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Tuesday, September 23, 2014
Primolut-N to Prepare for a Hysterectomy
Hi.. I am a 44 yr old female who is preparing for a Hysterectomy. Due to consistent heavy periods for most of my life I am severly anaemic. i have decided to have a hysterectomy. My Blood Count is presently 7.0. My doctor won`t operate until its at least 11. Since I do not want a blood transfusion, I have been placed on Primolut-N to stop my period thus increasing my blood count. I have however heard that primolut-N should be stopped 6 weeks prior to a surgery. Therefore, is it safe for me to be on this medication as I would be on it right up to my surgery?
A common reason to have a hysterectomy is heavy menstrual bleeding. This bleeding can be so heavy that a woman becomes severely anemic. However, being severely anemic can also lead to complications of surgery, which is why doctors may take one of several approaches to improve the anemia prior to surgery.
If surgery needs to be done emergently, a transfusion prior to or during surgery may be necessary. If more time is available, medication can be given so that the body increases its blood stores more quickly, for example with iron and erythropoietin (a hormone that boosts blood production).
Finally, the menstrual bleeding can be temporarily suppressed, either with a high dose progestin (like norethindrone, for which Primolut is a brand name) or a medication like leuprolide, which creates a temporary menopausal state.
Any of these approaches are appropriate, and the route chosen will depend on what is causing the heavy bleeding, the degree of anemia, and other factors in the patient's health history.
Jonathan A Schaffir, MD
Clnical Associate Professor of Obstetrics & Gynecology
College of Medicine
The Ohio State University