How can I manage my bleeding after 4 years of menopause?

Question

Hello doctor,

I have been experiencing post-menopausal bleeding that started four years after menopause. After thorough testing and investigation, a non-cancerous polyp was detected in my uterus, which was subsequently removed. Due to my existing conditions of diabetes and hypertension, rather than opting for a hysterectomy, hormonal treatment was recommended.

I have been adhering to a prescribed regimen of Primolute N for the past five months, following the instructions diligently. Typically, during my menstrual periods, I experience extremely heavy flow accompanied by large blood clots, necessitating the use of at least four sanitary pads and an adult diaper. However, this time, the bleeding was lighter during the initial three days before returning to its usual heaviness.

Upon the advice of my doctors, I commenced the Primolute N dosage on the ninth day, taking two tablets thrice a day, alongside Tranexamic acid 500 mg thrice daily. Despite following this regimen, as of the twelfth day, there has been no relief or reduction in bleeding.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

The optimal approach for addressing post-menopausal bleeding caused by the presence of a polyp is through hysterectomy, involving the removal of the uterus. It is important to conduct an endometrial biopsy to rule out any potential endometrial carcinoma.

Hormonal treatment:

Medical treatments such as Primolut (Norethisterone).
Other similar options are unlikely to provide a cure in such cases.
Surgery remains the definitive solution for this condition.

Surgery:

Before undergoing surgery, it is imperative to ensure that diabetes and hypertension are adequately controlled.
Surgery should be considered the primary recourse for managing this pathology.
Failure to address this condition promptly may result in complications such as anemia, accompanied by lethargy and weakness.

Thus, timely treatment is essential to prevent further health issues. I hope this information will help you. Please feel free to ask if you need further guidelines.

Thank you.