PCOS & flooding (periods)

[RowsOfFlowers]

Hello,
I am really struggling with my periods. For the last few years, they’ve been super heavy. I’ve recently started investigations with endocrinology and it’s suspected I may have PCOS based off of my symptoms and recent ultrasound. My cycles are usually 30-35 days but my most recent one was 47 days - longest it’s ever been, and I started my period today. It’s so heavy that I stained my sheets, and I’m having to wear x2 night time pads plus have a towel down for bed tonight. This is absolutely not normal, and I’ll be telling my endo at our next appt end of the month.

My question is - what’s the treatment? Other than contraception as my partner and I are ttc. What helped you? Endo mentioned metformin. Can this help heavy periods?

I already take tranzemic acid but it takes 1-2 days to kick in and stop period from being so heavy.

Contraception like Mirena works but you can’t use it at present. Metformin can make your cycle regular 28-30 days which can lighten it though not a huge difference.
If your periods are painful then work on reducing the pain as the more painful it is the more flooding you will have. I used ibuprofen from 2 days before period and it helped then during my trip to India a gynaecologist gave me ‘drotin m’ for heavy painful period. It worked wonders both with the pain and the flooding. Used it for a couple years then had a mirena.

I have perimenopausal flooding so not the same as you, but the things that have helped are taking tranexamic acid as soon as I get light staining at the very start, super plus tampons, period pants for nighttime (get the full briefs and check from tge photos that they really are full and not high leg, or get the shorts), or incontinence pants, and Always Ultra size 6 which can be difficult to get but definitely worth searching for or buying online. I also use progesterone but appreciate that's not for you. Sending sympathies, it's really miserable, and hope your endo appointment helps. .

Thank you xx really helpful ideas. Yea, very miserable indeed… I’m hoping it helps too!! It’s a nightmare trying to work like this.

Merformin did help me in your circumstances but I had to go on quite a high dose - 2000mg per day I think. They usually start you on a lower dose so you might have to persevere at going up. It took around 6months for the effects to fully kick in.

If you are ttc, are you taking inositol? You can buy that in places like Holland & Barrett so you could start immediately but make sure you talk to your endo if you do go on metformin as they can have similar effects so you don't want to double up unnecessarily.

Agree with everything @SirChenjins has said - i have a TXA prescription on standby for whenever I need it, heavy duty period pants, the heaviest flow pads. Lots of spares in my bag.

Good luck - after a long process we have one DD who was conceived using letrozole for ovulation induction and one DD who was a natural conception. Hope you get there in the end 💐

Edit to add - if you do go on metformin, ask for the extended release version as it is much softer on your system. The side effects on the normal version can be quite harsh.

Thank you so much @CrispAppleStrudels btw I love your username.

I have contemplated inositol, but I think you’re right in that I’ll wait to speak to the endocrinologist about this. It’s interesting about the high dose. I have heard slow release is best yes. Can I ask what letrozole is, is it an alternative to clomid?

Yes, letrozole is a drug that works in a similar way to clomid but it is a newer drug, more effective and a lower risk of multiples. Its especially more effective if you have a higher BMI. When I had treatment for DD1 in 2020, it was still very new, but I think lots of hospitals have switched to letrozole over clomid now.

Our family is probably complete now (we think!) so I've not gone back onto metformin after having DD2, but I have kept up with the inositol and I do feel like its making a difference to my cycles.

thank you. I do hope the metformin helps us to conceive. My BMI is 26. I’m 5”3 and weigh 68kg but find it hard to lose weight. I also have an autoimmune condition (hashimotos). I would be happy even just to have one child as we prioritised our careers over children and I feel sad about that. We have two dogs which help tho.

do you think metformin will help or is it better to try the letrozole? Appreciate ur not a medical professional and apologise for bombarding with questions lol, but this is a v new journey for me and I’m always to hear other peoples experiences in a similar boat. If you’d prefer to DM me you’re welcome to if you’d rather it was confidential.

thanks x

I’m sorry you are going through this shit. Been there. I was put through numerous tests, medications, etc over years - you name it, they tried it with me. Most worked for a short time then the flooding started again. I was lucky to have a job where I could WFH (years before Covid, lol) when things were so bad I literally couldn’t get through sanitary products fast enough. It was grim and affected my self esteem. Eventually I had surgery (a uterine ablation) which totally solved the problem - I didn’t have kids in the end though. I have pets instead, lol. I guess what I’m saying is, yet again, women’s health is under researched in this area, and it seems very much trial and error - some drug may work for you, and you may need to work at it, to find it. I hope you have a good, sympathetic doctor on side. Good luck with it, I hope you find something that works for you.

You can do metformin and letrozole at the same time, so i don't think it haa to be either / or (unless the hashimotos makes a difference). We were in our early and mid 30s when ttc so we decided to just try everything. I started metformin and the endo referred me to fertility at the same time. They obviously have a process to go through as well so I just kept going with the metformin whilst we went through all of their tests, scans etc. (Although if you are going private it will be much faster than NHS I'm sure!) We did 3 rounds of letrozole - the first one didnt lead to ovulation, the second round we upped the dose and I ovulated but no pregnancy and the third round was the same dose as the second and was successful. Then I came off the metformin at between 12-16w pregnant i think? on the advice of the endo.

Honestly, sending you such good luck. I think there are some hashimotos / conception / pregnancy threads as well so might be worth looking up those as well if you havent already done so?

Thanks v much.

Yes, I’ll have a look at those threads too, but also need to limit the pregnancy and ttc threads as also find them a bit triggering too 😖

I am mid 30s.

Thank you dear. I’m sorry you went through it as well. It is horrendous. I work 4 days from home, and 1 day in the office. It’s honestly the worst, I dread coming in to work when I’m on my period as fearful I’m going to leak!! I am even on iron supplements because it led to iron deficiency.
I barely got much help from the NHS, they’ve really disappointed me. To the point I dread speaking to male NHS GPs. I fortunately got a new job last yr that included private health cover, so it’s when I went private that I finally got some help and proper investigation.

The healthcare system absolutely lets down women. We are constantly gaslit, and patronised and fobbed off.

It’s really affecting my self-esteem as well and limiting what I can do. I’m only 35. I’ve been having these issues since I turned 30. I’m reaching the point where if we aren’t successful in conceiving, I want to have some kind of surgery too…