Q & A: Heavy Bleeding (Menorraghia)
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Heavy Bleeding (Menorraghia)

Q:

After my second child and my tubal ligation at 31yrs, I was put on Provera. It seemed to make my PMS worse, and my periods got more and more irregular. I would bleed heavily for two days, then it would taper off and I’d spot for about a week. During that week I felt really bad! The worst was the fogginess and dizziness in my head—like a film over my eyes. I also experienced anxiety, fatigue, dry and brittle hair, and increased hair loss, dry skin, mood swings, depression and headaches. So I stopped the Provera.

I went to every doc, had every test done, and they said I was fine. Finally my endrocrinologist put me back on Provera, and lo and behold, I got better, but I still suffered from the bad PMS. I felt this drug was no good for me. So I stopped it again, and started natural micronized progesterone capsules. What do you think?

   
A:

I am not surprised by your story. Unfortunately, I have seen dozens of women patients who have been put through the same hell as you.

When doctors say you are fine, they mean that the labs can't find anything. That is because doctors, in general, don't know the difference between average (normal) and healthy (right for you). To say that you are fine because your labs fit you into a range that covers 95% of the population is as ignorant as if your doctor said you were healthy because your weight was between 75 and 260 pounds. Those are "normal" weights, but may not be healthy for you.

Find a doc who knows thyroid and hormones. You really sound like you are having problems with both.

I suggest you get a copy of Dr. Elizabeth Vliet's "Screaming to Be Heard: Hormonal Connections Women Suspect...And Doctors Ignore." She discusses the thyroid and the bad menses, and she talks about why most women have problems after a tubal ligation: it decreases blood flow to the ovaries, and the estrogen levels drop prematurely. This makes bad PMS worse.

You have described the classic symptoms of hypothyroidism: irregular periods, brain fog, dizziness, anxiety, fatigue, dry brittle hair, increased hair loss, dry skin, mood swings, depression and headaches. In his book, "Solved: the Riddle of Illness", Stephen Langer, MD tells how you can check your own thyroid for free with just a basal temperature.

In 1888 the first paper was written on the link between PFH (Periods from Hell, as one of my patients called the ones that are crampy, clotty, irregular, with bleeding for more than 10 ten days a month). Unfortunately, docs today don't seem to recognize this because the labs miss most of the common causes of thyroid trouble in women. This includes Autoimmune Thyroiditis which some say is 25 times more common in women than in men. The most common story is that things got especially bad following the second pregnancy. Gaining weight, feeling sluggish, tired, depressed, and cold. Some women go through a time of overactive thyroid initially while the gland breaks down and leaks hormones.

The slightest thyroid imbalance can really wreak havoc with periods, pregnancy, and fertility. All that most docs look at is the TSH (thyroid stimulating hormone) which doesn't detect the real problem. Provera can sometimes help, but the real cause is usually in the metabolism, not the lining of your uterus. For those who might choose Provera over progesterone, it is important to remember that our bodies were designed to operate with natural hormones produced by the body. For those who might choose Provera over progesterone, it is important to remember that the natural hormones are "bio-identical," the ones that are naturally in people and with which their bodies were designed to operate.

When doctors says you are fine, they mean that the labs can't find anything. That is because doctors, in general, don't know the difference between average (normal) and healthy (right for you). To say that you are fine because your labs fit you into a range that covers 95% of the population is as as if your doctor said you were healthy because your weight was between 75 and 260 pounds. Those are "normal" weights, but may not be healthy for you.

Check out a few thyroid support groups, where you will hear your story repeated countless times. The minor variation is that instead of getting thyroid help, most women get a hysterectomy done for the heavy periods. I have taken care of many women with exactly the same experiences. You have my prayers that you get what you need to get well.

Don Michael, MD

 

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  Disclaimer: Opinions expressed here are for informational purposes only and do not constitute a physician-patient relationship. The information should not be considered as medical advice or as a substitute for a visit to your healthcare provider. You are strongly encouraged to seek the advice and supervision of a physician or other certified practitioner regarding any medical issue.

 

 

 

 

 

 

 

 

 

 

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Updated 09/29/2010