Heavy Periods (Menorrhagia)
Heavy menstrual bleeding is also called menorrhagia, it’s the loss of an excessive amount of blood during periods. Many women think they just have to tolerate it, but heavy bleeding is much more than an inconvenience. It can negatively affect a woman’s physical, emotional and mental health, so it’s something that should be taken seriously.
What is heavy bleeding?
How much blood counts as excessive? In the past gynaecologists used to talk in terms of the actual volume of blood lost – but let’s be honest, that can be incredibly difficult to measure and assess. The truth is, that if you think your periods are heavy and impacting on your life, then they probably are. However, there are some clues that can help confirm that you are suffering from menorrhagia:
- If you have to use double protection with towels and tampons
- If you regularly leak through your sanitary protection
- If you have flooding of blood onto your clothes or bedding
- If you notice large clots
- If you are becoming tired, weak or anaemic
- If you have to plan your life around your periods
In short, if your periods are so heavy that they’re affecting your health, your well-being and your quality of life then it’s a problem that needs to be investigated and resolved.
What causes heavy bleeding?
The good news is that heavy periods does not necessarily mean there is anything seriously wrong. In fact, there is often no physical abnormality, with around 40-60% of women having no specific cause identified. However, there are some recognised reasons for heavy menstrual blood loss.
Polyps: These non-cancerous growths in the lining of the womb or the cervix
Endometriosis: In this common condition affecting two million women in the UK, patches of the womb lining are found outside the uterus. Endometriosis can affect the ovaries, the tubes, the lining of the pelvis and the bladder or bowel. It characteristically causes severe pelvic pain, but in some women, it can also lead to menorrhagia.
Fibroids: These are non-cancerous growths in the womb that can cause discomfort, pain and very heavy periods.
Adenomyosis: In this uncomfortable condition, glands from the lining of the womb become embedded in the muscle of the uterus. This results in significant pelvic pain and heavy bleeding.
Cancer: Cancer of the womb is thankfully uncommon but should always be considered as a potential cause of heavy bleeding, especially if it occurs after the menopause or in between periods.
Underactive thyroid: Thyroid disease can affect the whole body. Hypothyroidism can cause tiredness, weight g.ain, changes in your hair and skin quality as well as intolerance to the cold and heavy periods
Clotting problems: If there are issues with blood clotting the menstrual loss will be heavier. Diseases like Von Willebrand’s, platelet problems and liver disorders can all affect clotting and increase your monthly bleed.
Medical treatments: Certain medical therapies can trigger heavy bleeding. These include the contraceptive coil, anticoagulants, and some anti-cancer drugs
What tests should I have?
Often taking a thorough history, talking through your health and symptoms in detail and performing a full examination can tell your gynaecologist an enormous amount about the potential cause of your problem.
Further investigations may then be arranged to check for any underlying conditions and to see if the heavy bleeding has affected your health. These may include some, or all of the following procedures:
Blood tests: To check for anaemia, clotting problems and thyroid disease
Ultrasound scan: To look for fibroids and polyps
Hysteroscopy: This is a procedure that can be done as an outpatient to examine the lining of your womb, check out any polyps and take biopsies for analysis if required
Heavy periods can be uncomfortable, upsetting and occasionally embarrassing. However, there are excellent treatments available that can ease the bleeding and soothe any associated pain.
What treatment is available?
Treatment options include:
- Non-hormonal medications
- Mirena coil
- Hormonal treatments
- Endometrial ablation
- Surgical removal of fibroids and polyps
You don’t have to suffer in silence, look at our treatment page and take the first steps to controlling your periods, instead of them controlling you.