calcium tablets along with multi vitamin. I hope this helps. If you have further queries, do write to me through Healthcare Magic. I will be happy to answer. Regards, Dr Ramadevi wani