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Ask Dr. Norm S. Your Own Question
Dr. Norm S.
Dr. Norm S., Doctor
Category: Medical
Satisfied Customers: 11231
Experience:  Over 30 years of experience in OB/GYN practice.
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Background: I am a healthy 36 year old woman with two children,

Customer Question

Background: I am a healthy 36 year old woman with two children, aged two and three. I had a copper coil put in after the birth of my second child, but my periods were so heavy that I went on the pill (microgynon 30) five months ago, to regulate the bleeding. The GP didn't recommend that I had the coil removed and she thought that the two forms of contraception would not interfere with each other. Before conceiving both children with the help of Clomid, I found out that I had polycystic ovaries. I was on microgynon 30 before then for 12 years (from 18 years old to 30 years old), and it worked very well for me, with no irregular mid-cycle bleeding.

All has been fine since going back on the pill, although initially I bled quite a lot (although I believe this is normal). However, last week - from days 14 to 17 of my pill cycle (ie. when I should not bleed) - I had phenomenally heavy bleeding. It got gradually worse, to the extent that I was soaking a tampon every 40 minutes in addition to passing blood clots the size of tampons. I felt weak, dizzy and sick, so on Saturday I went to the out-of-hours clinic. They checked I wasn't pregnant, then I was given a four-day course of tranexamic acid tablets to stop the bleeding, which is slowly beginning to work although I am still bleeding, just not to the same extent.

The doctor felt my stomach and there was no specific pain, other than general tenderness. He didn't offer an explananation and I'm not able to get home to my GP until Wednesday.

I am a little concerned about this mid-cycle situation, not least because I've been feeling extremely tired for 4 weeks. I am normally highly energetic, enjoy rude health and go running three times a week. For the last month however, I have tried to run but feel exhausted immediately. There is nothing specifically painful, just a sense of lethargy which is most unlike me. I can't stop yawning and have swollen, tired eyes despite getting lots of sleep. Nothing circumstantial has changed, I have a wonderful family with a huge amount of support from my husband and parents.

Is there an obvious explanation to you (perhaps, that I need to have the coil removed?) Or does it sound like an infection/growth/polyp/fibroid?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Norm S. replied 4 years ago.
I think your abnormal bleeding is most likely due to the copper IUD, and will probably resolve when the IUD is removed. There might be some infection, but even if there is, it will usually respond best to removal of the IUD, with or without antibiotics. If there is much tenderness on pelvic exam, then antibiotics will probably be prescribed as well. There is also some possibility that both the bleeding and the tiredness are due to excessive stress, which can cause both. Part of your fatigue must be from the bleeding you've been having, and I would recommend taking at least one iron tablet (over the counter) daily. When you see your doctor, be sure they check your hemoglobin for anemia. If you had fibroids, they are usually felt on pelvic exam, which hopefully you had 5 months ago when you saw your GP. Polyps are not likely, but if your abnormal bleeding persists after having the IUD removed, then studies could be done to look for other causes. In case the bleeding doesn't become normal after removal of the IUD, you may need a D&C, both to stop the bleeding and figure out the cause. However, most likely once the IUD is removed, your bleeding will resolve. Best wishes.
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Customer: replied 4 years ago.

Thank you, XXXXX XXXXX you clarify what a D & C is?

Expert:  Dr. Norm S. replied 4 years ago.
D&C stands for Dilation and Currettage, which means dilating the cervix and curretting (scraping) the lining tissue inside the uterus. The tissue can then be examined microscopically. This will remove polyps, but won't generally remove fibroids, which if present can be treated in other ways.
Expert:  Dr. Norm S. replied 4 years ago.
Thank you for your payment.

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