Heavy periods: Your expert guide

In this informative article, we hear expert insight on heavy menstrual bleeding from leading consultant obstetrician and gynaecologist Ms Sharon Griffin. The leading specialist discusses how periods are determined to be heavy, potential underlying causes and the available treatment options.

How are a woman’s periods determined to be heavy?

Heavy periods are subjectively assessed by each individual woman, however when a woman's period interferes with her work and social life, they should be regarded as problematic.

Women often report excessive flow not controlled easily by sanitary protect causing flooding and leakage. There is often associated clotting. This can mean a woman may change her routine, prepare with extra clothes, or struggle with needing to get up at night time.
 

Can heavy menstrual bleeding be associated with underlying conditions?

Heavy bleeding can be associated with benign conditions such as fibroid, polyps or associated with adenomyosis or endometriosis. Rarely it can be due to clotting disorders that increase bleeding.
 

What can happen if heavy periods are left untreated?

If left untreated, heavy menstrual periods can lead to anaemia which can develop slowly leading to extreme fatigue and exhaustion. If extremely severe, this may require management with iron infusion therapy, or even blood transfusion.
 

What types of tests may be performed?

Investigations often include blood tests to exclude anaemia and thyroid disease. A pelvic ultrasound can assess for fibroid or polyps that would require treatment. Depending on the investigation, a hysteroscopy (telescopic examination of the womb lining) may be required. This allows a direct look at the lining, and can be combined with removal of a polyp or fibroid, and insertion of hormonal devices.
 

What types of treatment are available?

For some women, treatment will be simple tablet therapy such as tranexamic acid. Some will use hormonal contraceptive tablets to help regulate and reduce flow. Additionally, a hormonal device insured into the uterus can stop periods or significantly reduce the flow.

Surgical treatments other than removing a polyp or fibroid would include an endometrial ablation which cauterises the lining of the uterus and aims to reduce or stop periods. A definitive surgical approach is a hysterectomy.

Can periods become heavier with age?

Periods tend to get worse with age and cycle control can be lost leading to prolonged irregular bleeding especially in perimenopause.



To schedule a consultation with Ms Griffin, visit her Top Doctors profile today.