Heavy periods
This is defined as menstrual loss of greater than 80 mls with each period. It affects more than 1 in 5 women. Heavy periods is one of the most common causes of iron deficiency anaemia in women.
Periods are considered to be heavy when:
Menstrual flow that interferes with your regular activities e.g. becoming house bound due to the heavy periods.
Menstrual flow that soaks through one or more tampons.
Menstrual flow that includes large blood clots.
Anaemia causing tiredness.
Causes of heavy periods
The commonest cause in the younger age group is due to an hormonal imbalance or dysfunctional uterine bleeding (DUB).
Pelvic pathology
Pelvic inflammatory disease.
Uterine Polyps.
Investigations
Blood tests: To exclude anaemia.
Ultrasound scan: To exclude uterine polyps or fibroids. Assessment of the ovaries are also made.
Endometrial biopsy: A sample of endometrial tissue that is obtained to be examined under a microscope.
Hysteroscopy: Assessing the lining of the uterus.
Treatment
This is based on the patient's age, contraceptive wishes and the severity of the heavy periods.
Medical
Oral contraceptive pill.
Tranexamic acid.
Mirena coil.
Surgical
By removing the lining of the uterus by ablation ie. Novasure Endometrial ablation. This procedure has a high success rate and may be performed under sedation with local anaesthetic.
Hysterectomy
Abdominal.
Subtotal or partial (conserving the cervix).
Vaginal.