Heavy Periods and Menstrual Bleeding Treatment

Heavy Menstrual Bleeding (HMB) or Menorrhagia is classified as vaginal bleeding which continues for more than 7 days. Most women who suffer from HMB need to change a tampon or pad after less than 2 hours. Some women also pass large blood clots.

It is more common in women over the age of 35, and when women have stopped using the combined oral contraceptive pill. I also see many young women who have developed HMB, and there are many effective treatments, targeted at the underlying problems.

When HMB is also left untreated, will affect the quality of your life, and can leave you not only tired, but will lead to becoming anaemia.

The causes of HMB

Fibroids: Benign Growths or tumours which grow in the uterus. They can increase the size of the uterine cavity which will result in heavier periods.
Polyps: which grow from the endometrium, the lining of the uterus.
Copper Containing IUDs.
Hormone-related problems: anovulatory periods, where no eggs are produced. (PCOS related) and Thyroid disease.
Bleeding-related disorders, such as von Willebrand disease (VWD) or problems with platelet function disorder.
Pelvic inflammatory disease.
Endometrial cancer (uterine cancer)

Key Points

HMB is common and affects over 30% of women.
Many will suffer from Iron Deficiency anaemia and exhaustion.
Hypothyroidism is often associated with HMB.
Many women affected by HMB do not seek medical support, and HMB continues to be underdiagnosed and is poorly treated.

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I offer patients a full blood count, ferritin levels, and an ultrasound scan. I will perform a detailed ultrasound scan to assess the uterine cavity and for polyps and fibroids which can cause HMB. I may perform an endometrial biopsy to assess the endometrium.
For most women who suffer with significant HMB I will also perform either a hysteroscopy or a MyoSure procedure as both a diagnostic and therapeutic procedure.
Young women respond well to the Combined oral contraceptive pill, the Mirena IUD coil, and to Tranexamic acid. I often advise iron supplements.
Women with submucous fibroids and polyps can be successfully treated with Myosure, and for women who have completed their family a NovaSure procedure is an excellent treatment.

HMB will reduce the quality of your life, being tired, becoming chronically tired, and these symptoms disappear with correct treatment.
Anaemia can put you at risk of infection, and other diseases and this is reversed with iron therapy and medical treatment.
A MyoSure procedure will stop heavy periods from polyps and submucous fibroids.
Mirena Coils are at least 80% curative, and a NovaSure procedure has a 95% success rate.

I am 24 years old, and have started to experience painful heavy periods for the first time What should I do?

This is a common condition, and it is important that you ask your GP to measure your FBC and Iron levels, and also arrange a scan. Tranexamic acid and the combined oral contraceptive pill are excellent medical treatments, and will improve your symptoms.

I am 36 years old and have completed my family, my periods are ghastly, what treatments are available for me?

You will benefit from a FBC and Iron levels, and a scan. Most women can be medically managed with Tranexamic acid and or a Mirena coil. You also could opt for a NovaSure procedure.

I am 56 years old and still having excessively heavy periods. What should I do?

You need to ask your GP to refer you to a Gynaecologist, who will investigate your bleeding, by scan and either by a hysteroscopy or an endometrial biopsy. Because of your age, you are at a higher risk of uterine cancer, and this needs to be excluded.

I am 45 years old and recently had a tubal sterilization. My periods are now much heavier. Why? I had been taking the combined pill for many years and stopped after the sterilization.

This is very common, the combined pill resulted in light withdrawal bleeds. Tranexamic acid will help you.

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