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Disclaimer: period talk, blood

Anemic and Exahausted black lettering. Multiple red splatters in the backgorund.

My rheumatoid arthritis (RA) has been on the back burner for a little while. My biggest health concern since I moved across the country is severe, debilitating anemia. But, unlike many of my symptoms, I know why I am anemic.

Since April 2021, I have experienced abnormal menses. Let me be specific. Since April 2021, I bleed for 3 out of 4 weeks, every month. No, actually, let me take that back. My menstrual cycle is normal. I get my period at the same time every month, it lasts for the same amount of time and ends like clockwork. The abnormality lies with how much I bleed the rest of the month.

At first, I experienced intermittent blood loss. I’d bleed for a few days, it stopped, and then re-started 12-24 hours later. It was never “period heavy” but, it was still noticeable.

Let me preface this all by saying that I am very good at keeping track of my RA symptoms. I keep a food/medicine journal where I detail any symptoms, habits, and activities. However, I am absolutely terrible at tracking my period. I tell myself to mark it down, forget and that’s all they wrote. For three months I wasn’t entirely sure anything was wrong. I had an inclining but no certainty.

I moved in August 2021 and hit the ground running. Oddly, my period normalized for two months. This good fortune did not last, however because in October, I started to bleed for three weeks; but now, I bled in a big chunk with a heavier flow.

If I wasn’t anemic before I definitely was now. I had to sit for iron infusions. Due to scheduling conflicts, I did not start them until February 2022. I sat for one a month for three months. My blood levels increased. But, only for a little while. Soon, my hematocrit and hemoglobin plummeted once again. I had full blood panels done. My levels were normal, including my thyroid and hormones. My specialists couldn’t figure out what was wrong. I went to my primary nurse practitioner (NP) who referred me to a gynecologist. She made a great point that even if I sat for an iron infusion every month it would never counter the continuous blood loss.

The gynecologist did a pelvic exam and an ultrasound and everything was normal. There were no polyps or cysts, no inflammation or anything that could explain the bleeding. So we started to think of solutions. I couldn’t continue this way. I was exhausted. I fainted when I stood up and my extremities went numb if there was pressure on them. So, we started a list:

hormonal birth control pills? No.

I had used them a little while before due to an ovary issue (a different story) but get this, they made me bleed EVERYday! That was not an option. What else?

An IUD? Tried it (updates to come)

It did not work.

The third option?…Sterilization.

And, what’s funny is I always wanted to get a hysterectomy (uterus & cervix removal). I never wanted to birth a child. I would much rather adopt or foster. I do not want to take the chance of passing on my chronic illness genes to another person.

Ideally, I’d wait on the hysterectomy because it is an invasive surgery and I have an autoimmune condition. There are a lot of risks and my recovery is at least 50% longer than the average healthy person. Time is a factor. Do I have the time (with school and work) to lay up for 8+ weeks?) No. I wanted to wait until after vet school. It was always an elective surgery I wanted in the future. I never thought it would be a medical necessity.

Now, here’s the thing. Insurance in this state is shit. It doesn’t cover my medications and barely covers my RA infusions. It won’t cover the surgery even if it’s medically necessary. I just cannot afford a big surgery right now, point blank. As much as I need this surgery it will have to wait.

Here’s the problem. I’ve hit a critical point. I now bleed heavily for three weeks (“period heavy”). I am in school and I need to be alert and functional; which I cannot be while so anemic. It also puts me in a vulnerable position to catch colds, flus, coronaviruses, and other nasty illnesses. At this rate, I will continue to feel more and more ill. I need/WANT relief.

It kind of bothers me that I don’t know why this is happening. I believe that everything has a reason yet we cannot figure this out. I tend to blame everything on my chronic illness so I am going to do that again. I don’t know how but this is the RA’s fault! Here’s the thing, though. Plenty of females have inflammatory conditions, take the same medications I do, and do not experience such torrential menstrual cycles. Maybe this time it’s not the RA. I want to find the cause for this bleeding but mostly, I want a fix. I have had my fair share of periods and I am so over them. If I never had one again, I would be on cloud nine.

Hi, my name is Monica and I have RA.