Anemia & ablation. Other options?

[Ripley]

I've been treated for anemia and iron-deficiency for years. My anemia has worsened the past five years, since the birth of my youngest. It's guessed to be caused by heavy periods (two days of heavy can't-leave-the-bed-much-less-the-house, changing-overnight-pads-every-45-minutes flow).

 

I have no evidence of fibroids or cysts, and no pain during periods or intercourse. I currently see a hematologist for quarterly IVs of iron. I've been getting quarterly infusions for the past four years. Every infusion series brings me up or close to the minimums (10-12 hemoglobin and 10-15 ferritin), but those go down again by my next infusion. My typical numbers are 8-10 hemoglobin and 9-12 ferritin.

 

OB/GYN suggests an ablation. I don't like what I read about those. I'm a minimal invasion girl, in my 30s, and not necessarily done having kids. The rub is that I put off more kids while I got my iron and blood issues under control, so it's chicken/egg.

 

Next suggestion was BCP or IUD. I'm Catholic, and haven't used (or researched) either. I worry about hormones, and don't know if one method is "better" than the other - in terms of controlling flow, of short-term effects, of long-term complications, etc. What do I need to know and what might I expect from either option?

 

I did a search and read through several past threads on ablation. New info and any info on BCP and IUD use is very appreciated. Is there any other option I'm missing, to control heavy periods (and therefore, anemia and IDA)? I have appointments with my OB/GYN and PCP tomorrow to discuss, and I want to arrive with questions ready. I have the second infusion of my quarterly series on Friday, and my hematologist wants to know the game plan.

 

I'm very "as little intervention as possible" but am at the point where I need to consider all options. I've 80% ruled out the ablation due to my age, but it's not completely off the table. Help? Hugs? BTDT?

 

 

[Donna]

:grouphug: 

 

I am older than you and had an ablation a little over a month ago due to extremely heavy periods like you describe. I have fibroids and a cyst so slightly different case. I have had no problems with it but I would not go that option if I were younger and not finished having children. 

 

Hope you find a good option.

[trulycrabby]

I can really, really relate. I'm early 50's so the cause is different, but I have been going through something very similar the last few years. It's kind of a helpless feeling, isn't it, when you cannot stop the bleeding? My next visit is on Monday, and I have a sinking feeling the obgyn is going to say the H word. :(

 

I dont know how old you are, (don't need to know), but has your doctor ever put you on medroxyprogesterone for the bleeding? The BCP's usually add estrogen, which most women do not need, but progesterone is far superior, according to my OBGYN.

 

Have you ever tried taking ibuprofen three days before, then during your period? Ibuprofen can really help cut down the bleeding, and medroxyprogesterone pill plus ibuprofen has averted an er visit several times recently.

 

The people I know who have had ablation say good things about it, but most of the women I know who have had it are a bit older.

[Silverwood]

I do not know of any alternatives, but I can tell you about my experience. I had an ablation at 23 years of age (I am now 27). Same reason as you, anemia and heavy periods. Recovery was fine, resumed normal activity two days later. About 8 weeks later, started hemmorhaging and had to have emergency partial hysterectomy.

 

Deciding to have the ablation was difficult, since I was young and only had two children, and thought about having more. I had already tried several different birth controls, none really helped the actual flow, just reduced time from 3 weeks to about 10 days. So for myself, I felt like ablation was all that was left.

 

Now at 27, I do have hard days knowing I will not be able to have children (at least biologically, adoption is something we have discussed), but I do feel healthier overall, and have more energy now. I wish you the best of luck!!

[Loowit]

I have had trouble with heavy bleeding for years.  My doctor has put me on progesterone for the last two weeks of my cycle.  I also take a double dose of Ibuprofen at my doctor's advice starting a day or two before my period though having stopped bleeding for two days.  My problem is that I am very irregular and never really know when my period will actually show up.  This has helped quite a bit, although last month was really bad with bleeding and clots, but overall I have seen an improvement.  My doctor did suggest ablation might be an option, but it just isn't something I am comfortable with right now.

[Seasider]

Because I knew I was done with childbearing, I opted for the ablation. No amount of supplementation could get my anemia under control and I apparently have a lower than average capacity for iron binding (I forget what specific tests measures this).

 

Though my GYN had hoped my periods would completely cease, I do have a regular cycle. It is now like a normal event rather than an I-can't-leave-the-house-for-a-couple-a-days event. My iron levels have finally remained normal and I actually have to push myself to get my heart rate up when exercising.

 

I do not believe that ablations are as trouble-free as advertised, but I am not sorry I had one.

[hellen]

This is kind of out there but have you tried alfalfa capsules? A midwife recommended them to me for heavy postpartum bleeding. Something happenned because my blood loss was a fraction of what it had been in prior pregnancies. I don't know if it works for periods but it could be worth googling.

[Cera]

One of the requirements before being approved for an ablation is a permanent form of birth control (essure, tubal ligation) so it is definitely not a solution if you aren't 100% sure you are done having kids.  

 

I had one a year and a half ago to try to control anemia and have been very happy with the results.  I actually had a second one done 9 months after the first didn't reduce my periods as much as the doctor and I had hoped.  Following the second I now spot for maybe half a day each month.  The anemia is gone and I feel better than I have in years.  It isn't a perfect solution but it was absolutely worth it for me.

[Ripley]

Thank you all for your posts. It gave me some direction before I spoke to my doctors, and has encouraged me to really sit down and think about the size of family in relation to my every day health.  If I decide to shut down the fertility shop, I think I'll gamble on the ablation. I just need to get there mentally. My OB/GYN was familiar with the alfalfa suggestion and seemed surprised I mentioned it.  LOL

[Ripley]

I can really, really relate. I'm early 50's so the cause is different, but I have been going through something very similar the last few years. It's kind of a helpless feeling, isn't it, when you cannot stop the bleeding? My next visit is on Monday, and I have a sinking feeling the obgyn is going to say the H word. :(

 

I dont know how old you are, (don't need to know), but has your doctor ever put you on medroxyprogesterone for the bleeding? The BCP's usually add estrogen, which most women do not need, but progesterone is far superior, according to my OBGYN.

 

Have you ever tried taking ibuprofen three days before, then during your period? Ibuprofen can really help cut down the bleeding, and medroxyprogesterone pill plus ibuprofen has averted an er visit several times recently.

 

The people I know who have had ablation say good things about it, but most of the women I know who have had it are a bit older.

 

This was especially helpful, thank you TrulyCrabby!

 

I asked about this at my appointment, and I'm glad I did. I don't think it would have been her first course of action (BCPs were) so it gave us a better starting ground to addressing the issue.

 

I hate that you're in the same boat. I hope your Monday appointment goes better than planned :(

[Donna]

Thank you all for your posts. It gave me some direction before I spoke to my doctors, and has encouraged me to really sit down and think about the size of family in relation to my every day health.  If I decide to shut down the fertility shop, I think I'll gamble on the ablation. I just need to get there mentally. My OB/GYN was familiar with the alfalfa suggestion and seemed surprised I mentioned it.  LOL

:grouphug:  I know it must be a difficult decision for you. Wishing you the best possible outcome.

[Moxie]

One of the requirements before being approved for an ablation is a permanent form of birth control (essure, tubal ligation) so it is definitely not a solution if you aren't 100% sure you are done having kids.

 

I had one a year and a half ago to try to control anemia and have been very happy with the results. I actually had a second one done 9 months after the first didn't reduce my periods as much as the doctor and I had hoped. Following the second I now spot for maybe half a day each month. The anemia is gone and I feel better than I have in years. It isn't a perfect solution but it was absolutely worth it for me.

Really? My friend just had an ablation and she isn't sterilized or on birth control. I thought the ablation was permanent sterilization? Hmmm...

[FriedClams]

I think there are different levels of ablation. I was talking with 2 friends about getting the send-aunt-flo-packing one for me, and one of my friends mentions she'd had an ablation before having her 3 kids (all in their 20s now). I'd get as much info as you can before panicking or making a decision.

[texasmama]

If I was not done with childbearing, I would not have an ablation.  I had one almost two years ago, and it has been wonderful.  No periods at all.  No more anemia.  I was 45 at the time with four kids and a dh with a vasectomy, though, so I was the perfect candidate in all ways, including medically.

 

My 18 yo dd was put on prescription strength ibuprofen for heavy bleeding.  It does help if you have a regular cycle and can start before your period is due.

 

I am pretty low intervention, but the ablation was a great choice for me.

[trulycrabby]

This was especially helpful, thank you TrulyCrabby!

 

I asked about this at my appointment, and I'm glad I did. I don't think it would have been her first course of action (BCPs were) so it gave us a better starting ground to addressing the issue.

 

I hate that you're in the same boat. I hope your Monday appointment goes better than planned :(

I hope it helps! :)

 

I'm just a little nervous because I've never had an endometrial biopsy before and have heard they can be quite painful. I can get a tooth drilled with no novocaine, but the girl parts are a different story. :o

[TheBugs]

When I lived in the UK, I was prescribed tranexamic acid to control the bleeding and mefenamic acid for pain and it worked very well. When I asked the gynecologist here in the US for a prescription she said she didn't feel comfortable prescribing it to me, but I could certainly seek a different opinion. I think she didn't think enough time had passed to really know the safety of that regimen. I've also used prescription strength ibuprofen to help make the bleeding less. I am a little nervous about possible kidney damage from long term use, since I also have endometriosis which causes pain on other days during the cycle too.

 

For the last two years I have been taking a BCP called Generess FE. It has 24 active pills and 4 inactive pills that contain iron. It has stopped my periods aside from occasional light spotting. It has really helped me to rebuild my iron stores since I don't bleed monthly. But I think I am experiencing hormonal side effects such as weight gain. I also think it may be contributing to muscle cramps I have been experiencing. I just feel a bit off, I think about stopping the pill, but I don't want to go back to being anemic of course, and I don't want an IUD, ablation or hysterectomy.