Obstetrics & Gynaecology

Heavy Periods (Menorrhagia)

Introduction to Heavy Periods (Menorrhagia)

Menorrhagia is heavy periods in which a woman loses an excessive amount of blood. It can occur by itself or in combination with dysmenorrhea (menstrual pain).

Written by Doctify Team 27/04/2020

What are Heavy Periods (Menorrhagia)?

A period is a bleed from the womb which happens approximately every 28 days. It begins when a girl hits puberty and goes on until menopause. Menorrhagia is heavy periods in which a woman loses an excessive amount of blood. It can occur by itself or in combination with dysmenorrhea (menstrual pain).

What causes Heavy Periods (Menorrhagia)?

In half of the cases there are no identifiable underlying cause. However, when causes are identified, heavy periods are usually caused by uterine fibroids (non-cancerous growths in the womb), endometriosis (pieces of womb lining found outside the womb), endometrial polyps (non-cancerous growths in womb lining), pelvic inflammatory disease, polycystic ovary syndrome, blood clotting disorders, hypothyroidism (lack of thyroid hormone), and insertion of intrauterine contraceptive devices (IUD).
Heavy periods can also be caused by ongoing medical treatments like anticoagulant medications or chemotherapy.

What are the symptoms of heavy periods?

Women should have a good idea about how much bleeding is normal and are usually conscious if the amount increases. Other indications include using high number of tampons or bleeding through to your clothes or bedding.

How are heavy periods treated?

If the heavy bleeding does not affect you emotionally, physically or socially, there is no need for any treatment.
Medication is the main treatment for heavy periods. Your GP will talk you through the effectiveness of treatments and whether contraception will be required.
A small plastic device (levonorgestrel-releasing intrauterine system – LNG-IUS) may be inserted into your womb to release progesterone, hormone produced by the female reproductive organs. This prevents growth of your womb lining and subsequently reduce blood loss. If contraception is not desired as in LNG-IUS, tranexamic acid tablets can be taken up to a maximum of three to four days, to cause blood clot and reduce bleeding. It can be used in combination with non-steroidal anti-inflammatory drugs (NSAIDs) which act as painkillers. Some other alternatives are gonadotropin releasing hormone analogue (GnRH-a), synthetic progesterone called norethisterone which is taken orally or progesterone injection. Combined oral contraceptive pills can also help treat menorrhagia. They are a more reversible form of contraception compared to LNG-IUS and help to regulate your menstrual cycle.
If medications are not effective, your GP may refer you to a gynaecologist which will recommend you some surgical procedures carried out under local anaesthetic or general anaesthetic.

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