Your Health Blueprint

The situation

You have had prolonged abnormal uterine bleeding and pelvic pain that started after a stressful episode and persisted through multiple procedures, including hysteroscopy, two D&Cs, and trials of norethindrone and then medroxyprogesterone. Bleeding continued despite treatment, and pain became severe enough for an ER visit when you were doubled over and your lips looked blue.

ER imaging showed a heterogeneous uterus with concern for adenomyosis versus other abnormal tissue change; the CT report said a neoplastic cause could not be excluded and recommended pelvic MRI. A prior lumbar spine MRI showed disc herniations at L4-5 and L5-S1 with nerve root impingement, which can cause back or leg nerve pain but does not explain uterine bleeding.

The conventional medicine view

From a standard medical perspective, the main issue is ongoing abnormal uterine bleeding with pelvic pain, plus imaging that needs further clarification. Common explanations clinicians would continue to evaluate include:

• Adenomyosis
• Endometriosis
• Recurrent or missed uterine polyps
• Endometrial overgrowth or other tissue changes that need biopsy to rule out

A clinician would typically discuss:

• Pelvic MRI for better tissue detail
• Endometrial sampling/biopsy if not already done or if results are incomplete
• CBC and iron studies to check for anemia from long bleeding
• Review of how well the current hormone treatment is working

Your spine MRI is a separate issue, but it could explain low back pain, leg pain, numbness, or sciatica-type symptoms. It would not usually cause persistent uterine bleeding.

The holistic & functional view

A functional lens would look at how stress, nervous system sensitization, sleep disruption, and iron depletion may be worsening both pain and cycle instability. The long bleeding itself can also leave you depleted, which can make pain feel harder to tolerate.

Daily practices to consider:

• Track bleeding, pain, and medication timing daily — good evidence for helping clinicians see patterns and treatment response.
• Prioritize sleep, hydration, and regular meals with iron-rich protein — limited evidence, but helpful for energy and recovery during prolonged bleeding.
• Use gentle movement, heat, and paced breathing when pain flares — limited evidence, but often helpful for pain modulation and stress reduction.

The traditional & herbal view

No specific herbs or supplements were discussed in the transcript, so there is not enough here to give a useful herbal summary. Because your imaging raised concern that serious causes must still be ruled out, any herbal plan should wait until your pelvic workup is complete.

Questions for your doctor

1. Could my pelvic pain be from adenomyosis/endometriosis, or could any of it be referred pain from my lumbar disc herniations?
2. Do I need a pelvic MRI and endometrial biopsy/sampling to rule out concerning tissue changes?
3. Why is the bleeding continuing despite progesterone treatment, and what does that suggest?
4. Should I have CBC, ferritin, and iron studies checked now?
5. Does the blue-lips episode suggest I need any evaluation beyond gynecologic causes?
6. What non-surgical options are realistic if I want to avoid hysterectomy?

Sensible next steps

1. Arrange prompt follow-up for the pelvic MRI and review of the CT/ultrasound wording.
2. Ask about biopsy/sampling if it has not already been clearly addressed.
3. Check for anemia and iron deficiency if not recently done.
4. Keep a symptom log of bleeding amount, pain level, and timing of hormone doses.
5. Seek urgent care sooner for heavy bleeding, fainting, shortness of breath, chest pain, blue lips, fever, new leg weakness, saddle numbness, bladder/bowel changes, or uncontrolled pain.

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