Can Progesterone mini pill be used for heavy menstrual bleeding instead of having a coil or hysterectomy?

Hi doctor,

My periods have always been heavy. I have been on blood thinners for five years. I am on the following medications: Apixaban 2.5 mg, Quetiapine 200 mg, Estrogen 75 mg, and iron tablets for heavy bleeding. I have undergone a hysteroscopy and two internal scans, both of which were clear.

I had my period at an early age. From this early age up until I was 35 years old, my periods would last for seven days and be very heavy, and then I would have spotting for five days. My periods were reasonably on time. I had given birth to two boys by C-section, and I lost one son due to pre-eclampsia.

I also suffered from a blood clot long ago. When I hit 40 years, my periods went down to three days, still very heavy, and I would spot for four days. My GP back then thought it was perimenopause, and I had a coil fitted, after which I had no periods.

Everything was fine until last year when I suffered an unprovoked blood clot. The hospital put me on 20 mg of Apixaban, which caused extremely heavy periods and resulted in me being anemic. I was told this was a gynecology problem, not hematology. I was referred to a gynecologist who was horrific.

A male doctor had no respect and treated me like a piece of meat. He said I had thickening, which was hormone-driven. He said I had to have the coil or a hysterectomy, from one extreme to the other. He sent me for an internal scan, which was clear, and a hysteroscopy and biopsies, which were all clear.

A coil was fitted but slipped, so now I face going back to gynecology, hopefully, women, but I do not want a hysterectomy. My question is:

• Could I stay on the Progesterone mini pill? As that has always helped, and I have had no problems.
• Do I also have to use estrogen gel?

I really need some advice.

Thank you.

Kindly help.