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Lisa, MSN, FNP-BC, CCRN, Nurse Practitioner
Category: Health
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Experience:  Board Certified Family Nurse Practitioner
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I am 57 and still having heavy periods. I stopped for 5

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I am 57 and still having heavy periods. I stopped for 5 months and had a few hot flushes but started again as bad as ever. I have fibroids and I am overweight. My gynaecologist has offered me a hysterectomy. I am currently using Norethisterone after trying Cerazette. I am not a suitable cadidate for a Mirena coil. I am concerned about incontinence in later life if I go ahead. Surely I must be nearing the upper limit for the menopause - should I just wait?
lt;p>Hello;</p><p> </p><p>Thank you for writing in today.   </p><p> </p><p>I understand why women do not want to have a hysterectomy. This is not only a physical issue but psychological too. </p><p> </p><p>Since you have a history of dysfunctional bleeding and fibroids, your bleeding could continue for a very long time, even as you adjust to the hormone changes of menopause. In addition, your bleeding does not seem to respond well to the combination (estrogen and progesterone) pill. This indicates that your bleeding may be a bit more difficult to treat. </p><p> </p><p>When making this decision, I would encourage you to weigh the pros and cons. As for cons, you should consider the possibility of anemia from blood loss and the inconvenience of dysfunctional bleeding.</p><p> </p><p>Although heavy and irregular bleeding can be associated with perimenopause, there are other possible causes to consider, particularly endometrial cancer. In your particular case, if you have not had an endometrial biopsy, ultrasound, and recent Pap smear, you may want to discuss this with your provider.</p><p> </p><p>I hope this helps. If you have any additional questions or concerns, please let me know.</p><p> </p><p>Ms. Lisa</p>
Customer: replied 8 years ago.
What about later problems associated with hysterectomy, such as poor bladder function? I have had smear, biopsy and ultrasound. Are there any other treatments I could try? What about HRT? Would losing weight help? What is the oldest age record for having periods?
lt;p>Hello;</p><p> </p><p>Thank you for writing in today. </p><p> </p><p>There are cons to the hysterectomy, including bladder prolapse problems. It's also very important to consider these as well.   You may try starting a pro and cons list. It's a decision you'll have to make, based on what is most important for you and what you believe to contribute to your quality of life.</p><p> </p><p>I am glad to hear that you have had the additional evaluations. They are very important. </p><p> </p><p>As for other treatments, hormones and hysterectomy are the most common. Sometimes ablation is used, but in your case this is less likely.</p><p> </p><p>As for HRT, you are already taking some hormone with your pill. However, you could talk to your provider about possibly adjusting your hormones. You may have some alternative available to help with your bleeding. This could include adding some hormones or changing your current pills.   This is definitely worth discussing with your GYN provider. </p><p> </p><p>As for the oldest age record for menstruation, I do not have this information specifically; however, the oldest person I've ever work with was 60.</p><p> </p><p>Ms. Lisa</p>
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