Women's Menopause Health Center  September 15, 2005 Newsletter.

 

Causes and Treatments of Heavy Menstrual Bleeding.
 

One of the most frequent questions we here at the Women’s Menopause Health Center receive relate to irregular and heavy menstrual bleeding. This month we’ll examine the causes and various courses of treatment.

The primary cause of heavy menstrual bleeding in the years before menopause is estrogen dominance. Estrogen dominance causes the lining of the uterus to overgrow. Instead of the normal monthly buildup and shedding of the uterine lining, too much endometrial tissue builds up and then breaks down in a disordered way that results in spotting or irregular heavy menstrual bleeding. It must be noted that emotional stress of any kind can make this heavy menstrual bleeding worse.

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In addition to hormonal imbalance, there may be physical conditions that may interfere with normal contractions of the uterus that help stop the heavy menstrual bleeding each month. One of the most common physical causes of heavy menstrual bleeding is fibroid tumors. (For more information on treating fibroid tumors, click here.) Bleeding is usually caused by sub mucosal fibroids which or located under the mucous membrane that lines the uterus (the endometrium).

Another common cause of heavy menstrual bleeding is adenomyosis. Adenomyosis results with the endometrial glands that line the uterus grow into the uterine muscle (the myometrium). Little lakes of blood form in the uterine wall when this happens that do not drain during menstruation. The uterus enlarges and becomes spongy and engorged with blood over time disrupting normal uterine contraction patterns.

Both of these conditions are associated with excess estrogen and too little progesterone. Often, the heavy menstrual bleeding is controlled with the application of USP progesterone cream. (Click here for more information on Preserve Progesterone Cream.)

Now, heavy menstrual bleeding may mean different degrees to different women. What is considered in the real of normal is heavier bleeding on the first or second days of the menstrual period which then slows down a bit. Heavy menstrual bleeding begins to be classified when it prevents one from leaving the house or keeps one from following a normal schedule for more than two days a month; when you routinely soak through a couple of tampons and a pad all in place at the same time and then soak through your clothes; or, if you’ve been diagnosed with iron deficiency anemia. If these conditions apply, action needs to be taken.

The most conservative course of treatment for heavy menstrual bleeding is, of course, the application of progesterone cream. However, along with using progesterone cream, a physical and Pap test are called for to rule out any more serious conditions.

To use a nonprescription USP progesterone cream like Preserve to decrease heavy menstrual bleeding, rub ¼ to ½ tsp on the soft areas of your skin (like the skin on the insides of your arms) two times a day starting two to three weeks before your period begins. Stop when your period begins, then start again one to two weeks later. You should see results after about three months.

For some women, that amount of progesterone isn’t enough to balance their own estrogen, so ½ to 1 tsp of progesterone is called for. For some women who do not respond to the increased dosage within three months, a prescription progesterone like Prometrium may be an option to discuss with your doctor.

If heavy menstrual bleeding continues, harsher treatment methods may be needed. These treatments that we consider the nuclear option and treatments of last resort include:

• Synthetic progesterone.
• Birth control pills.
• D&C.
• A surgical procedure called endometrial ablation.
• Finally, hysterectomy.
   

September Menopause Recipe: Quick, Easy and Delicious Oriental Pasta.

September Bath and Body Recipe: Natural Deodorant Cream.

September Exercise Tip: Ease into Menopause with Exercise.
 

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