Cameron writes:
I have very heavy bleeding. What are my options besides a hysterectomy?
My reply:
Step one is often learning the roles & responsibilities of our hormones. Progesterone, for example, is our hormone responsible for regulating bleeding. Too often, I hear from women, like you, who experience heavy bleeding but believe they are “just unlucky” or bleed heavily because their mothers did, or sometimes, aren't yet aware of what constitutes heavy bleeding in the first place. This article should help with that.
![](https://static.wixstatic.com/media/6c96db_be2c2cf6de72434393f542a47338a49c~mv2.png/v1/fill/w_980,h_735,al_c,q_90,usm_0.66_1.00_0.01,enc_auto/6c96db_be2c2cf6de72434393f542a47338a49c~mv2.png)
When progesterone fluctuates, and then declines, in perimenopause, the most common experiences are changes to mood, sleep and bleeding.
Sometimes a hysterectomy is recommended and selected as the individual's best option, and I understand that decision. However, removing the uterus or choosing an ablation (a uterine procedure to stop bleeding) does not address the root cause ie. low progesterone of the bleeding.
I hope you can have an investigate conversation with a health care provider who can explain the options available to you, so you can choose the solution that is right for you.
That should include:
determining the root cause of the bleeding: is it fluctuating progesterone, fibroids, or something else?
are you a candidate for progesterone therapy, or an IUD, or in some cases, both?
what is your ferritin level/are you iron deficient (most women who still have a period are iron deficient) and if so, what is the most efficient way to course-correct?
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