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Women's Health

Anemic due to excessive menstrual periods?

12/04/2007

Question:

I AM CURRENTLY HAVING INJECTIONS OF IRON ONCE A WEEK TO BRING MY IRON UP TO WHERE IT`S SUPPOSED TO BE. IT IS SUPPOSE TO BE LIKE 35 BUT IT`S 17. IN THE MEAN TIME I HAVE BEEN TO THE GYN TO HAVE TESTS DONE. I HAVE HAD A SONOGRAM, A PAP SMEAR, ANOTHER TEST WHERE THEY TAKE A SAMPLE OF YOUR UTERUS (DON`T REMEMBER WHAT`S IT`S CALLED). ALL THE TESTS CAME BACK. NOTHING WAS FOUND TO BE WRONG. NO CANCER, TUMORS, ETC. THE ONLY THING THAT THE DOCTORS NOTICED WAS THAT MY UTERUS IS THE SIZE OF A WOMAN WHO IS 20-22 WEEKS PREGNANT. NOW, THE DOCTOR WANTS TO HAVE ME GO IN FOR ANOTHER SURGICAL PROCEDURE TO INSURE THAT THERE`S NOTHING THAT THEY MISSED AND HE WANTS TO TAKE ANOTHER SAMPLE FROM MY UTERUS AND POSSIBLY PUT IN AN IUD, WHICH I DO NOT WANT. I HAD ONE BACK IN 1980 AND HAD TO HAVE IT REMOVED. I HAD NOTHING BUT PROBLEMS WITH IT. I AM 48 YEARS OLD AND OVERWEIGHT. I HAVE DIABETES BUT NO OTHER HEALTH CONCERNS. IS THERE SOMETHING THAT YOU CAN RECOMMEND FOR ME TO TRY AND TALK TO HIM ABOUT TO HELP ME WITH MY PROBLEM WITH THE HEAVY PERIODS? HE SAYS HE DOESN`T FEEL COMFORTABLE WITH DOING A HYSTERECTOMY BECAUSE OF THE ENLARGED UTERUS, MY WEIGHT AND THE DIABETES. DO YOU HAVE ANYTHING THAT YOU CAN SUGGEST FOR ME TO TRY. MAYBE THERE`S SOMETHING THAT WE HAVEN`T THOUGHT OF YET. ANY HELP WOULD BE GREATLY APPRECIATED. THANKS!

Answer:

Excessive menstrual bleeding is a common cause of anemia (low blood count) in women.  It can be caused by an abnormal growth in the uterus, such as:

The only procedure guaranteed to stop menstrual bleeding is a hysterectomy, but there are many other ways to treat bleeding in women who cannot or do no want to have the uterus removed.

Sometimes the bleeding can be slowed down with the use of hormonal medication such as progestins, which can be administered as a pill or a shot.  There is also an intrauterine device that contains this hormone and applies it to the uterus where it is needed and does not have as many side effects

(Note: This is different from older IUDs available in the 1980's which did not have this hormone, and that were sometimes associated with more problems like infection).

Other more invasive options are endometrial ablation, in which the lining of the uterus is burnt or scalded to stop it from bleeding, or uterine artery embolization, in which a radiologist blocks the blood flow to the uterus through a catheter (thin tube) inserted in the groin.  These options avoid the side effects of hormones without all of the recovery issues of major surgery.

Please be aware that if your uterus is truly the size of a 20 week pregnancy, then not all of these treatments may be appropriate.  That would mean that there is definitely some tumor present.

For more information:

Go to the Women's Health health topic, where you can:

Response by:

The Ohio State University Jonathan A Schaffir, MD
Assistant Professor
Division of General Obstetrics and Gynecology
Department of Obstetrics and Gynecology
College of Medicine
The Ohio State University
Jonathan A Schaffir, MD