Medication to control heavy menstrual with extremely low PLT
 

Hello,

My wife was diagnosed with AA early last year after carrying the dx of ITP for many years. Her issue is mainly platelets (10k~15k) with HGB between 11-12 and ANT between 0.8 and 1.2. Since then, she had extremely heavy menstrual periods every month and needed to be transfused at ER a couple times. We live in a small city and the doctors here do not have much experience in controlling bleeding in AA patients - their recommendation is Lupron shots plus Aygestin (norethindrone). We did some research online and decided to stay away from Lupron so she started Aygestin at 15 mg/day then slowly tapered to 2.5mg/day. This medication did a wonderful job in controlling her bleeding. She actually only had a few days of spotting in the last 6 month with the medication.

Our issue is that a more experienced OB doctor has recently recommended an oral contraceptive pill with both norethindrone and estrogen. He believes the OC pill will be as effective as taking norethindrone alone in controlling the bleed, but can also help to prevent pregnancy. We are concerned with switching over to a different drug would cause breakthrough bleeding, plus given the proven result by Aygestin we are hesitant to switch to something new.

Has anyone here dealt with similar issues before? I would really appreciate it if you could share your experience with either medication, their effectiveness in controlling the bleeding, and any concern with long term side effects (e.g. liver damage).

Thank you for your help!!!

Roger

Hi Roger,

I can't comment on the medications, but wanted to advise that you should get your wife's iron levels checked periodically if she is having heavy bleeding. Iron deficiency can be caused by heavy bleeding and could be contributing to her low hemoglobin levels.

Hope you find some answers to your other questions...

I had the same problem. After 3 weeks of heavy bleeding and multiple transfusions I was put on Progesterone. Funny thing was I had to initiate it! It completely stopped my periods. I was on it for 2 years and never had any problems.

Sorry if someone has already said this as I haven't had time to read the posts properly but I take northistorone to completely stop my periods as I can't afford to lose any blood xxx

Hi, me again, sorry just read your post properly, ok so for me I just take northistorone 10mg tablets 3 times a day, it has always worked well and I haven't bleed at all, I stopped it purposely one so we could get some embryos frozen before my chemo started for my transplant and the bleeding was ridiculous I needed so many transfusions but I cam off the did not switch to another form, also I was lead to believe and I'm pretty sure it's right that northistorone is not a contraception.

I spoke to my doctor about going on the contraceptive pill and coming off the northistorone and she has refered me to a specialist as we all know how many drugs us AA patients are on and would need some thing effective so when I've had my appointment I can update you with my suggestion xxx