Heavy Periods (menorrhagia)
This is defined as menstrual loss of greater than 80 mls with each period. It affects more than 1 in 5 women. Heavy periods is one of the most common causes of iron deficiency anaemia in western women.
Periods are considered to be heavy when:
- Menstrual flow that interferes with your regular activities e.g. becoming house bound due to the heavy periods
- Periods that last longer than eight days
- Menstrual flow that soaks through one or more tampons or napkins every hour for several consecutive hours
- Menstrual flow that includes large blood clots
- Anaemia causing tiredness
Causes of heavy periods:
The commonest cause in the younger age group is due to an hormonal imbalance or dysfunctional uterine bleeding (DUB)
Pelvic pathology
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Investigations
- Blood tests - to exclude anaemia
- Ultrasound scan - To exclude uterine polyps or fibroids. Assessment of the ovaries are also made
- Endometrial biopsy - a sample of endometrial tissue that is obtained to be examined under a microscope.
- Hysteroscopy- Assessing the lining of the uterus
Treatment
This is based on the patient's age, contraceptive wishes and the severity of the heavy periods.
Medical
- Oral contraceptive pill
- Tranexamic acid
- Mirena coil
Surgical
- By removing the lining of the uterus by ablation ie. Novasure Endometrial ablation. This procedure has a high success rate and may be performed under sedation with local anaesthetic.
Hysterectomy
- Laparoscopic (key hole surgery)
- Abdominal
- Subtotal or partial (conserving the cervix)
- Vaginal
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