Heavy periods

Menorrhagia (heavy period) is a condition of abnormally heavy or prolonged menstrual bleeding. Uncontrolled/untreated menorrhagia may cause blood loss and pain that impacts on your usual activities.

Symptoms

The Most Common Symptoms of Menorrhagia are:

  • Severe menstrual flow that necessitates use of multiple pads every hour for several consecutive hours
  • The need to use double sanitary protection to control the flow of blood
  • Disturbed sleep  or frequent awakening in night to change your pad
  • Prolonged bleeding period for more than 7 days
  • Large blood clots in the menstrual flow
  • Fatigue, weakness or shortness of breath

Causes

  • Dysfunctional uterine bleeding (periods are heavy and no other cause can be found)
  • Uterine fibroids (noncancerous tumours of the uterus)
  • Uterine/endometrial polyps
  • Adenomyosis (endometriosis in the muscle wall of the uterus)
  • Hormonal Disorders
  • Rare causes. In rare cases, conditions such as endometrial hyperplasia (abnormal overgrowth of the lining of the uterus), cancer of the uterus, bleeding disorders, or the use of medications can cause heavy bleeding.

Investigations

May include the following:

  • A pelvic examination (an internal vaginal examination).
  • Pelvic ultrasound scan.
  • Hysteroscopy – a procedure that involves placing a tiny tube with a light source through your cervix to obtain a direct view and a biopsy of the lining of the uterus.

Treatment options

Treatment options will depend on the cause of menorrhagia, the severity of menorrhagia and the overall health status of the patient.

Some common treatments

  • Iron supplements may be started if you also have anaemia
  • Nonsteroidal anti inflammatory drugs (NSAIDs) may help reduce menstrual blood flow as well as cramping
  • Tranexamic acid – a medication which works by making clots that line the uterus and limit bleeding. Tranexamic acid is taken three or four times a day during the period, and can reduce bleeding a great deal.
  • Oral contraceptives may be given to help reduce bleeding and your menustrual cycle more regular
  • Hormonal preparations such as oral progesterone may be given to correct hormonal imbalance and reduce menorrhagia
  • Insertion of intrauterine MIRENA coil
  • Surgery may be needed if medication therapy is not successful.