What causes menstrual flow with late scondary endometrium?

Question

Hi doctor,

I am 40 years old. I have been suffering from heavy menstrual flow for the past 11 to 12 months. I had a heavy flow with clots for the last two months. Now, I have been menstruating for the past 10 days with heavy flow and clots. It started exactly at the cycle period date and continued for five days and again on the seventh day, it started again with heavy flow. I have had a cyst, high levels of prolactin which have been treated during this period. Last month my doctor recommended the endometrium biopsy but the report was normal and the diagnosis was late secretary endometrium. My current medications include Ovuloc, Femilon, Meprate 10 mg two times a day, Iron tablet, and pause MF (on SOS basis). Can you please advice?

Answer 1

Hi,

Welcome to icliniq.com.

Your biopsy report is good. The medicines you are taking are also good. But instead of taking hormones daily, I recommend that you put in a hormone-releasing intrauterine device called Mirena. That remains in your uterus without a problem.

Delivers the hormones where they are actually needed, cutting down the side effects of excessive hormone intake, plus you get rid of the daily responsibility of taking your pills. However, as per the ultrasound finding of a bulky uterus, you may have adenomyosis, which is causing this abnormal uterine bleeding.

Adenomyosis is a condition that affects the wall of your uterus. Unfortunately, it does not respond well to hormonal treatment. Please get an MRI of the pelvis done. If that shows adenomyosis, you may still try Mirena, but if that is ineffective, you may even need surgery.

I hope this helps.

Thank you.