Menorrhagia (Heavy Periods)
Causes, Symptoms, and Treatments for Heavy Menstrual Bleeding.
May 20, 2009
Menorrhagia (heavy periods) are a common cause of poor health says Dr Lucy Caird, Consultant Obstetrician and Gynaecologist at Raigmore Hospital, Inverness. Around 1 in 20 women aged 30 – 49 will seek advice from their GP to help resolve them.
Causes of Menorrhagia
Potential causes of heavy menstrual bleeding include fibroids, pelvic inflammatory disease, PCOS, endometriosis, or polyps in the cervix or womb. However, in 40-60% of cases the reason is unknown, which is called ‘dysfunctional uterine bleeding’. They are thought to be a sign of hormonal imbalance.
Symptoms of Menorrhagia
In medical terms heavy periods are defined as a blood flow of above 80ml during each period. This can be difficult to measure but if you aren’t able to work or carry out daily activities as a result of your periods then they are defined as heavy. Other symptoms include: -
- Bleeding for seven days or more.
- Needing to change sanitary protection more than 10 times a day.
- Anaemia and tiredness. According to a 2005 survey by the NWHRC nearly 40% of women with menorrhagia develop anaemia.
- Blood clots and/or flooding.
Treatment Options for Heavy Bleeding
Your GP will carry out several tests to work out what is causing your heavy periods. A pelvic examination will check for any cell abnormalities. Blood tests will determine anaemia. If the cause is unknown you will be offered some form of treatment to help you manage your periods and prevent anaemia. Current treatment options include: -
- Hormone therapy – the most common hormonal treatment is the contraceptive pill. In 2007 the FDA approved Lybrel, a pill that stops a woman’s periods completely. However research has shown that the contraceptive pill is effective in around 50% of cases.*
- Non-hormonal therapy – Tranexamic Acid is a treatment that stops blood clots forming in the womb and reduces blood flow during menstruation.
- Mirena is a contraceptive coil that releases progestogen in the womb, which reduces blood flow.
- Endometrial Ablation treatments such as the NovaSure System, the most widely used method of ablation in the US. It involves minimal surgery - laser treatment to destroy the lining of the womb, which causes the monthly bleed. It can be done as an outpatient treatment and takes 4 ½ minutes in total. The American College of Obstetricians and Gynaecologists (ACOG) recommends it as a first-line treatment for women who have heavy periods and who have completed their families. Results of studies to assess its effectiveness have been positive.
- Hysterectomy – a final, irreversible procedure that involves removing the uterus and possibly ovaries. This is a final resort for most women and can have serious side effects such as early menopause.
References
*Cooper KG, Parkin DE, Garratt AM, et Al. British Journal of Obstetrics Gynaecology – Randomised comparison of medical and hystereoscopic management in women consulting a gynaecologist for treatment of heavy menstrual loss. 1997, 104:1360-1366.
This article is for general information purposes only. Consult your health practitioner for specific guidance on a health issue.
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