Hallow Dear, There are different options for controlling heavy uterine bleeding. First you have to find out what is the cause of heavy uterine bleeding. Dysfunctional uterine bleeding is that uterine bleeding wherein no palpable pelvic pathology is identifiable. Have you got investigated thoroughly? Have you undergone ultrasonography to find out whether there is any other cause like fibroid in the uterus, chronic pelvic infection, etc. If not, please undergo this investigation before you take any hormones. Your history informs me that you had undergone Dilatation and Curettage some time ago. Was the uterine lining (endometrium) sent for laboratory study? If so, what was the report? Your further treatment should depend up on the report of endometrium. Moreover, again heavy bleeding has started after few days which is continuing for 36 days. This is not a case for IUD nor for blind hormonal treatment. So you have to rule out any possibility of endometrial cancer. You are a smoker, so it is likely that your endometrial blood vessels could have undergone atherosclerotic changes which further leads to heavy uterine bleeding, particularly in perimenopausal age. At this age and with the history of heavy uterine bleeding, I do not feel you are a good candidate for IUD. It will worsen your condition. If there is no other pathology in the uterus or pelvis, if there is no cancer, then you may think of some alternative therapy to control the bleeding. Thermal ablation of the uterine lining will burn all the endometrium and thus your bleeding will be stopped permanently. Alternatively you may opt for removal of the uterus. However, I feel before you take any drastic action, I would urge you to undergo thorough investigations. Based on the reports of the investigations, further rational management can be planned. I would definitely like to help you with a scientific advice if you ask me a Direct question. Dr. Nishikant Shrotri