Heavy periods – Dr Mark Sillender – Glengarry Private Hospital

Heavy periods and/or painful periods are common in the years after they start and in the years leading up to menopause. These bad periods can be painful or painless. They can also be very irregular, or come very frequently. There may be spot-bleeding in between the bad periods. Often there are clots passed. These clots can vary from small to very large. Some clots can be the size of a hand for instance. Flooding can also occur as well as clots. Flooding occurs when there is too much blood to even clot properly and is a sign of very heavy bleeding.

Firstly, if you’re over 40 years, or have irregular spotting, we need to rule out conditions such as polyps or abnormal thickening inside the womb. Occasionally cancer of the womb is found. Ultrasound can be helpful but doesn’t always detect subtle causes of bleeding, for instance small endometrial polyps. At the same time as we’re finding out what’s going on, usually by hysteroscopy, we can offer a couple of treatments at the same time as the assessment. Both the two following gyno treatments have good satisfaction rates, and add little to recovery times; recovery is rapid. They are usually completed as a day procedure at Glengarry Private Hospital.

Mirena

Mirena is a device that is placed in the womb for up to 5 years. it releases a small dose of hormone which “turns off” the womb lining. It’s very safe, and is also an excellent contraceptive. The main drawback is irregular bleeding for the first few months – this usually settles. Two-thirds of women are happy with the method.

Endometrial ablation

Endometrial ablation where we treat the lining of the womb just after doing a hysteroscopy. An ablation is irreversible. Recovery is usually rapid (1 week), complications are unusual, and satisfaction high (90%); most women go home same day. You still need to think about contraception, so it’s good for women who have been sterilised or who have partners with a vasectomy. If you would prefer, we can always do a sterilisation by keyhole surgery at the same time as the ablation.

Hysterectomy

There are various types of hysterectomy, each with their own benefits and drawbacks. Not everyone will be suitable for each type of hysterectomy.

Medical therapy

The contraceptive pill, anti-inflammatory medication, and medication to enhance clotting can be used to help the periods.

Painful periods

Periods may be painful simply because they’re so heavy (primary dysmenorrhoea) or because of other conditions such as endometriosis and adenomyosis (secondary dysmenorrhoea). Endometriosis may be treated using keyhole surgery. Adenomyosis is trickier, but the Mirena can often be helpful for pain due to this condition, as well as treating heavy or bad periods.