Conditions

Heavy periods or menorrhagia is defined as excessive blood loss at the time of a period, which interferes with the quality of a woman’s life.

It can be associated with pain either at the time of a period or at other times during the cycle.

It can also be associated with anaemia causing excessive tiredness.

Causes of menorrhagia include:

• Dysfunctional uterine bleeding (No cause found on investigation)
• Fibroids
• Adenomyosis
• Endometriosis
• Thickening of the lining of the uterus (endometrial hyperplasia)
• Abnormal function of the thyroid gland
• Abnormal blood clotting

After taking a careful history and performing an examination, further investigations may include:

• Blood test to check for anaemia, thyroid and blood clotting abnormalities
• Ultrasound scan to check for abnormal thickening of the lining of the uterus, fibroids and ovarian cysts
• Endometrial sampling (taking a sample from the lining of the uterus)
  • Pipelle sample
  • Hysteroscopy with dilatation and curettage (D&C)

Treatment options include:

• Non hormonal treatment with Cyclokapron
• The oral contraceptive pill
• The Mirena Intrauterine Device (IUCD)
• Endometrial resection or ablation
• Laparoscopy with removal of fibroids (if present) via Myomectomy procedure
• Hysterectomy (removal of the uterus with conservation of the ovaries)