Curing the World One Patient at a Time
TOLL FREE: 855.251.9116

Dx Heavy Menstrual Bleeding Treatment: Read more...


$
Observation:
Heavy Menstrual Bleeding

The Merck Manual Home Edition states:
"During the reproductive years, vaginal bleeding may be abnormal when menstrual periods are too heavy or too light, last too long, occur too often, or are irregular. Any vaginal bleeding that occurs before puberty or after menopause is considered abnormal until proven otherwise. Most causes of abnormal vaginal bleeding are not serious. Menstrual disorders include premenstrual syndrome (PMS), menstrual cramps (dysmenorrhea), dysfunctional uterine bleeding, absence of menstrual periods (amenorrhea), and premature menopause. Some disorders that are related to the reproductive organs but not specifically to the menstrual cycle, such as pelvic congestion syndrome and polycystic ovary syndrome, cause some of the same symptoms as menstrual disorders."

[Editor] There can be abnormal bleeding also with pregnancy and with an ectopic (pregnancy in the tube). The key words are for either "pain" and/or "heavy" -- seek medical attention.

Medications Used in Treatment:
1. Progestins
2. Oral Contraceptives
3. Danazol
4. Androgens
6. Estrogen Antagonists
7. Aromatase Inhibitors
8. Surgical Aspiration


Suggested Links:
*N.H.S. United Kingdom
*Medscape
**Stopping the bleeding and pain in Endometriosis

*[Editor] In our experience, and those of others, the use of low dose danazol controls, for many women, non-emergency bleeding. As a gynecologist, an office D&C (dilatation and curettage) can be performed to stop the bleeding and rule out malignancy. The pelvic examination may help determine if there is a persistent mass. Many women whom have had persistent uterine bleeding elect to have an "endometrial ablation" invented by my colleague, Milton Goldrath, M.D. in Detroit, Michigan in 1979. The procedure has worked well for 30 years; today, the Editor follows a course of mixed androgen therapy if danazol is ineffective or not tolerated. Not only is the bleeding controlled, but the hormonal replacement is beneficial for maintaining bone and muscle, mental focus, and libido, even into the menopause.

The recent article by K.M. Wishall showed that a full 19% of women have hysterectomies after endometrial ablation with more having an increase in pain. (Journal of Obstetrics and Gynecology 2014; 124(5):904-910)
*[Editor] This makes another strong case for using mixed androgen injections prior to any expensive surgery for disruptive menstrual bleeding or pain.

Over the last 15 years, the post-operative use of aromatase inhibitors has gained favor. The original medication, Tamoxifen, had the troubling side-effect of thickening the uterine lining and causing more uterine bleeding so it was added to Lupron®. The second generation medication was Arimidex®/anastrozole with Alesse® was better, then letrozole can be used with northisterone. The strongest of the aromatase inhibitors is Aromasin®/exemestan. Data is limited but when it has been added to Lupron® in creates a more atropic (dry) endometrium which is matched by the use of proprietary doses of nandrolone and stanozolol as published for treating extensive endometriosis.

*[Editor] Two previously approved F.D.A. medications have been used previously in Europe in menopausal women, even with breast cancer.
1) Stanozolol
has been used in patients with advanced metastatic carcinoma with almost half having a positive response.
2) Nandrolone
has been combined with the aromatase inhibitor (tamoxifen) for prophylaxis against breasts cancer recurrences. The use of these two anabolic steroids do not raise, rather they lower estradiol levels. These anabolic steroids can improve the quality of life: the women have less symptoms of menopause: they offer treatments for the hot flushes, insomnia, osteoporosis, poor memory and loss of libido. The two anabolic steroids used together will produce usually a profound atrophic endometrium.

Copyrighted 2014©