Heavy sudden bleeding with Mirena at 44, no pain or clots

[AgualusasL0ver]

I have read a number of the other threads on heavy bleeding, and all seem to have slightly differing circumstances. I know a doctor is the only one who can actually help with the cause, the reason I haven't called 111/101 yet is because I have no other symptoms whatsoever. Salient info.

• 44, and due to other reasons, mostly emotions related I think I am definitely peri-menopausal at least.
• today a significant amount of blood, very dark red and so much, the bathroom looked like someone had been shot.
• in 3h I have soaked through, destroyed the bathroom and ruined my knickers 3 times.
• I haven't noticed any clots but when I get to the toilet there is a sound of the blood hitting the bowl as if it is clotted, but checking is had because it keeps trickling down my legs even if I stand for one second and then the water is so red I cannot see
• no cramps, no pain.
• I can feel it leave my body very acutely.
• previously smear tests have shown polyps but I was totally oblivious so gynae didnt suggest removing them.
• mirena coil of about 2 years, to control migraines which they felt were hormonal.
• After some reasonable bleeding at the beginning and on and off very light bleeding with the mirena (sometimes I can have a small amount of blood at 1am and by 6am no blood, that on and off).
• This doesn't feel like a period as I normally do have a headache/migraine around the same time which alerts me.
• My mum (appreciate she is not me) said she had very heavy flooding for a time during menopause.

I'm reluctant to be told by 111 go and get seen due to the long wait time and need to be near a toilet that is my own. I can see a GP on Monday and/or use my health insurance to see a gynae.

I think def call 111. I have had very heavy bleeding with morten and it was my body flushing it out. I have another one now and it is ok so far. My fear would be it’s moved and is in a tricky position causing bleeding and/or has perforated something. 111 / GP may refer to you hospital for ultrasound.

just been again and some small clots this time and a very heavy thud

Thanks - I think I will have to call

Hi, you may have decided what to do by now but just giving my opinion, as a healthcare professional specialising in contraception.
I would class sudden very heavy bleeding to this degree as a medical emergency no matter where you were bleeding from, and would go to A&E now. It’s true that heavy bleeding/flooding can be part of perimenopausal symptoms for some, but it’s unusual when the Mirena has been in place for 2 years with a pattern of light bleeding established. Various more serious causes of the bleeding need to be ruled out such as miscarriage, ectopic pregnancy, perforation of the uterus, gynae causes etc. before putting it down to perimenopause. If you carry on bleeding at this rate it won’t be long until you become generally unwell with low blood pressure/shock. Is somebody with you?

Thank you, I am going to call now and then suspect go in and get seen

Maybe take a pregnancy test. It is possible to get pregnant but you need to be screened for ectopic if you have any type of coil. Also how long have you had your coil for. After 5 yrs the hormone affect wears off so you’re more likely to bleed.
With heavy blood loss it is important to seek medical advice though. There are other complications that need investigating.
If 111 send you to A&E they are likely to do a pregnancy test first.
My DSis became pregnant with the Mirena and it was treated as an emergency to rule out ectopic. She went through miscarriage, this is what the coil is designed for. It stops the uterine lining from thickening so implantation is not really possible, if there is plantation the coil physically disrupts it leading to very early miscarriage. Tends to happen more often after the coil has been in for 5+ yrs Shen the hormone is depleted.

Is it odd that I am in no pain at all, not even light period cramps

111 have insisted on sending an ambulance as they said they don't think I should be on public transport with this level of bleeding. I feel bad about this since I feel absolutely fine otherwise, but I was worried on the bus on the way back from my mums that sitting down would result in leaving a stain and standing up with it running down my leg (was in a dress).

Good luck OP. I am glad you are getting an ambulance. I hope you get seen quickly

Got home about an hour ago. The ambulance crew were two of the loveliest people I have ever come across and though it has been a LONG afternoon/evening I am so glad of the NHS.

They haven't diagnosed anything, but I was put on a drip for meds and was just able to have a shower and clean up without it looking like the mafia had been, so already working. Need to go back in the morning for actual course of meds and then back to gynae on Monday for a scan when we will know more, and then a treatment plan if necessary.

Thanks for the push everyone, I probably would have just sat here crying until the GP on Monday.

Glad you’re OK @AgualusasL0ver, been wondering how you were getting on. Sounds like the A&E team decided to prioritise dealing with your acute blood loss as a first step then will hand over to gynae to figure out the cause later, which I thought might happen on a busy Saturday! Hope you managed some sleep and that the bleeding has slowed/stopped for now.

Glad to also read you are ok.

You may well be prescribed northisterone. I had bleeding not too dissimilar to what you describe and what eventually ceased it altogether was endometrial ablation where the lining of the uterus is removed under GA. I refused the Mirena (Gps only suggestion apart from a blood test which came back normal) because I thought it would just mask the underlying issues causing the bleeding. It falling out was a distinct possibility too.

In my case a fibroid and constant rises and falls of both progesterone and oestrogen hormones arising from Endo and PCOS (I was diagnosed with both PCOS and endometriosis previously) were the root causes. You need a diagnosis first and foremost and hopefully the scan will reveal more.

Yes, hopefully Monday will produce some direction, once I’ve had the scan. I am knackered today and had to move my mothers days lunch with my mum, but she was with me the first time yesterday so understood.

Thankfully, the bleeding has stopped. I’ll have this appointment on Monday and then see if it’s worth switching to my work healthcare. They cover menopause in particular so probably worth it.

How did you get on with your scan OP? Hope you're well.

Hope the scan went okay, OP. x

Just seen these comments, thank you for asking. Scan was totally clear, an internal exam showed a polyp so they removed that. They said it 'might' have caused it. They took some swabs and am waiting on those, but there had no explanations or thoughts beyond hormones, which is frustrating. Nothing showed up immediately or obviously.

Thanks for he support.