Ask a doctor on the topic of Gynecology

Menopause - Bleeding doesn't stop

January 5, 2017 | 25,00 EUR | answered by Dr. med. Ive Dr. Schaaf

Menopause.

Good day.
I am 50 years old and have been experiencing various menopausal symptoms for about 2 years (including night sweats, sleep disturbances, heart palpitations, joint pain). My period was very regular and consistent until August 2016. Since September 2016, my period has become irregular, sometimes after 6 weeks, 3 weeks, or 8 weeks. I had my last period on December 14, 2016, which was heavier than usual. The bleeding lasted until December 21, 2016. Already on December 24, 2016, I started experiencing light bleeding again, which has not stopped since. I also have lower abdominal pain (pulling in the lower abdomen on the right and left). On January 4, 2017, I visited my gynecologist. She could not detect any cysts, polyps, or fibroids on ultrasound. The uterine lining was not very thick, almost normal. She mentioned that my hormones are completely out of balance and I may need to consider a dilation and curettage. But first, she prescribed me the hormone medication Climen for one month. This should stop the bleeding after a few days, and at the end of the treatment, a period should come. I googled the medication at home and read that it can cause side effects such as thrombosis, stroke, heart attack, etc. Since there have been several strokes in my family, I am extremely afraid and do not want to take the medication. I also do not want a dilation and curettage, as many women report that it did not help. My questions:

1. Will taking this medication for only one month have any effect? Will hormone levels be permanently normalized with one-time use?

2. Can the mentioned side effects occur with a one-time monthly dose of the medication, or do they refer to long-term use?

3. What alternatives are there besides hormone medication and dilation and curettage? Homeopathic remedies to stop bleeding?

4. What happens if I do nothing, wait and see, but continue to have bleeding? Is it dangerous? How long can one tolerate light bleeding without concern?

Thank you for your effort!

Dr. med. Ive Dr. Schaaf

Good day,

Regarding your questions:
1. The hormones are not permanently regulated by Climen. Climen is an estrogen preparation that initially stops bleeding and causes withdrawal bleeding at the end of the pack.
2. Yes, all the mentioned side effects can occur even with just 4 weeks of intake, as with any other estrogen-containing pill such as a birth control pill.
3. There is the option to supplement hormones with herbal remedies, but first we would need to know which hormones you are lacking. If it is estrogen, you can try Remifemin (black cohosh extract), if it is progesterone (which is likely the case), you can supplement progesterone as a cream through the skin (prescription from the pharmacy). DHEA is also available as a plant extract from yam root, for example as Women Cream, which could be suitable in your case, see http://www.vital-life.de or through the pharmacy.
Your gynecologist should advise you on this. However, it always comes down to trial and error, as every woman reacts differently and effects are only expected after about 4 weeks.

4. Nothing will happen as long as you have a healthy starting point with good Hb (hemoglobin). Only in the case of pre-existing iron deficiency could anemia occur. If you had a normal complete blood count not too long ago (from your general practitioner or gynecologist), you are probably safe.

By the way, what you are experiencing is not uncommon. Continuous spotting for several months (usually two or three) often occurs during this transitional phase. And the experiences of your acquaintances also correspond to life experience.

My specific suggestion: Talk to your gynecologist again and tell him that you would like an alternative on a herbal basis (especially for your other symptoms). Have him comment on the suggestions mentioned and take it slowly.

Get well soon.

Dr. Schaaf

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