Heavy Bleeding Stopped After Taking Primolut. Ultrasound Showed Endometrial Hyperplasia. Should I Continue Primolut?
Thanks for writing to us. I am trying to solve your problem.
According to your ultrasound report (USG), you have diagnosed endometrial hyperplasia (19 mm) with association of endometriosis of ovary or PID. These are causing irregular spotting to heavy bleeding in concurrent cycle and may lead to dysfunctional uterine bleeding (DUB) in later stage.
Other associated factors for above condition are hormonal imbalance (common in perimenopausal age group), stress/ anxiety/ psychological factor, thyroid disturbance etc. Here, complete hormonal assay, blood sugar test & endometrial biopsy are advisable to rule out other pathology.
In this stage, medical treatment includes haemostatic agent combined with oral progesterone tab (like Primolut N) for 3-6 months duration to control bleeding and regularize cycle. It should be taken in this manner "3 weeks on-1 week off" for highest effectiveness. So, you can continue above said medication until you visit your gynecologist.
In case of failed medical therapy, uterine curettage (D & C) and endometrial ablation/ resection can be done to treat the same.
In extreme cases, total abdominal hysterectomy (removal of uterus, tube & cervix including ovaries) is the ideal choice & gold standard procedure in your age group to control bleeding & future complication completely.
After that, Hormone Replacement Therapy (HRT) can be given for few years to control menopausal symptoms (like hot flushes, vasomotor changes etc).
In addition, the following things should help:
1) Take healthy diet with iron supplements.
2) Drink more water/ juice and eat more vegetables/ fruits.
3) Try to avoid heavy work or strain full activity. Keep bowel habit regular
4) Avoid stress/anxiety by XXXXXXX breathing & maintain personal hygiene properly.
Hope I have answered your query. If you have any further questions, I will be happy to help.
Wish your good health & take care yourself.
Regards,
Dr Soumen
Thanks very much
Thanks for follow up query. I am happy to help you.
There are two types of medical treatment (hormonal) modalities in cyclic therapy to treat above said condition. These are as follows:
1) In case of ovular cycle with heavy bleeding, it is given from day 16th to day 25 to arrest bleeding and regularize cycle.
2) In case of anovular cycle with irregular bleeding, it is given from day 5th to day 25th of cycle or continuous 3 weeks from any starting day with 1 week off (in this time you will get withdrawal bleeding, similar to period) for at least 3 consecutive cycles.
In my thought, 2nd option is appropriate for your case. It has dual benefit in controlling bleeding & regularization of cycle along with suppression of endometrium (as you are suffering from endometrial hyperplasia) with high effectiveness. Usually duration of the course is 3-6 months with same dose as before.
Hope, I am able to understand you all of my points with more clarification.
Be well & stay healthy.
Regards,
Dr Soumen
You are most welcome in our XXXXXXX platform.
You can directly consult with me in future by visiting my profile on WWW.WWWW.WW
Take care yourself.
Regards,
Dr Soumen