Heavy Periods / Menorrhagia
How many women suffer from heavy periods?
About 5 per cent of women between the ages of 30 and 49 see their doctor each year because of heavy periods. However, in one national survey, 31 per cent of women described their periods as heavy. Most women lose between 30 and 40ml (six to eight teaspoonfuls) of blood during each period. It is very difficult to know whether your own period is heavier or lighter than this, as it is impossible to measure blood loss accurately. However, If you are passing large clots, or find that you need to change towels or tampons more than every two hours, you may want to ask your doctor for advice. Some women find that their periods come more or less frequently than every four weeks, or that they bleed for more than five to seven days. This can be quite normal. However, If you get bleeding or spotting (very light bleeding or brownish discharge) between your. normal periods, or after intercourse, or after you have reached the menopause and stopped having periods altogether, you should see your doctor.
Most women get cramping pain with heavy bleeding, particularly when passing large clots. Some women find that their heavy periods are painless.
What causes heavy periods?
In many women who have heavy periods, no cause can be found. Some women with heavy bleeding have one or more fibroids (muscular swellings in the lining of the womb). Sometimes heavy periods are caused by a coil (IUD), or by having been sterilised previously. Heavy periods also seem to be more common in overweight women.
Should heavy periods be treated?
If you are coping well with your periods then no treatment is usually needed. However, if your periods are disrupting your life you should discuss them with your doctor.
Heavy periods can cause anaemia, as more iron is lost than can be replaced each month during a heavy period. If this happens, you might feel very tired, dizzy, or you may even faint. Usually it comes on very gradually, so you may not notice. If this happens, as well as giving you iron tablets, your doctor will try to cut down on the amount of blood you are losing.
What tests will I need?
Your doctor will want to do an internal examination to check your womb and ovaries and a smear test it you are due for one. If your doctor thinks you may be anaemic, then he or she will do a blood test to check this for you.
If you have had irregular bleeding as well as heavy periods, your doctor may refer you for a test to look at the lining of the womb. However, the D and C (Dilatation and Curettage) operation is not used as often nowadays. If necessary, a small sample of the lining of your womb can now be taken in the clinic or surgery.
Usually your doctor will start by recommending tablets that you take only during your period (or you may start them the day before) to cut down the flow. There are two types of these and both work in different ways, so if one is not suitable, your doctor may prescribe the other.
Sometimes the heavy bleeding is helped by giving extra progestogen, one of the hormones which controls your periods. You will only need to take these tablets for part of the month, usually starting around the middle and stopping before your period is due. These can also help if your periods are coming too close together.
Many women find that their periods are much lighter when they are on the combined oral contraceptive pill. There Is also a new type of contraceptive coil which slowly releases a very small amount of progestogen into the womb. This keeps the lining thin and makes the periods very light, often stopping them altogether.
If none of these treatments help your heavy periods, your doctor may then recommend an operation to cut down the bleeding or stop it altogether.
A hysterectomy removes the womb, often with the ovaries as well. This will cause your periods to stop altogether. A newer treatment either scrapes out the lining of the womb (endometrial resection) or treats it with a laser-this should cut down the amount of blood lost each month. In some women, this stops the periods altogether.
Help yourself
- If you are anaemic, eat plenty of iron-rich foods such as red meat, spinach, eggs and milk.
- If your doctor has given you tablets to help control your heavy periods, make sure you take them exactly as recommended.
- Even if your treatment does not work the first month you take it, keep taking it exactly as recommended; it may be more effective the second month.
- Keep a note of the dates of each period, and any other spotting or bleeding, in case your doctor asks you for this information. It may also be useful to count how many towels or tampons you use.