What are heavy periods?
Heavy periods can occur on their own or in combination with other symptoms, such as period pain (dysmenorrhoea). The amount of blood lost during a period varies from one woman to another, but the average blood loss during a period is two to three tablespoons. Periods are generally regarded as heavy when the blood loss is regularly more than this and they interfere with every day life.
Specialist in treating heavy periods
Mr Burrell has a special interest in treating women with heavy periods (menorrhagia) and offers conservative treatments as well as the latest advances in endometrial ablation.
Symptoms of heavy periods
Women with heavy periods may typically:-
- Need to change a pad or tampon every one to three hours
- Need to use both pads and tampons at the same time (double protection)
- Need to change pads or tampons during the night
- Pass large blood clots
- Bleed through clothes or bedding (‘flooding’)
- Be anaemic
Conditions that can cause heavy periods
The exact reasons why periods may become heavy aren’t fully understood, however there are certain conditions that can make them more likely such as:-
- Fibroids or polyps (growths of tissue) in your womb
- Endometriosis – a condition in which cells that normally line the womb grow outside the womb in other parts of the body
- Pelvic inflammatory disease – an infection of the reproductive organs, usually caused by a sexually transmitted infection (STI)
- Polycystic Ovary Syndrome PCOS – a condition in which the ovaries aren’t working properly
- Bleeding disorders
- An underactive thyroid
- Medications such as anticoagulants
Heavy periods and/or irregular menstrual bleeding can be investigated and if required there are a number of treatment options available. These may include treatment with medication, insertion of a Mirena coil, an endometrial ablation (a modern minimally invasive surgical technique) or a hysterectomy.
A pelvic examination will be performed together with an ultrasound scan to check for any cause of the bleeding such as endometrial polyps or fibroids. Depending on what these reveal the following may also be performed:-
- Blood tests
- An endometrial biopsy – a small sample of the womb lining
- A hysteroscopy which uses a small telescope to look inside the uterus
Heavy Periods Treatment Options
Medicines such as the combined oral contraceptive pill or Tranexamic acid can help with heavy bleeding and heavy periods.
Heavy Periods – Information
Mirena is an intrauterine system (IUS) commonly known as a coil. It is a small plastic ‘T’ shaped device which works by slowly releasing a hormone similar to the natural progesterone that your ovaries produce. Mirena is a good first choice for women also requiring contraception. It works by thinning the lining of the womb and can therefore be very effective in treating heavy periods. It can also significantly improve period pain. Generally you would expect to see a reduction in blood loss after 3 months with the maximum benefit 6 months after insertion.
Endometrial ablation is a procedure that destroys the uterine lining (endometrium) and is used to treat dysfunctional or abnormal bleeding in women who have completed their family. It can be a very good alternative to hysterectomy for many women although it isn’t suitable if you have large fibroids, in which case a hysterectomy may be necessary.
Hysterectomy is a surgical procedure to remove the womb (uterus) which is carried out to treat conditions that affect the female reproductive system, including:
- Heavy periods (menorrhagia)
- Long-term pelvic pain
- Non-cancerous tumours (fibroids)
- Ovarian cancer, uterine cancer, cervical cancer or cancer of the fallopian tubes.
There are different types of hysterectomy & the type performed will depend on the reason for the surgery and how much of the womb and reproductive system can safely be left in place.
- Total hysterectomy, where the womb and the cervix are removed
- Subtotal hysterectomy, where the womb is removed but the cervix is left in place – this can often be done with keyhole surgery
- Radical hysterectomy, where the cervix and surrounding tissues including the womb and part of the vagina are removed
There are also different ways in which a hysterectomy can be performed
- Vaginal where the womb is removed through the vagina
- Abdominal where the womb is removed through a cut in the abdomen
- Laparoscopic where a few small incisions are made in the abdomen & the womb is removed through one of these.
If it possible for a hysterectomy to be performed laparoscopically it has significant advantages over a vaginal or abdominal hysterectomy i.e.
- Less Blood loss
- Less pain after the operation
- Shorter stay in hospital (approx. 1-3 days)
- Faster recovery time (1-2 weeks instead of 4-6)
- Minimal scarring.
The ovaries are usually left in place because they produce oestrogen. If the ovaries are removed this will induce the menopause. After a hysterectomy, you will no longer have periods or be able to become pregnant.