When That Time of the Month Becomes a New Problem

And everything you thought you knew changes.

It is common for many women during perimenopause to experience occasional heavy periods. Some may experience months or years of heavy bleeding. For me, it was years, and it all started in my mid-forties.

I also dealt with more frequent migraines during perimenopause.

When I first started my period at age eleven, it was always on the heavier side. The first two days were the worst. It would last a week, and I’d experience lots of cramping.

I was regular though. My cycle was bang-on every twenty-eight days, until my mid-forties when my cycle changed to every twenty-two to twenty-five days.

I’ve always kept track of my periods on the calendar. Stopped using tampons after giving birth in order to keep better track of my bleeding. My prolonged heavy menstrual bleeding resulted in anemia.

My family doctor referred me to a gynecologist. I was forty-five years old.

The gynecologist wanted to do a D&C and a biopsy.

I was familiar with the dilatation and curettage procedure where the cervix is stretched to allow the curettage to enter and scrape the lining of the uterus, removing tissue. I’d had the procedure performed twice after giving birth.

A D&C can also help regulate periods.

Since I was older now and had more health issues, I wasn’t keen on general anaesthesia. I expressed my concerns to the doctor, and we compromised.

He’d perform a biopsy in his office and we’d go from there.

In the meantime, I was to keep a menstrual log, keeping track of my heavy days and how many days my period lasted. I’d end up keeping this log for years.

I was also to continue taking 600 mg of ferrous fumarate for anemia.

On my heavy flow days, I’d feel gush after gush of blood pour into the thick Kotex pad. I’d soak the pad in a matter of minutes. It was frightening waiting for the blood to slow. I’d sit on the toilet, letting the large blood clots drop into the bowl instead of in the pad I was wearing.

When the bleeding slowed, I’d clean myself up and put on a fresh sanitary pad.

March 7, 2003, the day of the biopsy, the doctor had his nurse accompany him to assist in the procedure. I got on the table as if I were having a PAP smear. The doctor felt he could still get a tissue sample, even though I was bleeding heavily.

The pain during the biopsy was more than I’d expected. It felt like he was pulling my uterus out of my body.

I had not been prepared for such pain.

Just when I thought it was over, he said he hadn’t gotten enough and had to repeat the procedure. This time I knew what was coming and my body tensed. The nurse held my hand while he took another sample.

Finally, it was over. I sat up and was lightheaded, and complained of nausea. My vision was blurry. My hearing like I was under water. All signs I might faint. I told the nurse how I felt, and she gave me a cool cloth to place on my forehead.

“Do you have a history of fainting?” the doctor asked.

I admitted I’d fainted as a teen during a dental extraction and came close to fainting during a core breast biopsy.

“If I knew that,” he said. “There’s no way I would have done this with you awake.”

The doctor left the room after finishing. I could tell he wasn’t pleased with me.

The nurse stayed and helped me off the bed. There was a lot of blood and large clots. My upper thighs were smeared with blood. “You poor dear,” she said, while she helped clean me up. “That’s such a heavy flow.”

She then told me that she always tells women to take pain medication before the procedure. Unfortunately, she’d not been there the day my biopsy had been booked.

“Do you have someone to drive you home?” she asked.

“No,” I said. “No one told me I might need someone.”

I realized how unprepared I’d been for the trauma of the procedure.

Near tears, I left the city that day and went home and took pain medication, treating it as a good lesson learned.

My biopsy results came back and it was determined that the heavy bleeding was due to hormonal changes. The doctor started me on oral progesterone.

Fifteen days after my period started, I would take the progesterone pills for the next ten days.

I kept a separate calendar to record the days on progesterone. With a red coloured pencil and a Sharpie marker, I detailed my menstrual flow. Drawing red dots with the marker for clots. Lighting shading in red pencil for lighter days.

I continued this treatment for the next year, hoping it would make a difference.

Every four months, I went for blood work and hoped my red blood cell count would rise.

I kept trudging along, not ready to face the surgical options of an endometrial ablation or a hysterectomy. I held out hope the progesterone would solve the problem and I’d make it to menopause, which the doctor told me was at the average age of fifty-two. Seven years seemed so far away at that time.

In hindsight it was but a flash. It also wasn’t the end of my problems with heavy bleeding.

BARBARA CARTER is a visual artist and writer with a focus on healing from childhood trauma, alcohol addiction, and living her best authentic life.