“Extremely heavy periods and huge blood clots?”

This is Dr. Robert W. Vera. I am a gynecologist. Menopause in the United States occurs at age 51. Still having periods at age 53 is not common, but it occurs. Saying this, the periods in the perimenopause should not be characterized as you have described, that is, hemorrhage with passage of clots and associated with pain. This is abnormal. Hormones may be a part of it, but there may be other associated problems. These may include fibroids (i.e., iomyomas), endometrial polyps, and/or cancer (endometrial cancer or cervical cancer). A diagnosis must be made. This should start with a good pelvic examination, possible ultrasound of the pelvis, pap smear or biopsy of the cervix, and an endometrial biopsy. Most of these, except, perhaps, the ultrasound, can be done in the gynecologist's office. I would not hesitate in getting all this done. In the meantime, I would go to the pharmacy and ask the pharmacist for some good over-the-counter iron pills you could start taking daily to help avoid severe anemia, which would complicate your care, especially if you need surgery. Again, do not hesitate in finding a good gynecologist or gynecologic oncologist in your area and setting up an appointment within a few weeks.

Hormones are not always the answer. If you are post menopausal you should have a work up to include ultrasound and endometrial biopsy to rule out hyperplasia or worse in the lining of the uterus. If you are PMP you shouldn’t have any bleeding. If you are not post menopausal you still need a work up and could benefit from treatments like Endometrial Ablation or medical therapy to control the heavy and irregular bleeding.

Your heavy bleeding and cramping is indeed hormones out of balance but there is DEFINITELY something that can be done about this. What you need to do is get your bloodwork done for the following labs: Estradiol, Progesterone, Ferritin, CBC and thyroid panel plus thyroid antibodies; all of these hormone groups work together but the most important ones are the 2 female hormones of Estradiol and Progesterone. You are likely Estradiol dominant and that builds a larger lining that you have to bleed out; if your uterus doesn’t stabilize that lining with Progesterone, then you just bleed out quite heavily and your cervix needs to dilate (like you are in labor) in order to pass any clots and the uterus will cramp VERY HARD in order to help pass all of that extra blood because the uterus is a muscle that doesn’t like to be stretched. I recommend that you get a copy of my book, FULL BLOOM, Perimenopause, Menopause, Postmenopause and Beyond which is available on Amazon; it will further explain what is going on and there is a section in the back of the book that is all about how to talk to your doctor. If your doctor is unable or unwilling to do your bloodwork for you, then feel free to contact my office: 262-524-9116 and we will send you the lab requisition that is properly filled out in order to find out where your levels are. YOU DO NOT HAVE TO SUFFER due to the ignorance of the medical profession.