Seeking Medical Insights on Heavy Periods and Anemia
Hello, I'm reaching out to gather some general health information rather than seeking a specific diagnosis. I reside in the UK and utilize the NHS for my healthcare needs. As a 38-year-old woman (5'6, 94kg - actively working to lose weight, having shed 18kg in the past year), I have endured a prolonged struggle with exceptionally heavy and painful menstrual cycles that include clotting, along with recurring iron-deficiency anemia. Previously, I experimented with both the combined oral contraceptive pill and the Mirena IUD; however, neither provided relief, as the IUD resulted in additional cramping and discomfort. I do not have children or prior pregnancies. My current medications include: - Duloxetine 60mg taken daily (for anxiety and depression) - Ferrous gluconate 300mg once daily - Vitamin C 1000mg daily (self-sourced, based on research suggesting it aids iron absorption) Recent bloodwork showed the following: - Hemoglobin: 110 g/L - MCV: 76.5 fL - MCH: 24.3 pg - RDW: 14.7% - Serum ferritin: 8 µg/L - White blood cells and platelet counts were normal A pelvic ultrasound indicated: - A normally positioned anteverted uterus - Endometrial thickness measured at 13 mm - An echogenic focus in the endometrium (62 × 74 × 44 mm) with a blood supply, suspected to be an endometrial polyp - Normal ovarian appearance, and no free fluid present I have several inquiries: I was informed that an iron infusion may not be necessary since my levels aren't sufficiently low, and I was advised to continue taking iron pills for three months followed by a re-evaluation with additional blood tests. However, I feel quite unwell. Should I advocate more aggressively for an infusion or consider private options? Is the size of the polyp linked to increased bleeding or iron-deficiency anemia? Should I be worried about potential malignancy due to its dimensions? In premenopausal patients exhibiting these symptoms, is a 13 mm endometrial thickness something to be concerned about? My general practitioner suggested that I “shouldn’t worry” and mentioned a 7-8 month wait to consult with a gynecologist. Nevertheless, I’m finding it difficult to cope with the pain, the heavy bleeding, and the anemia, which remains difficult to manage; other bleeding causes have been excluded. What are the standard procedures following this? Should I seek a more immediate referral? When hormonal therapies do not yield positive results, what other treatment options are typically explored? Thanks for your attention to my situation. Summary: 38-year-old female enduring chronic heavy, painful menstrual flows with clots and iron-deficiency anemia (Hb 110, ferritin 8). Pelvic ultrasound indicates a sizable potential endometrial polyp (62 × 74 × 44 mm) with a feeding vessel and endometrium thickness at 13 mm. Seeking general medical advice on whether this could clarify my symptoms and the steps I should take next.
Answers (1)
12/16/2025, 11:40:55 AM
OpenHealth AI
It sounds like you are facing several challenges related to heavy menstrual bleeding, painful cycles, and recurrent iron-deficiency anemia. It's important to address these issues thoroughly. Your concerns about the potential endometrial polyp and overall management of your symptoms are very valid.
Key Points:
- Heavy Periods and Potential Causes: Heavy menstrual bleeding (menorrhagia) can indeed be linked to endometrial polyps, and the size of the polyp can contribute to excessive bleeding.
- Iron Deficiency and Symptoms: Anemia can lead to fatigue, weakness, and discomfort, and it's crucial to manage your iron levels effectively.
- Waiting Times and Options: Given your symptoms and the impact on your daily life, it may be worth considering a more proactive approach to your healthcare.
Explanation:
- Endometrial Polyp: A polyp is a growth in the endometrial lining, and larger polyps can cause increased bleeding. While most polyps are benign, their size and the presence of blood supply may warrant further investigation to rule out any malignancy.
- Endometrial Thickness: In premenopausal women, a thickness of 13 mm can be within a normal range, but in the context of heavy bleeding and the presence of a polyp, it should be closely monitored.
- Symptoms of Anemia: Your hemoglobin level indicates anemia (normal is typically above 120-130 g/L for women). This can significantly affect your quality of life and suggest that your body is struggling to cope with blood loss.
Next Steps:
-
Consider the Iron Infusion: Since you are feeling unwell, it might be beneficial to advocate for an iron infusion, especially given your low serum ferritin and ongoing symptoms. Discuss this option further with your GP or consider seeking a private consultation for a quicker assessment.
-
Gynecological Referral: If the waiting time for a gynecologist is too long and your symptoms are debilitating, consider pushing for an expedited referral or explore private options. Emphasize how your quality of life is affected.
-
Monitor Symptoms: Keep a detailed record of your symptoms, including menstrual flow, pain levels, and any signs of fatigue or weakness. This can provide valuable information for your healthcare provider.
-
Alternative Treatments: Discuss other therapeutic options with your GP or gynecologist if hormonal methods have not worked. Options may include:
- Progestin-only treatments: Would be an alternate hormonal approach.
- Non-hormonal medications: Like tranexamic acid to manage bleeding.
- Surgical intervention: If the polyp is confirmed and continues to cause issues, a D&C (dilation and curettage) or polypectomy may be recommended.
Final Thoughts:
Your health and comfort are important, and it’s valid to seek more assertive treatments given your chronic symptoms. Be open and communicative with your healthcare providers about how you're feeling and do not hesitate to seek additional opinions if needed. You deserve to feel better and have manageable periods. Please let me know if you need further clarification or support!
Related Questions
Assessing This Situation: Home Care or Emergency Visit?
What could this be, and is it manageable at home? My husband mentioned this issue arose yesterday. While I’ve had hemorrhoids in the past, I’ve never experienced one this size, nor have I felt such intense discomfort – my husband seems to be struggling more than I did. It's difficult for him to walk, and rising from bed is quite painful. He’s 35 years old and spends extended periods in the bathroom without any issues with constipation or straining. I’m seeking clarity on whether this condition is typical or if it necessitates seeking urgent medical help. Right now, we’re applying Doctor Butler's and Dermoplast for relief.
Increasing Pain in the Sternal Area
A 26-year-old female, standing 5 feet 2 inches tall and weighing 150 pounds, is seeking insights into her health condition. **Current Medications:** birth control and Allegra. **Past Medical History:** includes irritable bowel syndrome with constipation (IBS-C), bilateral cubital tunnel syndrome that required surgical intervention at ages 17 and 18, and minor kyphosis. For the past year, she has experienced considerable stiffness, along with clicking and popping sensations, accompanied by mild discomfort located at the costosternal junction, particularly around the second to fourth ribs, with greater intensity on the left side. Recently, during the last three days, she noticed a notable increase in pain on the left, to the extent that it occasionally causes a sharp sensation that temporarily immobilizes her. However, once she changes her position, the pain becomes more bearable. Notably, she is not experiencing any shortness of breath. The pain appears to be triggered by movement and can be replicated, leading her to believe that cardiac or pulmonary issues are unlikely. Attempts to alleviate the discomfort with a lidocaine patch have been largely ineffective, although she has found some slight relief with ibuprofen. This situation appears to align with typical presentations of costochondritis; nonetheless, she acknowledges that such symptoms typically resolve within a few weeks, while hers have persisted for an entire year. She has encountered information suggesting that chronic costochondritis might point to rheumatoid disorders, and she is uncertain about the validity of this claim. Given her earlier struggles with ulnar nerve entrapment, which occurred during her teenage years, she is contemplating whether this pain warrants further medical evaluation. Currently, she lacks comprehensive health insurance, and she wishes to avoid any extensive diagnostic processes if they are unlikely to yield actionable results. However, if there is a possibility that her symptoms could indicate a more serious condition, she is prepared to follow through with recommended evaluations. Thank you for your assistance!
Experiencing Severe Discomfort - What Are My Options?
Age: 35, Height: 5'2", Weight: 61 kg. I have been suffering from intense discomfort located beneath both of my ribs, particularly a sharp pain deep under my left rib cage. A significant medical event occurred on November 25 when I underwent gallbladder removal. This morning I experienced diarrhea, which has since improved after taking loperamide. However, about an hour ago, I was abruptly awakened by significant pain radiating under my ribs. Additionally, I've experienced minor nausea that hasn’t alleviated my symptoms. I took co-codamol roughly three hours ago for pain relief, but it has proven ineffective against the current level of pain I'm enduring. What might be causing these symptoms? I live in the UK and I'm hesitant to utilize emergency services unnecessarily. Yet, given that co-codamol hasn't alleviated my discomfort, and I have a demanding 12-hour shift ahead tomorrow, what steps should I take next?
Concerns About Potential Oven Cleaner Exposure: Should I Be Worried?
I'm a 23-year-old male, weighing 225 pounds, living in the United States. After shifting to a new apartment, I discovered that the oven still had dried remnants of oven cleaner that hadn't been washed off. My roommate had recently applied a different oven cleaner and scrubbed it with a Brillo pad, followed by rinsing. The next day, when I used the oven to heat some food, I noticed some leftover residue in the corners. A chemical odor caught my attention, and after about 15 minutes, I decided to transfer my food to the microwave for safety. Moreover, I had used the same Brillo pad to clean the oven tray before placing my food on it, unaware that it had been previously used with oven cleaner the night before. Now, I'm feeling anxious that I might have ingested some oven cleaner. I’m experiencing an unusual cold sensation in my mouth and throat, which comes with a scratchy or dry feeling. I'm wondering if the amount of cleaner I might have been exposed to is concerning or if it's merely a negligible trace. Any insights from others who have experienced this would be greatly appreciated.
Navigating Motion Sickness and Cybersickness
Hello everyone! I'm a 16-year-old female, with a height of 162 cm, and I’ve dealt with motion sickness for most of my life. Recently, however, it has worsened significantly, extending to cybersickness as well. Spending more than 25 minutes in front of a screen leads to severe discomfort—something that is particularly challenging since I need to use screens for my schoolwork and beyond. After these episodes, I often find myself unable to do anything but lie in bed for the remainder of the day, wrestling with nausea or even vomiting. This issue doesn’t just arise from screen time; I also experience stomach upset during walks or jogs, which leaves me puzzled about how to alleviate this condition. I frequently rely on over-the-counter travel sickness medication, specifically Avomine, and while it does offer some relief, the effect is minimal. I’m seeking advice or suggestions that might help me regain a sense of normalcy in my daily life. For your reference, I don't smoke and only consume alcohol on very rare occasions. I’m located in the UK! Any tips would be greatly appreciated!