Q: I am a 32 years old female suffering from excessive bleeding during periods. I am a mother of two and this problem started eight months after my first delivery. I am taking medicines for the last seven years to keep thyroid levels under control. Also, after my second delivery, I started having spotting on my day of ovulation. Nothing has come out in the scan. Why do I bleed so much during periods? How can this be treated?

A:If there is no problem identified on clinical examination and scan is normal, your symptoms could be hormone related. Your symptoms have nothing to do with your childbirth. It may be worth trying combined oral contraceptive pills. These pills will work by inhibiting ovulation. Therefore you will not have any ovulatory bleed. If you take three packets of pills back to back (i.e. without taking the 21 day break which the manufacturers would recommend), you should have no periods for three months while you are on the pills. After three months when you get your periods, you may take some other preparations (such as tranexamic acid and mefenamic acid) to reduce the volume of blood loss. You may try this for a few cycles after which try to stop the pills. You may restart the above treatment cycle if your symptoms return after stopping the pills. Mirena coil is a very effective treatment for problems such as yours. I am not sure what side effects have put you off. You certainly do not have to undergo hysterectomy (removal of uterus) at your young age. There are many other treatment methods, which you can pursue before going for a radical procedure such as hysterectomy.