My wife is having heavy menstrual bleeding for 13 days. Please suggest treatment.

Question

Hi doctor,

My wife is 46 years old. She is having heavy bleeding during menstruation. She did not have her periods for eight months. Now, she started to have periods before 13 days and it is continuing to date. She uses five to six sanitary pads a day. Also, she has abdominal pain and constipation for the past three days. She is taking Trenaxa thrice a day, Spasmodart for abdominal pain, and Shelcal once a day. From yesterday, she is taking an injection of Aquaviron 25 mg. She also has weakness in her body. I need a second opinion and please suggest some treatment options.

Answer 1

Hi,

Welcome to icliniq.com.

From the history, it is clear that she is in her peri-menopausal stage and so she is experiencing menorrhagia or excessive bleeding for 13 days. It is commonly seen in peri-menopausal women. She has been given antifibrinolytics in the form of Trenaxa (Tranexamic acid) and it is fine. If the bleeding is uncontrollable, then she needs to do an ultrasound pelvis to check her present endometrial thickness. If the endometrial thickness is above 9 mm, then she can start taking Progesterone pills for ten days to control the bleeding along with Diosmin and antifibrinolytics. If she has dizziness and weakness, then she may require hospitalization for having intravenous support.

Answer 2

Hi,

Welcome back to icliniq.com.

As her endometrial thickness was 24 mm on her previous scan, then she needs to do an ultrasound pelvis immediately and if there is a need, she needs to do a D&C (dilation and curettage) procedure to take the endometrium out. It has to be sent for histopathology to rule out endometrial hyperplasia with or without atypia or endometrial cancer. Curettage will help to stop the bleeding. In the meantime, she can continue taking Trenaxa.

Answer 3

Hi,

Welcome back to icliniq.com.

You are welcome.