Hello doctor, I am 48 years old. I have two fibroids 9 cm total size and was advised to take 2 x 500 mg three times a day but it completely stops the bleeding but the bleeding starts after three days again. I have had on and off bleeding for two weeks now. Is this a common problem with the medication? I am extremely worried and cannot be normal. Please help and advise.
Hello,  Welcome to icliniq.com. It would have been helpful if you could attach the report of your ultrasound for me to have a look. Based on what you mentioned about the total size of two fibroids to be ~9 cm, I am assuming each one must be less than 5 cm and not so huge. Fibroids would not cause irregular bleeding unless they are lying close to the uterine cavity. Usually, in the perimenopausal age group of women, like you are already 48, we prefer to give medical management so as to control the bleeding in those who have excess bleeding. As with age, your menopause may set in and menses will eventually stop and then you will not have any problems because of the fibroids. This is done to avoid unnecessary surgery when the bleeding would anyways stop after menopause. In your case, I would like to know if the fibroids are close to the uterine cavity on ultrasound which may cause irregular bleeding. Also, in your query, the drug name has not come, but I guess it is Tranexamic acid (or Trapic or Pause) which just controls the excessive bleeding means will reduce the bleeding. But will neither stop the bleeding pattern due to hormonal disturbance in the perimenopausal abnormal bleeding nor due to the fibroids which bleed due to the close situation to the uterine cavity. Other causes if irregular bleeding apart from fibroids need to be evaluated like hormonal changes, thyroid issues, or uterine lining (endometrial) thickening, etc. If it is due to fibroid position that is causing off and on bleeding, it may not stop with Trapic (but only will reduce in amount) and may stop only after menopause or after the surgical removal of the uterus. But if it is due to the hormonal disturbance or due to the perimenopausal phase, it needs to be controlled with some hormonal medications. It would be good if you could connect with me through chat and share the reports of yours so that we can have a close look if any further evaluation needs to be done regarding the abnormal bleeding pattern. Ultrasound report needs to be reviewed. ? Thyroid abnormalities, ? perimenopausal AUB (abnormal uterine bleeding), ? Ca (cancer) endometrium, ? EIN (endometrial intraepithelial neoplasia). please revert back with reports.