Heavy periods are common. In most cases no cause can be found. In some cases a cause is found such as endometriosis, fibroids, and other conditions (listed below). In most cases treatment is effective by using medication to reduce bleeding, or by surgery.
What is a normal period, a heavy period, and menorrhagia?
About 1 in 3 women describe their periods as heavy. However, it is often difficult to know if your periods are normal or heavy compared with other women. Some women who feel they have heavy periods actually have an average blood loss. Some women who feel they have normal periods actually have a heavy blood loss. Most of the blood loss (about 90%) usually occurs in the first three days with either normal or heavy periods.
Some medical definitions of blood loss during a period are:
- Menorrhagia means heavy periods that recur each month. Also, that the blood loss interferes with your quality of life. For example, if it stops you doing normal activities such as going out, working or shopping. Menorrhagia can occur alone or in combination with other symptoms.
What causes recurring heavy periods?
The cause is not known in most cases
This is called dysfunctional uterine bleeding and is the cause of heavy periods in 4 to 6 out of 10 cases. In this condition, the womb (uterus) and ovaries are normal. It is not an hormonal problem. Ovulation is often normal and the periods are usually regular. It is more common if you have recently started your periods or if you are approaching the menopause. At these times you may find your periods are irregular as well as heavy.
A chemical called prostaglandin may play a part. The amount of prostaglandin in the blood may be different in women with heavy periods. The lining of your uterus is more sensitive to the effects of prostaglandin, which results in heavier periods. In some women, the blood vessels that supply blood to the lining of the womb are larger (dilated), which then results in the blood loss being heavier. This dilatation is also thought to be due to prostaglandins in the body.
Do I need any tests if I have heavy periods?
I carry out following tests for heavy periods
1. Full blood count
2. Full and thorough pelvic assessment
3. Internal swabs to rule out pelvic infection
4. Pelvic ultrasound scan
5. Endometrial biopsy
6. Any other test which may become necessary as a result of the above tests such Hysteroscopy ( to look inside womb with camera)
Keeping a menstrual diary
It may be worth keeping a diary for a few periods (before and after any treatment). Please keep the record of frequency of periods, heaviness of periods, any associated symptoms.
What are the treatment options for heavy periods?
Treatment aims to reduce the amount of blood loss.
My approach is completely focussed on patients quality of life and trying to return to normality as soon as possible. I consider all the options to treat the problems however the order of the treatment options is completely individualised and bespoke with the availability of the most modern options.