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Heavy bleeding with large clots for over a month. Started…

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Hello! Heavy bleeding with large...
Hello! Heavy bleeding with large clots for over a month. Started taking Progesterone to control bleeding for a couple weeks now, ab pain has been consistent since taking progesterone, however bleeding didn't stop, only reduced. Dr sent for ultrasound, showed uterine fibroid. Now started heavier bleeding with clots again and stronger ab pain. Is this normal?
Submitted: 1 year ago.Category: OB GYN
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Answered in 5 minutes by:
7/30/2017
OB GYN Doctor: Dr. Muneeb Ali, Doctor replied 1 year ago
Dr. Muneeb Ali
Category: OB GYN
Satisfied Customers: 10,327
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Hi,
Welcome to JA and thanks for this question. Im sorry to hear about your symptoms. Actually this is NOT normal especially if the bleeding is worsening over time and the abdominal pain as well. Usually the progesterone would work in controlling the bleeding however it wont reduce the size of the fibroids. if the progesterone fails in controlling the bleeding then you would need to be started on another medication to control the active bleed such as tranxenamic acid which can be helpful during the heavy days of bleeding. Another option is Gn-RH agonists (Lupron, Synarel, others) which treat fibroids by blocking the production of estrogen and progesterone, putting you into a temporary postmenopausal state. As a result, menstruation stops, fibroids shrink and anemia often improves.

But if all of these fail to control the bleeding then you may a surgical option to remove the fibroid and control the bleeding. This can involve several different methods depending on the size of the fibroid.

Uterine artery embolization. Small particles (embolic agents) are injected into the arteries supplying the uterus, cutting off blood flow to fibroids, causing them to shrink and die. This technique can be effective in shrinking fibroids and relieving the symptoms they cause.

Myolysis. In this laparoscopic procedure, radiofrequency energy, an electric current or laser destroys the fibroids and shrinks the blood vessels that feed them. A similar procedure called cryomyolysis freezes the fibroids.

Laparoscopic or robotic myomectomy. In a myomectomy, your surgeon removes the fibroids, leaving the uterus in place.

Endometrial ablation. This treatment, performed with a specialized instrument inserted into your uterus, uses heat, microwave energy, hot water or electric current to destroy the lining of your uterus, either ending menstruation or reducing your menstrual flow.

All of these procedures are minimally invasive meaning you dont have to undergo major surgery at all and can be very effective in controlling the bleeding. But to answer your question simply, NO this is not normal and needs to be re evaluated as your bleeding is worsening.

Do you have any more questions?

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OB GYN Doctor: Dr. Muneeb Ali, Doctor replied 1 year ago

Would you like to know anything else? Any clarifications or additional questions that you might have, i would be happy to answer them for you. If done for now, please remember to leave a positive rating as that is the only way we are compensated for our time spent helping you. You can continue to ask follow-up questions even after the rating.

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