Hi Joy.  If her hemoglobin and hematocrit are within normal limits, I
wouldn't do anything.  If she is anemic, however, I would start her on the
"mini" pill plus use condoms.  The result would probably be a marked
decrease in flow, but may also have break through bleeding which can be
annoying but not serious health wise.  Actually, since she is nursing,
using the mini pill will probably prevent a pregnancy completely as long as
she takes it at the same time every day.

Basically, must look at her H&H to determine if the heavy menses are really
something to be concerned about.  If continues ( with no TX) , recheck
every 3 mo, because the accumulated blood loss usually takes a while to
show up.

Hope this helps.

Jude Kurokawa, CNM
Wolf Point, MT
Mailto: [log in to unmask]
A Coyote midwife sits by the hole and waits....

Only Cowards cook on low.

----------
> From: joy <[log in to unmask]>
> To:
> Subject: MENSTRUAL PROBLEMS DURING LACTATION
> Date: Saturday, October 18, 1997 10:52 PM
>
> hi!
>
> I've been looking for any mention of this problem and the
> reasons/solutions in my textbooks and haven't had any luck - hoping the
> collective lactnet brain can help me out! - thanking you all in advance!
>
> Mother, 29, first baby is 10 months old and breastfed with solids as
> desired - about 5 breastfeeds daily and baby doing fine.  Mother had
> regular and light to moderate menses prior to falling pregnant.  Menses
> returned when baby 3 months, and have occured monthly since then.
> However, each has been much heavier than she is accustomed to - enough
> to stop her going out, frequent changes and double-pads.  She has had a
> previous ectopic pregnancy whilst on the minipill (oestrogen
> contraindicated because of history of spontaneous venous thrombosis) and
> is not at all keen on using this again.  (using barrier methods).  Her
> heavy menses are enough of a problem on their own to warrant
> intervention but I have not been able to think of a solution as yet -
> also i would like to understand why? - she is otherwise very well and
> clinically no systemic illness - blood results awaited.  Ideas??
>
> Many thanks!
>
> Joy MBBS DRACOG Albany, Australia
> (in early stages of learning about lactation issues and really
> appreciate
> the info and ideas i get from lactnet!)
>