Perimenopause interventions for frequent cycles--input please

[cintinative]

So I am on my fifth cycle since Sept 18th, lately about every two weeks. It's not fun.  Generally not super heavy so I am not worried about anemia.

My gyn says my options are:

1. do nothing. Could get worse (e.g. bleeding constantly for four weeks solid), or could go months without a cycle.

2. birth control (Not a real option because I have breakthrough bleeding all month on the pill)

3. Mirena IUD. Will help the bleeding but not the UTI sensation and night sweats.

4. Oral progesterone

5. Endometrial ablation (surgical)

6. Vivelle dot estradiol patch with micronized progesterone 

 

 

If you have been through this frequent bleeding issue, can you comment? 

Other pertinent info: I have PMDD and anxiety/depression treated with antidepressants. For this reason, I am scared based on stories I have heard about the progesterone. 

 

Thanks in advance!

[EKS]

I did nothing.  It eventually gave way to extreme irregularity and then finally to nothing.

[popmom]

19 minutes ago, EKS said:

I did nothing.  It eventually gave way to extreme irregularity and then finally to nothing.

Same. I just waited it out. It was a pain in the a**, but it was never heavy. It is very common. 

I'd consider the oral progesterone. No one ever offered that to me. 

If I had it to do over again, I ((might)) be open to seeing someone about HRT. I am still exploring that option even though I am post menopausal by several years. 

PS: enjoy the tea while you can! 😉

Edited November 17, 2023 by popmom

[Katy]

The least invasive option (and fastest to reverse) is a progesterone-only “mini pill.” Watch your moods for at least two months. There’s just as high a chance that it will fix PMDD as worsen depression. If it works well & causes minimal side effects after 3 or so months, you’ll know it’s okay to switch to an IUD. If you do have bad mood effects, they’ll return to normal in 3-5 days after stopping. 

FWIW, I’d switched to a different kind of pill a few weeks before my dad died. I was stuck in depression and when I stopped the pill it lifted in 3 days. But I do fine on the mini-pill. 

[BusyMom5]

I have been having AF issues as well- heavy, clotted bleeding.   I posted a few months ago asking for suggestions before my Gyn appt.  My first appt I just asked for information on my options.  BC was out due to blood pressure (tried it in March,  2 weeks n, 3 day headache, BP 180/117). Hormones may be needed at some point?  Ablation surgery or Mirena seemed to be my best options for controlling bleeding.  I got Mirena my next cycle (best to put it in right around AF).  First cycle I bled for 20 days- never heavy.  It's stopped now, and fingers crossed it doesn't do that again.  I read a lot of similar stories and the Dr office said this is normal.  I go back in a few months for a check and plan to ask more questions.

[City Mouse]

I just waited it out, or I’m waiting (been 77 days so far and hope I’m done). It was really bad for about two years. I keep supplies everywhere - in both cars, my purse, the bags I take to school, etc. 

[Shoeless]

Mine were becoming eratic, (heavy then light...every 4 weeks, then every 2.5 weeks, then back to 4...). I went on the pill, but if that isn't an option, I'd probably try the patch and see how that went. 

 

[ScoutTN]

Acupuncture can be very helpful.

Edited November 17, 2023 by ScoutTN

[cintinative]

1 minute ago, ScoutTN said:

Acupuncture can be very helpful.

I'm ignorant about this. Can you elaborate?  Does it reduce the number of cycles?

[ScoutTN]

29 minutes ago, cintinative said:

I'm ignorant about this. Can you elaborate?  Does it reduce the number of cycles?

Acupuncture is very good at regulating hormonal issues. The practice I use specializes in all things female - cycle issues, infertility, menopause etc. They also always treat for stress, which is helpful. It’s not a quick fix, but works gently. It is not painful! I always feel so relaxed after a session. I have appreciated being treated ad a whole person, not just one part or system that us working less than optimally. My practice also does not disregard Western medicine, but works alongside, doing things it cannot. 

Alas, acupuncture is rarely covered by insurance, except for pain relief. For me, it has been worth the cost. I would likely never have had children without acupuncture/Traditional Chinese Medicine.

[Momto6inIN]

Mine weren't frequent but were spectacularly heavy and I was anemic. They did an ultrasound and I had very thick endometrial lining and they suspected a polyp underneath. They did a D&C and then an ablation (they were right about the polyp and removed that too). Now they are less heavy but not gone. Frequency hasn't changed but flow has.

[kbutton]

13 hours ago, cintinative said:

stories I have heard about the progesterone. 

If it’s WTM stories only, I know my experience was with bioidentical progesterone from yams, and I think that was also the case for the other person who is vocal about the issue.

 

[cintinative]

24 minutes ago, kbutton said:

If it’s WTM stories only, I know my experience was with bioidentical progesterone from yams, and I think that was also the case for the other person who is vocal about the issue.

 

it is actually a person I know locally. She said it made her suicidal. That's just not worth the risk for me--I'd rather deal with twice monthly periods.

[kbutton]

2 minutes ago, cintinative said:

it is actually a person I know locally. She said it made her suicidal. That's just not worth the risk for me--I'd rather deal with twice monthly periods.

I don’t blame you!

I’m not sure why some of us are so sensitive to our own hormones, but it stinks!

[Grace Hopper]

I had flows so heavy I couldn’t leave the house, and had a uterine ablation. For five years I had a “normal” cycle, but many women stop flowing completely. 
 

About 5 years later the heavy flows returned. I had a D&C to stop a six week long bleeding episode, which failed to correct the heavy flow (at the time it did, but a month later it returned to very heavy periods every few weeks). I finally had an ovary sparing hysterectomy and felt like I got my life back! It wasn’t just the flow, I was also quite anemic. 

[Wheres Toto]

I had an ablation when I was at that point, although anemia was a real consideration for me.  

I didn't want to go on the mini-pill or get Mirena since I wanted non-hormonal options at that point.  I had been on the pill quite a bit for birth control, almost always had bleed through that would get worse the longer I was on it, plus it tended to give me headaches.  I didn't need birth control since my tubes were tied.

My ablation was about 5 years ago and I never had any issues from it.   I'm now further into menopause and was getting hot flashes and other symptoms, plus I have risk factors for heart disease so I just recently started HRT.   Estrogen patch and bio-identical progesterone.   The first month was rough with frequent cramping but once that settled down it's been great.  

Edited November 17, 2023 by Wheres Toto

[KSera]

@kbuttonis your inbox full?

[kbutton]

13 minutes ago, KSera said:

@kbuttonis your inbox full?

It might have hit capacity just today…let me see what I can do.

ETA: should be good now.

Edited November 17, 2023 by kbutton

[prairiewindmomma]

 I can't do anything hormonal for medical reasons, and went the Lysteda (clot breakdown inhibitor) route when I became anemic. I had about 9 months of cycles very close together and very, very, very heavy and then it began to ease. Now they are spaced far apart and 🤞I am close to being done.

Edited November 17, 2023 by prairiewindmomma

[SKL]

Since the flow is not super heavy, I would just wait it out and just always wear & bring protection just in case.  If you haven't already done so, consider investing in comfy cloth pads so there won't be irritation from wearing paper/plastic 100% of the time.

If your flow gets heavy, consider Naproxin (Aleve etc.), which reduces the amount of bleeding.

[stephanier.1765]

I went the Mirena route and couldn't have been happier with the results. Taking it out was unpleasant but, thankfully, by then my cycles were over. Yay!

[Ottakee]

2 hours ago, stephanier.1765 said:

I went the Mirena route and couldn't have been happier with the results. Taking it out was unpleasant but, thankfully, by then my cycles were over. Yay!

I had the same experience.  A bit of spotting for a few months and then nothing for the next 3 years….and then removal after blood tests showed I was through menopause.

[HSmomof2]

I’m in the frequent/long bleeding phase as well. Just went through biopsy, labs, and MRI to make sure it wasn’t something nefarious. For now, I’ve been using the minipill. I did have continuous spotting/bleeding for three months, a 10-day bleed in month 4, and nothing more than a couple days of spotting in months 5 and 6. No other side effects, and I had horrible mood side effects when I was younger on the pill and take meds for severe PMS anxiety, so was concerned. If anything, my mood has improved. As long as this keeps controlling the bleeding, I’ll continue it. I’m 51, so hoping to be in menopause in the next couple years. My MRI showed endometriosis and adenomysis, so the progestin should also help keep that under better control. If not, I will do a trial of Orilissa, and then possibly hysterectomy as a last option. 

Edited November 18, 2023 by HSmomof2

[Hilltopmom]

I did an ablation for super heavy periods right before covid lock downs and it was amazing. Just very light spotting for like 2 days a month until this summer when I starts having 3-4 days of heavier spotting that’s annoying but I can certainly live with.