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Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11231
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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I am a 47 year old female - my Dr put me on Premarin 0.625

Resolved Question:

I am a 47 year old female - my Dr put me on Premarin 0.625 just under six months ago for hot flushes and night sweats which have all but gone, I have been on a period for the last 7 weeks and instead of ordering a repeat prescription, I made an appointment with her for a bit of reassurance that prolonged periods was normal at my age and while HRT is getting into system. My Dr admitted she should never have put me on estrogen only HRT as I still have a uterus. She examined me and told me I had an enlarged uterus and has made me an urgent appt for an ultrasound and transvaginal scan and changed the HRT to Evoril Sequi and told me to start with the progesterone ones first. I am now absolutely terrified that because I was on estrogen alone for so long, damage has been done. I am still bleeding and passing small clots, about the size of a 10p piece and although the scans are just 3 days away, do you think damage could have been caused?
Submitted: 11 months ago.
Category: OB GYN
Expert:  Dr. Norm S. replied 11 months ago.

What were your periods like before starting the Premarin?

Did you have a pelvic exam 6 months ago, and if so, did you have an enlarged uterus at that time? Thank you.

Customer: replied 11 months ago.
My periods have always been painful and quite heavy but got heavier as I got older but never lasted longer than 10-14 days at the most.I had no examination 6 months ago, the Dr just took my blood preasure but my smears are up to date and last one last year was normal.
Expert:  Dr. Norm S. replied 11 months ago.

How regular were your periods coming before starting the Premarin? Were they coming every month?

Customer: replied 11 months ago.
The doctor has put me on Mefenamic Acid and Tranxemic Acid tablets in the past but I wasn't using them regularly as periods became more irregular as I got older and I haven't taken either of them for well over six months.Before starting the Premarin, my periods were around every three months on average.
Expert:  Dr. Norm S. replied 11 months ago.

I believe that you need to have an endometrial biopsy, which is when a sampling of the uterine lining is taken by a small tube through the cervix.

It's hard to know whether there might be cancer or pre-cancer change inside your uterus. The endometrial biopsy is the way to know. If you could see an OB/GYN doctor, that's the first thing that would be done.

Neither the 6 months on Premarin nor the enlarged uterus are that worrisome in themselves, and there may only be some minor buildup of your uterine lining causing the bleeding you're having. But the only way to know is by an endometrial biopsy or a D&C. If I were to see you, I'd probably do the D&C, because it would stop the bleeding plus give an answer as to whether there is anything serious going on. The ultrasound won't really tell you.

Customer: replied 11 months ago.
is the bleeding caused by the body trying to shed the build up of lining caused by the excess estrogen then?I worked out that in the last 61 days I've been bleeding for 50 of them so as you can imagine I am getting a bit desperate now.
Expert:  Dr. Norm S. replied 11 months ago.

The bleeding is caused by the buildup of the uterine lining. It builds up over time, and then it starts to bleed or spot.

The body won't shed that built up lining without either progesterone or a D&C.

Whether or not there is something serious doesn't depend on the number of days of bleeding. All that bleeding just tells you there is a problem which needs to be taken care of.

Customer: replied 11 months ago.
Okay I understand, so the heavy bleeding I'm experiencing now could be as a result of being on the progesterone part of the patches the dr has now put me on, although have only worn the first one for two days?
Expert:  Dr. Norm S. replied 11 months ago.

No, the bleeding is due to the buildup of the uterine lining, which has probably been building up for a long time.

The progesterone will help resolve the buildup, but that takes a while.

Customer: replied 11 months ago.
Okay thank you. As I said I'm having the scans on Monday morning but am just sitting here thinking all sorts of things but I guess I'm in the system now and am sure what needs to be done will be done but I am very scared something is really wrong.
Expert:  Dr. Norm S. replied 11 months ago.

You're welcome.

As I said, you'll probably be fine, but it may take a little while to be sure.

Please click the rating stars. Thank you.

Customer: replied 11 months ago.
Thank you very much for your time.
Expert:  Dr. Norm S. replied 11 months ago.

You're welcome.

Dr. Norm S. and other OB GYN Specialists are ready to help you
Expert:  Dr. Norm S. replied 11 months ago.

Thank you for your payment and rating.