Should I have tests to find out why my
periods are heavy?
This depends on your age and the severity of the bleeding. A blood count should be considered at any age as heavy bleeding can result in anaemia, which can be corrected with tablets containing iron. Teenagers and young women are likely to be particularly anxious, as they may be concerned that they will prove to have a fertility problem in due course. Furthermore, younger women tend to be more physically active and may particularly resent the limitations imposed by period problems. An ultrasound examination of the pelvic organs will usually provide reassurance. It may be prudent to check that the blood clotting mechanism is normal, particularly if there is a story of bleeding problems in the family or if you bruise or bleed very easily.
From late teens through the twenties and thirties, when obvious problems have been excluded, further investigation may be necessary only if the bleeding is extremely heavy or if it fails to respond to medication.
A physical problem becomes more likely in the forties and fifties. Visualisation of the uterine cavity by means of a hysteroscope (thin telescope Figure 24.2) and biopsy of the lining of the womb (cervical dilatation and endometrial curettage,
hysteroscopy D and C) are generally recommended by gynaecologists when medication fails to provide improvement.
   
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