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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Constant Vaginal Bleeding, No Relief With Provera, Advised Ablation. Should I Opt For Hysterectomy?

I am 44 and have had heavy consistant vaginalbleeding for months. Did biopsy and all came out fine. On provera now second cycle and still bleeding and cramping like regular period. Dr says ablation is next step. I have searched info on both ablation and hysterectomy It seems like many women end up with a hys. within a year after ablation so should I ask my dr about just going strait to hys. I have had 4 children. Two are from invitro b/c I also had two ectopic pregnancies. I also have non-hoskin s t-cell lymphoma which may not make any difference.
Thu, 21 Feb 2013
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OB & GYN Specialist 's  Response
Hello dear,
Thanks for the query. Menorrhagia which is not controlled by medical management, its better to go with surgery. Its all depend on you, about what surgery you want. I suggest you to go ahead with hysterectomy.
Hope I answered your question, Kindly reply me if you have any further queries or any comments. I will be very happy to help you.
Sincerely,
Dr Arif
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General & Family Physician Dr. Achuo Ascensius's  Response
Hello, thanks for using HCM.
Provera is a progesterone like drug with with one of its uses being to control functional menstrual abnormalities due to hormonal disequilibrium. However, some women on progesterone will experience abundant bleeding and progesterone only drugs are not recommended for control of abnormal menstrual bleeding.
If you started the provera after you had started having the heavy bleedings, then you won't have any benefits from it, however, if you started having the bleeding after you had started the provera, then you have to stop it.
If you are considering to have definitive birth control, then hysterectomy will be a better option with less worries once it is done correctly.
However, if you are not thinking of a definitive contraception, then other methods could be use to control your bleeding such as using oestrogen to rapidly cause proliferation and thus stops endometrial shedding and consequently bleeding and then putting you on a combined oral contraceptive or putting you on combine oral contraception which has at least 30mcg of oestrogen, to start with three tabs a day until bleeding stops, then two tabs daily for 5 days then i tab daily until day 21 from the beginning of intake of the oral contraceptive, then the seven day pills on the card (one a day) and during the next period continuing the oral contraception normally.
However, the definitive plan will have to be taken between you and your doctor as he is the one who has an appropriate history and findings about you.
Best regards and hope this helps.
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Constant Vaginal Bleeding, No Relief With Provera, Advised Ablation. Should I Opt For Hysterectomy?

Hello dear, Thanks for the query. Menorrhagia which is not controlled by medical management, its better to go with surgery. Its all depend on you, about what surgery you want. I suggest you to go ahead with hysterectomy. Hope I answered your question, Kindly reply me if you have any further queries or any comments. I will be very happy to help you. Sincerely, Dr Arif