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Will PROMETRIUM taking daily cause vaginal bleeding?

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*This is an OB/GYN question so, I hope an OB/GYN will respond. *
I am 58. Blood tests show that I am not in menopause FSH 25 Estradiol 230. I've had 4 biopsies in the past 5 years (no hyperplasia etc. benign), 2 sonohysterograms, D&C, Endo Ablation, Polypectomy, Hysteroscopy, (all done in 2010), many pelvic ultrasounds (last biopsy Jan. 2014, last pelvic ultrasound December 2014...last measurement 6mm lining). Did 5 1/2 months continuously on 10mg/day of medroxyprogesterone to thin lining Oct. 2013 to March 2014 then, did another 2 week round of Medroxyprogesterone (10mg/day for 14 days) to bring on withdrawal bleed. I was told now that I can do Medroxyprogesterone (10mg/day for 14 days) every 3 months and have a withdrawal bleed OR...take Prometrium 100mg/day continuously until my estrogen levels drop enough to stop producing a lining. 3 1/2 months ago, the 14 days produced a heavy bleed with severe cramping, anxiety and feeling moody and horrible. I am TERRIFIED of having another similar bleed this time but, have to do something. QUESTION: Will both give such a heavy bleed and anxiety? And since, I haven't done anything for 3 1/2 months (should have done something beginning of this month but, was sick with a nasty virus) would I be better to clean it out again with the Provera or just go onto the Prometrium and keep taking it every day? Will I bleed while on the Prometrium if I take it every day? Thank you in advance for reading my entire history and questions.

Category: OBGYN

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Category: Infertility Specialist
 27 Doctors Online

Thanks for posting your query at
Prometrium gives comparatively less side effects such as anxiety, moodiness etc.
Regarding bleeding, both are comparably efficacious.
So yes, you can just go onto the Prometrium and keep taking it every day.
The chances of a bleed such as the one you had, and are afraid of, are minimal.
Another option is to have the Mirena coil inserted for a short span of time until Menopause sets in, which it should, ina short while, since you are already 58.
All the best
Please feel free to discuss further.

Patient replied :

Thank you. One last question. Since it has been 3 1/2 months since I have had a bleed/shed of the liningetting do I need to clear it again with provera first or can I just go to daily use of prometrium and will it still thin the lining without a withdrawal type bleed like the provera did?

IF possible have a scan.
If the lining is thin enough, you can straightaway go to the Prometrium.
If it is mildly thick, you can first have a withdrawal with Provera, and then switch over to Prometrium.
Take care.

Dr. Aarti Vazirani
Category: Infertility Specialist
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
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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