Controlling Uterine Bleeding

It's a topic that comes up in the course of many women's lives and it's hard to know what to do. Thanks to the cumulative advice and experience of the women of the uterinefibroids list though I've learned some simple things you can try at home to stem bleeding.

Lie down -- this reduces your blood pressure which will help to slow the bleeding.

Cold pack -- lie down and place an ice pack on your abdomen, wrapped in a towel of course. Don't have an ice pack? Try a bag of frozen veggies.

Take Tylenol or Ibuprofen -- take approximately 400 mg of an anti-inflammatory like Tylenol or Ibuprofen. Don't take aspirin as it thins the blood and won't have the same affect.

Vitamin C -- a natural anti-inflammatory that helps to constrict blood vessels.

This worked well (within 20 minutes after two hours of hemorrhaging) when I was having really bad flooding in Spring 2004 but I tried it during my second miscarriage and I'm not sure if it worked then -- that's sort of a different situation though.


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Here is good reference about NSAIDs and menstrual bleeding:

Nonsteroidal anti-inflammatory drugs for heavy menstrual bleeding
(Cochrane Review)
Lethaby A, Augood C, Duckitt K

Von Willebrand's Disease can cause bleeding problems and isn't regularly diagnosed by docs.

Here's my post about types of bleeding and quantities, to help you understand what is problematic bleeding.

Menstrual Irregularities

Here's a page which illustrates/explains different types of menstrual irregularities:

http://www.femalehealthmadesimple.com/FileTwelveFinal.html

"Any woman of childbearing age who has missed more than two consecutive periods -- but was not pregnant -- needs to investigate it and possibly have her period induced. Preventing the development of hyperplasia is the reason."
From: Endometrial Hyperplasia, WebMD

"Excessive estrogen stimulation can lead to significant increases in uterine lining thickness. The tissue becomes hyperplastic or atypically hyperplastic . It may become cancerous."

(and)

"Inadequate ovulation may cause excessive, irregular, or frequent menses recurring less than every 3 weeks. Inadequate ovulation leads to an excess of estrogen, which stimulates growth of the menstrual lining, and a decreased level of progesterone - which normally would be present in levels that would adequately thin the menstrual lining and prevent excess or irregular bleeding."
From: Dr Decker, Heavy Menstrual Cycles Management Options

"We like to see a lining of at least 8mm in thickness when measured by ultrasound at the time of maximal thickness during the cycle (see above ultrasound images of an 11.5 mm lining). There is some ongoing debate as to "how thin is too thin", as well as to "how thick is too thick". In general, 8-13 mm is good, less than 6 is potentially a problem, and greater than 15 or so could possibly reduce chances for a successful pregnancy."
From: Uterine problems causing infertility or miscarriage

Anemia & Iron Rich Foods

Here are some links to pages with information about iron rich foods and some others about anemia generally. B vitamins are also important in healty blood production so make sure you eat a balanced diet with enough B vitamins.

Rules about iron include - take it with vitamin C, don't overcook foods (steaming is best), antacids, calcium (dairy products) and caffeine all block absorption so definately don't take at the same time. Iron from red meat and liver (heme iron) is more easily absorbed than from plant sources (non-heme) though taking non-heme foods at the same time as heme foods can improve iron absorption.

Here's a great link about iron absorption

Also, since some of the iron supplements are hard on people's stomachs I though I would share what I'm taking which hasn't caused me any difficulty (although if you are severely anemic this probably isn't strong enough) -- Nutrition Now Chewable Iron (25 mg of elemental iron per tab -- though they recently changed their formulation to ferric pyrophosphate and I don't recommend it anymore. Others I've met online have had good luck with Slow FE or Floradix.

"Which forms of supplemental iron are best?
All iron supplements are not the same. Ferrous iron (e.g. ferrous sulfate) is much better absorbed than ferric iron (e.g. ferric citrate).13 14 The most common form of iron supplement is ferrous sulfate, but it is known to produce intestinal side effects (such as constipation, nausea, and bloating) in many users. Some forms of ferrous sulfate are enteric-coated to delay tablet dissolving and prevent some side effects,16 but enteric-coated iron may not absorb as well as iron from standard supplements. Other forms of iron supplements, such as ferrous fumarate, ferrous gluconate, heme iron concentrate, and iron glycine amino acid chelate are readily absorbed and less likely to cause intestinal side effects."
From: Vitacost's Iron Information page


What foods contain high amounts of iron?

Eat Iron-Rich Foods

Iron: Vegan Society

Menorrhagia Diet

Iron

How much iron do certain foods contain?

Iron deficiency anemia in pregnancy: a short account

Iron Deficiency Anemia

Iron Balance - explains iron intake, losses and affects of iron
deficiency in women

Anemia and Fatigue

Iron Deficiency

and kind of unrelated but interesting information:

Workshop on Maintaining Iron Balance in Women Blood Donors of Child-Bearing Age

Six Weeks -- Feeling Pretty Fine

I haven't had my laptop so I haven't been able to upload any photos in a week. I'll have some soon of my healing belly. I don't think you can see much change on the outside but I can definately feel the difference on the inside. I'm a lot less sore now and I have more energy.

My cramps were awful last week, I thought I was going to die and I had spotting which isn't normal for me. My period came last week, over a week late, and it wasn't normal. I had more hemorrhaging for several days and felt very light-headed. It doesn't even take that much blood loss for me to feel this way. I was anemic to start with, something I've been working on since my surgery by taking iron supplements. I think my uterus might have had a hard time contracting properly and maybe it was still adjusting to all the recent changes.

I looks like things are getting back into order though, all biological signs are A-OK now. My incision is still sensitive but I don't have to wear the granny knickers anymore and I can comfortably sleep on my belly at night. Wednesday morning my body told me it was time to exercise again. I've been aching for the first time since my surgery, the kind of aches you get when you don't exercise for a while. I've been trying to pick it up and do more physical activity including a little jogging down the street and push-ups.

We babysat my 26 month old nephew at the beginning of the week and the kid had us running around for hours. My partner says that he's not sure he wants one now, that his life will be certainly over if he has to do that every night. I don't think he is serious, he would love a baby if we had one and be awesome about it. I told him we can get an au pair, though I don't know that we really would do that. We'll figure it out when the time comes.

My partner also noticed the other day that for the first time in a couple years there is this lightness to my person, some weight being lifted. I think it is from the fibroid mostly. It was a big psychological burden on me to know that I wasn't well and that I had to manage a condition that may or may not affect my fertility. My partner said that now I know I can get pregnant and now that the fibroid is gone things are looking a lot easier. Let's hope so.

It will be another 8 weeks or so until we're able to start trying to conceive. I'll be away on vacation for part of that time and then I'm going to try to take some art classes in the new year to help keep my mind off of it all.

Definitions of (girlie) bleeding

In the time I've hung out online with women trying to get pregnant I've had the chance to learn more of the nuances of spotting. I've heard women say that if there is any blood contained in your cervical fluid they they considered it spotting. At the end of your period though it it more residual flow, I have that too. This type of spotting tend to be brownish.

[added in this article link 2/4/06]
Menstrual Mysteries -- more info about determining problems with your menses based on quantity.

Spotting is bleeding outside of your period. I've had spotting this month and it just continued as red coloration to my cervical fluid, this is dysfunctional uterine bleeding related to my miscarriage.

Spotting also is the first sign of an impending period for many women. I'm pretty sure that this is light pinkish, with maybe a little brown as the blood oxidizes.

Heavy menstrual flow is when you need to use more than one pad an hour, though I consider this really heavy, medically referred to as Menorrhagia. Because your body is bleeding so much the chemicals that are supposed to keep the flow fluid can't work as well and you do get some coagulation -- the clots, or liver-like lumps. I find that when I have clotting I tend to get really nauseous kinda intense cramping feelings -- I think this might be the clot passing through the cervix -- when I miscarried there was a similarity to the sensation though the miscarriage was more painful in my opinion.

My previous period was unusual, again it seemed to be related to my body trying to get rid of retained tissue from my miscarriage. I had bleeding for 3-4 days that was bright red and had no clots. On toilet tissue it looked like I was dabbing at a wound, it was plain blood and without the mucus component of a normal menstrual flow. I consider this abnormal for me, though women with fibroids contacting the endometrium might experience this as a frequent event.

"Women lose between 20 and 80 cc's (1-2 ounces) of blood during a normal period." (hah! right)
http://www.fwhc.org/health/moon.htm

This page includes diagrams and links to more information about normal/abnormal menstrual bleeding and includes a reference to fibroids (scroll down the page)
MENSTRUAL ABNORMALITIES

I found a lot of mention of the fact that doctors often underestimate women's blood flows and that there is a pictorial chart (see link below) that women used in one study that was a clearer indictator of blood loss. I'm sure many of us have experienced this underestimate by docs -- perhaps if those of us with heavy periods would catch the blood that pours out of us when we go to the toilet and bring it to the doctor's office they might be able to see what we go through.

The Medical Algorithms Project has a copy of the The Pictorial Blood Loss Assessment Chart (PBAC), an excel spreadsheet that helps calculate blood loss
http://www.medal.org/