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Do Blood Thinners Cause Vaginal Bleeding In An Elderly Person?
Question: My mother is 57 years old.
History - Angioplasty 2 years ago with two stents.
She is on blood thinners are the regular medication for her heart condition.
Ever since she started aspirin ( thinners) she has observer vaginal bleeding.
We got her operated at Jaslok hospital in XXXXXXX They did a D & C since according to the doctor the uterus is too delicate to remove.
After the D &C the doctors said that there was a Polyp which was removed. The Polyp was sent for biopsy and it did not show up anything to be worried about.
The uterus lining was now 11 mm and we showed it to the doctors in Nasik.
They say that Obesity and Blood thinners are causing the vaginal bleeding.
We are worried since my mother had her menopause approximately 12 years ago.
Questions:
1. Do blood thinners and Obesity cause this problem ?
2. We have shown her to multiple doctors and all of them say that there is nothing to worry.
3. She has been bleeding for 4th day today and the flow is like menstruation with clots.
4. What should we now do?
History - Angioplasty 2 years ago with two stents.
She is on blood thinners are the regular medication for her heart condition.
Ever since she started aspirin ( thinners) she has observer vaginal bleeding.
We got her operated at Jaslok hospital in XXXXXXX They did a D & C since according to the doctor the uterus is too delicate to remove.
After the D &C the doctors said that there was a Polyp which was removed. The Polyp was sent for biopsy and it did not show up anything to be worried about.
The uterus lining was now 11 mm and we showed it to the doctors in Nasik.
They say that Obesity and Blood thinners are causing the vaginal bleeding.
We are worried since my mother had her menopause approximately 12 years ago.
Questions:
1. Do blood thinners and Obesity cause this problem ?
2. We have shown her to multiple doctors and all of them say that there is nothing to worry.
3. She has been bleeding for 4th day today and the flow is like menstruation with clots.
4. What should we now do?
Brief Answer:
Obesity and aspirin cannot be direct causes, maybe contributory.
Detailed Answer:
Hello dear.
I am Dr. Aarti, OB - GYN from XXXXXXX and I would be glad to assist you with your concerns regarding your mother.
Aspirin may lead to increased menstrual bleeding, but in your mother's case, the endometrial lining is quite thick, aspirin should not cause that at all.
Anyway, she is taking low dose aspirin ( ecosprin ) and at that dose, it is not likely that all these bleeding issues are being caused by the aspirin.
I have gone through the histopathology ( biopsy ) report of the polyp, and it is quite normal.
You mentioned the endometrial thickness to be 11 mm.
When was this scan done ?
Is it possible for you to upload that report ?
In my opinion, it is not aspirin that is causing these issues.
Regarding obesity, what is her height and weight ?
Obesity can contribute to hormonal imbalance leading to heavy bleeding, but it is not a direct cause again.
I am very sure she is having some form of hormonal imbalance leading to all these troubles.
I would suggest an endometrial biopsy ( simple 5 minute OPD procedure, not a major surgery ).
If it is normal, she can be put on medications to control the bleeding ( tranexamic acid.
SHe can be given progesterone supplements to control bleeding until menopause sets in.
I have a few pointers here -
Please go for an endometrial biopsy.
Please upload the scan report.
Get her thyroid ( TSH ) levels checked.
Start with exercises and diet to help her remain fit and lose weight.
Can you elaborate on why the doctors said that the uterus is too delicate to be removed ?
That does not make sense.
If bleeding is not controlled with medications, then that surgical option should be considered, although not right now.
I hope my inputs help you.
Please feel free to discuss further.
Obesity and aspirin cannot be direct causes, maybe contributory.
Detailed Answer:
Hello dear.
I am Dr. Aarti, OB - GYN from XXXXXXX and I would be glad to assist you with your concerns regarding your mother.
Aspirin may lead to increased menstrual bleeding, but in your mother's case, the endometrial lining is quite thick, aspirin should not cause that at all.
Anyway, she is taking low dose aspirin ( ecosprin ) and at that dose, it is not likely that all these bleeding issues are being caused by the aspirin.
I have gone through the histopathology ( biopsy ) report of the polyp, and it is quite normal.
You mentioned the endometrial thickness to be 11 mm.
When was this scan done ?
Is it possible for you to upload that report ?
In my opinion, it is not aspirin that is causing these issues.
Regarding obesity, what is her height and weight ?
Obesity can contribute to hormonal imbalance leading to heavy bleeding, but it is not a direct cause again.
I am very sure she is having some form of hormonal imbalance leading to all these troubles.
I would suggest an endometrial biopsy ( simple 5 minute OPD procedure, not a major surgery ).
If it is normal, she can be put on medications to control the bleeding ( tranexamic acid.
SHe can be given progesterone supplements to control bleeding until menopause sets in.
I have a few pointers here -
Please go for an endometrial biopsy.
Please upload the scan report.
Get her thyroid ( TSH ) levels checked.
Start with exercises and diet to help her remain fit and lose weight.
Can you elaborate on why the doctors said that the uterus is too delicate to be removed ?
That does not make sense.
If bleeding is not controlled with medications, then that surgical option should be considered, although not right now.
I hope my inputs help you.
Please feel free to discuss further.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hi Doctor,
Endometrial biospy was also done along with the polyp specimen report and that has that the same results.
11 mm scan is from last month.
I will check with her for the Thyroid levels. If not we will get it done.
My mom had me and my brother via a Caesarian operation. After my younger brother's birth the doctor stitched the uterus to the body and doctor Hinduja mentioned that it was not possible to do a surgery because of the condition.
I will send the hormonal reports to you by evening.
We had got the reports done three weeks ago.
My mom had a periods at the age of 9.
She then had her menopause when she was 47 \ 48.
For the last two years she has had spotting and we have gone through various rounds of doctors in Nasik and XXXXXXX
She then had the polypectomy and D &C.
I will send the reports to you once they are available.
Thank you for your help!
Regards,
XXXXXXX
Endometrial biospy was also done along with the polyp specimen report and that has that the same results.
11 mm scan is from last month.
I will check with her for the Thyroid levels. If not we will get it done.
My mom had me and my brother via a Caesarian operation. After my younger brother's birth the doctor stitched the uterus to the body and doctor Hinduja mentioned that it was not possible to do a surgery because of the condition.
I will send the hormonal reports to you by evening.
We had got the reports done three weeks ago.
My mom had a periods at the age of 9.
She then had her menopause when she was 47 \ 48.
For the last two years she has had spotting and we have gone through various rounds of doctors in Nasik and XXXXXXX
She then had the polypectomy and D &C.
I will send the reports to you once they are available.
Thank you for your help!
Regards,
XXXXXXX
Height is 5 Feet.
Weight 80
Weight 80
Brief Answer:
As below
Detailed Answer:
Hello again.
Thank you so much for the updates.
I have one more confusion here.
The 11 mm lining scan - was it done before or after the polypectomy plus D and C ?
What other hormone reports have been done ?
And can you please scan or send Dr. Hinduja's findings - did she mention on paper regarding the condition of inoperability ?
I understand that there were some post surgical complications after C section making repeat surgery difficult.
So basically she needs to be managed medically.
There are two options now - either take Tranexamic acid and Progesterone tablets monthly to control bleeding.
Or else go for insertion of Mirena ( intra uterine progesterone containing device ) which will help to control bleeding.
Is she diabetic ?
As below
Detailed Answer:
Hello again.
Thank you so much for the updates.
I have one more confusion here.
The 11 mm lining scan - was it done before or after the polypectomy plus D and C ?
What other hormone reports have been done ?
And can you please scan or send Dr. Hinduja's findings - did she mention on paper regarding the condition of inoperability ?
I understand that there were some post surgical complications after C section making repeat surgery difficult.
So basically she needs to be managed medically.
There are two options now - either take Tranexamic acid and Progesterone tablets monthly to control bleeding.
Or else go for insertion of Mirena ( intra uterine progesterone containing device ) which will help to control bleeding.
Is she diabetic ?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
When we did the D & C last year it was 8 mm.
11 mm is just last month.
Dr Hinduja did not mention on paper however she explained to us that it was not a feasible option.
The last doctor we consulted was Dr Pawar in Nasik.
He had prescribed Deviry and Hemocyl which my mother did NOT take since she was travelling and was worried that the blood flow would be uncontrollable.
For the last four days she has been having bleeding. There were blood clots for the first three days.
Today she is observing blood flow which is slimy in texture.
She is not diabetic.
Tranexamic acid and Progesterone tablets would be needed every month ?
Can you please explain how Mirena works and would that be feasible for her?
Also would these medicines affect cause problems with her heart medicines.
The report shows that her Testosterone levels are on the higher side.
Thank you for your time. Really appreciate it.
When we did the D & C last year it was 8 mm.
11 mm is just last month.
Dr Hinduja did not mention on paper however she explained to us that it was not a feasible option.
The last doctor we consulted was Dr Pawar in Nasik.
He had prescribed Deviry and Hemocyl which my mother did NOT take since she was travelling and was worried that the blood flow would be uncontrollable.
For the last four days she has been having bleeding. There were blood clots for the first three days.
Today she is observing blood flow which is slimy in texture.
She is not diabetic.
Tranexamic acid and Progesterone tablets would be needed every month ?
Can you please explain how Mirena works and would that be feasible for her?
Also would these medicines affect cause problems with her heart medicines.
The report shows that her Testosterone levels are on the higher side.
Thank you for your time. Really appreciate it.
Brief Answer:
As below
Detailed Answer:
Thank you for the appreciation my dear.
Deviry is progesterone and Hemocyl is tranexamic acid.
This is the same combination that I suggested.
Please ask her to take it, if the bleeding troubles her.
As such, she will reach menopause in some time.
If the bleeding is okay with her, if the investigations such as Pap smear, endometrial biopsy and ultrasound are normal, it is fine not to take any medications.
If the bleeding is very heavy or intolerable, then Tranexamic acid will be needed during the flow and Progesterone taken cyclically each month will avoid unpredictable, irregular and heavy bleeding.
So yes, it is to be taken every month for a few days, for 3 - 6 months, by which time we hope that she will transit into menopause.
Mirena is more hassle free, it contains progesterone and instead of taking the tablets each month, it delivers a steady stable supply of the hormone daily to the body, acting in the same way as progesterone tablets.
Both oral tablets ( tranexamic acid and progesterone tablets ) plus Mirena - they are safe for use in your mother, considering all the risk factors that she has.
Do not worry about the hormone levels, at her age, there are bound to be fluctuations and changes.
Eventually when menopause sets in , these issues should be fine.
If it has been more than a year since the D and C, a repeat endometrial biopsy and Pap smear is a must.
That is for surveillance.
Meanwhile, please encourage her to participate in daily exercise , yoga , meditation etc and a sensible diet plan to help her lose weight and gain fitness.
So basically outlining the plan -
1. Get a repeat Pap and endometrial biopsy if it has been more than a year.
2. Consider oral medication or Mirena as per her choice.
3. Plan to lose weight gradually.
You can contact me directly anytime by clicking on the following link -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.
As below
Detailed Answer:
Thank you for the appreciation my dear.
Deviry is progesterone and Hemocyl is tranexamic acid.
This is the same combination that I suggested.
Please ask her to take it, if the bleeding troubles her.
As such, she will reach menopause in some time.
If the bleeding is okay with her, if the investigations such as Pap smear, endometrial biopsy and ultrasound are normal, it is fine not to take any medications.
If the bleeding is very heavy or intolerable, then Tranexamic acid will be needed during the flow and Progesterone taken cyclically each month will avoid unpredictable, irregular and heavy bleeding.
So yes, it is to be taken every month for a few days, for 3 - 6 months, by which time we hope that she will transit into menopause.
Mirena is more hassle free, it contains progesterone and instead of taking the tablets each month, it delivers a steady stable supply of the hormone daily to the body, acting in the same way as progesterone tablets.
Both oral tablets ( tranexamic acid and progesterone tablets ) plus Mirena - they are safe for use in your mother, considering all the risk factors that she has.
Do not worry about the hormone levels, at her age, there are bound to be fluctuations and changes.
Eventually when menopause sets in , these issues should be fine.
If it has been more than a year since the D and C, a repeat endometrial biopsy and Pap smear is a must.
That is for surveillance.
Meanwhile, please encourage her to participate in daily exercise , yoga , meditation etc and a sensible diet plan to help her lose weight and gain fitness.
So basically outlining the plan -
1. Get a repeat Pap and endometrial biopsy if it has been more than a year.
2. Consider oral medication or Mirena as per her choice.
3. Plan to lose weight gradually.
You can contact me directly anytime by clicking on the following link -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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