Thanks for posting your query at Doctorspring.com
At 49, the most likely diagnosis is hormonal imbalance.
This is typical of peri menopause.
The hormones start fluctuating, leading to irregular and unpredictable cycles.
Often the lining of the uterus is not regularly shed and it builds up ( endometrial hyperplasia ) thus when it sheds, there is spotting followed by heavy bleeding.
Do not worry, as rarer causes such as a uterine fibroid, polyp, uterine malignancy etc are less likely.
You should have a thorough internal exam by a gynaecologist - per vaginum and per speculum.
Also, a pelvic transvaginal ultrasound scan and hormonal levels - FSH, LH, TSH, Serum estradiol.
Right now, you can take Tranexamic acid thrice a day tablets for a day or two.
IF that fails to stem the bleeding, progesterone can be taken, but have a gynecological evaluation before that.
There is no need to go to the ER, but have an appointment with your OB - GYN as soon as possible.
All the best
Please feel free to discuss further.
Patient replied :
Thank you, it makes my mind at ease. I will make an appointment with my OBGYN.
I appreciate you responding to me with this important information to me.
Hello Ms. Ruby,
Thank you for the appreciation.
Please feel free to get back to me anytime.