Pearl obstetrics | gynaecology


Heavy periods

  • Heavy periods
    Lots of good treatment options. Call us to discuss your choices.

Heavy periods – menorrhagia – Glengarry Private Hospital

Heavy periods or prolonged bleeding may cause blood loss and pain that interferes with work, relationships & activities. Heavy periods with clots are very common. Other common symptoms seen are

  • Severe bleeding with clots and frequent changes of pads & tampons.
  • Needing to use two types of protection at once.
  • Having to change protection at night.
  • Prolonged periods lasting 7 days or more.
  • Passing clots with the period. These clots may be small or sometimes surprisingly large.
  • Tiredness, weakness, light-headedness and anaemia. This is more likely when clots are passed, or flooding occurs.

 

Causes of menorrhagia

  • Dysfunctional uterine bleeding or DUB. Non-specific cause of abnormal bleeding. Common when the periods start, and leading up to the menopause. Probably related to subtle hormonal changes.
  • Fibroids – benign growths in the wall of the womb.
  • Endometrial polyps – benign growths in the lining of the womb.
  • Adenomyosis (endometriosis in the wall of the womb).
  • Abnormal hormonal stimulation eg. polycystic ovarian syndrome (PCOS), use of tamoxifen in breast cancer patients or thyroid disease.
  • Endometrial hyperplasia – overgrowth of the lining which can lead to….
  • …Cancer of the uterus
  • Use of blood thinners such as warfarin, or women with von Willebrand’s disease.

 

Useful tests

  • An examination
  • An internal (transvaginal) pelvic ultrasound
  • A biopsy of the lining of the uterus, to check for cancer.
  • Hysteroscopy – looking directly into the womb with a telescope, and then taking biopsies, or removing the cause of any bleeding.

 

Treatment options

Medical treatments for menorrhagia

  • Iron to replenish iron stores.
  • Nonsteroidal anti inflammatory drugs(NSAIDs) like Ponstan or ibuprofen may reduce bleeding & pain.
  • The pill may reduce & regulate periods.
  • Progesterone tablets or vaginal gel may regulate the periods (they don’t reduce the amount lost).
  • Tranexamic acid – can reduce very heavy bleeding in half.

 

Surgical treatments for heavy periods

  • Hysteroscopy, polypectomy & curettage – suitable for those with endometrial polyps. Mirena or an ablation can be done at the same time.
  • Mirena – Mirena is highly effective at reducing blood loss – takes a few months to work – lasts 5 years – 90% satisfaction ratings.
  • Endometrial ablation – ablation is a permanent treatment for periods – contraception still needed – can clip tubes at the same time – 90% satisfaction.
  • Myomectomy – suitable for those with fibroids who want to conserve fertility.
  • Hysterectomy – various types of hysterectomy exist – keyhole surgery usually offered. A permanent solution.

 


Heavy, prolonged or irregular periods

There are many causes, and many effective treatments. Give us a call.


PEARL obstetrics | gynaecology

Our office is situated opposite Glengarry Private Hospital in Perth. We provide easy free parking. We're easily accessible from Joondalup, Hillarys, Stirling, Currambine, Ocean Reef, Beldon, Connolly, Edgewater, Wanneroo, Burns Beach, Sorrento, Padbury, Marmion, Watermans Bay, North Beach, Karrinyup, Gwelup, Carine, Balcatta, Westminster, Mirrabooka, Malaga, Hamersley, Koondoola, Girrawheen, Marangaroo, Greenwood, Warwick, Madeley, Darch, Wangara, Kallaroo, Craigie, Heathridge, Woodvale, Scarborough, Doubleview, Innaloo, Osbourne Park, Wembley Downs, Tuart Hill, Trigg, North Beach. The Western suburbs (Cottesloe, Claremont, City Beach, Floreat, Swanbourne) are all within easy reach.