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Heavy menstrual periods with clots with DM2. Treatment?

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I am a 48-year-old female; age of menarche was 12y, 11m., multiparous (7 children, 2miscarriages, 1ectopic pregnancy). I have always had normal 29-day cycles. In less than two months I have had 4 extremely heavy menstrual periods (one of which was quite painful and I had not had any cramps since before I had my first child at 23) with large clots that lasted 5-7 days of which the first 3-4 included very heavy flow. My BMI is 29. My lipid profile is good as is my blood pressure. I feel healthy. I have mild DM 2. In researching perimenopause I have not found a description of menstrual irregularities similar to what i have been experiencing and so as my children's sole surviving parent, I am worried. I am a widow and have not been sexually active for years. My last pelvic exam was two years ago and it was grossly normal, as have been my mammograms.

Meds:

metformin 1000mg bid
amphetamine/dexamphetamine 30 mg bid
Saphris 10 mg sl qd hs
pramipexole 1 mg qd hs
alprazolam 0.5-1.0 mg tid prn (infrequently)


Category: OBGYN

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Category: Infertility Specialist
Dr. Aarti Vazirani is online now

Expert:  Dr. Aarti Vazirani replied 4 Days.

Hello,
Thanks for posting your query at DoctorSpring.com
THe irregularity that you describe is in fact very consistent with perimenopause.
Due to the associated hormonal imbalances, the lining of the uterus thickens ( hyperplasia ) leading to irregular and heavy shedding of the lining , resulting in frequent, heavy cycles.
You need to confirm this diagnosis by consulting a Specialist.
An internal exam, pelvic ultrasound scan and hormonal levels ( FSH, LH, TSH ) should be done.
THis will reveal any existing endometrial hyperplasia, polyp, fibroid , ovarian cyst etc.
If this is plain endometrial hyperplasia, cyclical progesterone therapy will mostly correct the issue.
Please get the workup done to confirm the diagnosis.
All the best
Please feel free to discuss further.
Regards.


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
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