09/17/2026
If you are planning your week around how close you are to a bathroom, changing a super tampon every 60 minutes, or waking up to ruined sheets, please hear me: heavy bleeding is common, but it is never something you just have to live with and should not be considered "normal."
First, your non negotiable lab check:
Ask your provider for a serum ferritin test, not just a standard CBC . A normal hemoglobin only shows that you are not in full blown anemia yet. It tells us nothing about your storage tank. If your ferritin is sitting below 30 to 50 ng/mL, your iron reserves are depleted . That is why you feel exhausted, dizzy on stairs, foggy, or notice hair shedding .
Second, your treatment toolkit. You have so many real options between "doing nothing" and major surgery:
🩸 Scheduled NSAIDs: Starting high dose ibuprofen or naproxen right as bleeding begins can lower prostaglandin levels and reduce flow by up to 30 percent or more.
🩸 Tranexamic acid: A non hormonal prescription pill taken only on your heaviest flow days that can cut blood loss by roughly 40 to 50 percent .
🩸 Micronized progesterone: Oral, body identical progesterone taken cyclically to stabilize erratic perimenopausal cycles and thin the uterine lining .
🩸 Synthetic progestogens: Oral options or injections that deliver stronger, continuous suppression of the endometrium . 🩸 Levonorgestrel IUD: Placed in the uterus to deliver localized progestin right where you need it, often cutting bleeding volume by over 80 to 90 percent .
🩸 Endometrial ablation: A quick procedure to treat the uterine lining if you are completely finished with childbearing .
🩸 Surgery: Structural options like uterine artery embolization, myomectomy, or hysterectomy when fibroids, adenomyosis, or severe bleeding require definitive care .
You deserve to have your iron stores protected, your bleeding controlled, and your energy back.
Save this post so you have this checklist ready for your next appointment, and tell me in the comments:
Have you had your ferritin checked recently? What was your number?
