Womens Health

Since I was 3 days after ovulation when the bleeding started, if I conceive this month, then conception had already happened before the bleeding started. So I guess what I'm really worried about is if the fertilized egg will be able to attach itself if I am steadily bleeding. As of today the bleeding has slowed but not stopped.

Implantation occurs about day 5-7 after fertilization. It implants in the uterus usually in the top or top-back on a very small area. I see why you are worried about the bleeding. If it continues heavy it could prevent implantation. It's still very possible, however, so just wait it out to see what happens.

47 y.o. with heavy clotting and pain each month (adenomyosis)

I am 47 years, and have had two children. I have always had pretty normal periods, although I was on the pill for 20 years. I have not been on the pill for about 6 years. Pap smears are normal.

For the last couple years, I have had really bad periods at least every third month. Then, last year, I started having heavy clotting, and pain every month. I went to a clinic and they said maybe I had endometriosis or cysts, or tumors...nothing specific....referred me to my ob/gyn. I never went, but it is really bad now.

Your age and with the above history, the most likely cause would be adenomyosis of the uterus. This is endometriosis interna or endometrial glands that go down into the muscle of the uterus.

At the time of menses the endometrial tissue in those pockets cannot get out of the muscle and it gives pain. Unfortunately, adenomyosis is a diagnosis of exclusion. Other causes of the heavy bleeding and pain need to be ruled out.

Your gyn doctor would probably recommend a vaginal ultrasound ( to rule out uterine fibroids or any ovarian cysts) with a saline sonohysterogram (injection of fluid into the endometrial cavity at time of ultrasound to detect any endometrial polyps or submucous fibroids).

If these are all normal, you could very strongly suspect adenomyosis as the main cause of your problems. Medical treatment for this at your age would be low dose birth control pills (if you are a non smoker) or Depoprovera injections to block your ovulation and menses until you become menopausal.

If any of the above studies suggest there is a mechanical cause of the bleeding or pain (polyps, fibroids, ovarian cysts) you will probably be recommended to have a D&C and hysteroscopy and possibly a diagnostic laparoscopy as outpatient surgery procedures.

Check out our menstruation forum to get more information about endometrial ablation.

Table of Contents
1. Abnormal Bleeding
2. Continuous bleeding
3. Bleeding and stress
4. Endometrial ablation
5. Spotting after sex
6. Coagulation problems
7. Bleeding stops implantation?
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