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 when women enter their forties, as the hormones start to become dysfunctional. Other common symptoms seen are

• Severe bleeding with frequent changes of pads & tampons needed.
• Needing to use two types of protection at once.
• Having to change protection at night, oe being woken from sleep.
• Prolonged periods lasting 7 days or more.
• Passing clots with the period. These clots may be small but can sometimes be surprisingly large.
• Tiredness, weakness, light-headedness and anaemia. These are 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 internal or pelvic 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 highly effective permanent treatment for periods – contraception is still needed – we 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.

 
 
A video showing a Novasure endometrial ablation
 

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Come and see us. Glengarry Private Hospital is a friendly medium-sized hospital in the Northern suburbs in Duncraig, very near to the freeway, midway between Joondalup and Osborne Park Hospital.