Are My Fibroids Causing Bleeding?

by Christiane Northrup, M.D.

Pelvic Health

Dear Dr. Northrup,

Over the past six months, I have had two episodes of prolonged vaginal bleeding (over three weeks) following my menstrual period. An ultrasound showed two fibroids: one outside of my uterus, the other on the inside. Both were small (1.5 by 1.7 cm). My doctor told me it’s unlikely that the fibroids are causing the bleeding and that the culprit is likely a low progesterone production that is causing anovulatory cycles.

Last month, I tried bioidentical progesterone cream. I applied 50 mg a day starting from the 12th day of my cycle, but it did not reduce or stop my bleeding. I still bled for 22 days. My doctor said only 50 percent of women respond to bioidentical hormonal creams, and I am probably not one of them. He suggests that I use the Mirena IUD with progestin. I am reluctant to do this because I had a bad experience with an IUD when I was younger. And I also don’t like to use synthetic hormones. However, I don’t know what else to do at this point.

Could you please recommend me something? Do you think the Mirena IUD will help?

Thank you very much in advance for your help – A.P.

Dear A.P.,

It has been my experience that even small fibroids, if located submucosally—just underneath the endometrial lining of the uterus—can cause abnormal bleeding. And in your case, this could be causing the bleeding. You could have that submucosal fibroid removed via hysteroscopy. And that may well take care of the problem. The Mirena IUD, which contains synthetic progestin, is another option. It’s certainly worth a try. The only problem there is that they are expensive. The good news is that, if it doesn’t work well, it’s easy to remove. No harm done.

I have a few questions for you. Are you in the perimenopausal age group? Say 42 or above? If so, then the bleeding is apt to be from estrogen dominance and not enough progesterone. A dose of 50 mg of bioidentical progesterone is very low. I’d increase it to 100 mg daily for two weeks out of every month. The other thing is this: You have had only two episodes of prolonged bleeding in six months’ time. In other words, for most months, your bleeding has been normal. You could simply watch and wait. Acupuncture often works very well in situations like yours.

One final thing. Are there any stresses in your family (blood family) that involve money, power struggles, or sexual issues? These are all second chakra issues that can affect the uterus. It’s all food for thought. And I’m certain that as you meditate on this response, the right course of action will come to you!

Best of luck – C.N.

Last Updated: June 16, 2010

Christiane Northrup, M.D.

Christiane Northrup, M.D.

Christiane Northrup, M.D., is a visionary pioneer and a leading authority in the field of women’s health and wellness. Recognizing the unity of body, mind, and spirit, she empowers women to trust their inner wisdom, their connection with Source, and their ability to truly flourish.

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  1. Ruthie Vecchio
    3 weeks ago

    During a pelvic exam 7 months ago, a polyp was found on the cervix with pap test normal. About five weeks ago I began to spot, not blood- it was a yellow discharge with no odor. It wasn’t much with a light pad taking care of the leaking. This occurred for about six days. My doctor encouraged me to bump up my ob/gyn exam which did occur. At that exam I had another pap with results all normal, however, this doctor diagnosed what we thought was a polyp as a “cervical lesion”. It is a tiny node on the cervix and I can feel it when doing my own pelvix exam. She recommended a biopsy and surgical removal but it wasn’t imminent. Just to watch for further spotting an indication for removal.

    Her exam was quite painful and I did spot a bit from this -pink to light brown for a day. I continue to spot the yellow discharge about every other day or so, sometimes, just a few dribbles throughout the day to a sudden cessation. I have scheduled the procedure however, I am so uncertain with having this procedure as I am not comfortable with this intrusion of my vagina.

    Looking for thoughts. Every doctor is encouraging removal. Thanks a bunch.

  2. Gina
    12 months ago

    I went Vegan Plant diet with some fish about a month before the bleeding started. Any chance there is a connection to eliminating animal proteins?

  3. Gina
    12 months ago

    Post menopausal bleeding after 10 years. Menopause at 38yrs I’m now 48. I take .075 HRT and Progesterone 200 at night. My FSH hormone is 42 (normal range for Post menopausal & on hrt)
    It’s been going on for 8 weeks now. I’ll Bleed for 3 days and then stop for about 10 days. Then it begins again.
    My Uterine biopsy was negative, ultrasound showed a small fibroid.
    Doctor suggested IUD or D&C.
    After doing some research here. I’m wondering if my HRT just needs adjusting……

  4. Janice Boursiquot
    2 years ago

    I am a 66 y.o. Black woman and have had 2 episodes of vaginal bleeding and 1 episode of vaginal spotting that lasted for 3 weeks. The 1st episode of bleeding lasted for a week (about 2 tbs. of blood a day, sometimes heavier.) The 2nd episode of bleeding occured 7 months later and lasted for 1 month. I had transvaginal & transabdonimal ultrasounds each time. 4 fibroids were detected. (I’ve always had fibroids). I went thru menopause 15-17 years ago and have not had a problem with my fibroids since that time, until now. Both reports stated that the ovaries are not visualized. My GYN recommends a complete hysterectomy. Is it necessary?

  5. Maria
    2 years ago

    I’m 55 white and I have been in menopause for 10 years after I had to remove both ovaries bcs of cancer. 5 yrs ago I’ve noticed extreme changes in my skin wrinkly and saggy plus my doctor told me I shrunk a good 1″. I don’t take any hormone supplements nor much of vitamins supplements. Searching online on how to help myself with aging I came across your knowledge in all of this. I was put on hormone cream estrogen right after removing my ovaries and so on but I heard through a friend that in my case w cancer history I shouldn’t take any hormone at all so I stopped. What do you suggest I should take to reverse sm of my aging if I start taking supplements minerals vitamins whatever you could recommend. Do you have a specific recommendations what to read and where to find more abt to knowledge myself in my case. Thank you so much Dr Northrup

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