What treatments are available for my heavy periods?
Several factors including age, fertility requirements, duration and severity of the heavy bleeding will influence decisions. Concurrent problems such as pelvic pain and premenstrual syndrome may influence clinical advice but you should be presented with all relevant information to help you plan with your doctor the most appropriate choice. Treatment may depend on the underlying cause for the heavy loss. Medical and surgical treatments (Figure 24.3) as well as a special intra-uterine contraceptive device, the levonorgestrel intrauterine system (Mirena; Figure 14.1) are available.
Figure 24.3
Figure 14.1 Mirena IUS In Uterus
We can consider specific interventions for a particular cause of the heavy loss such as removing fibroids or an intra-uterine contraceptive device. As previously stated, your periods may be heavy despite the presence of fibroids or endometriosis and not necessarily because of them. Fibroids, endometriosis or an intrauterine contraceptive device may be found in association with heavy periods but that does not necessarily mean that they are unequivocally the cause in every patient. It may be appropriate to offer treatments used in dysfunctional uterine bleeding (17) even in the presence of these conditions. When there is a possible cause for heavy periods, such as fibroids, skilled judgement is required to decide whether specific treatment such as myomectomy (17) is required or whether to offer a non-specific treatment such as tranexamic acid.
Every gynaecologist has a personal preference resulting from a combination of education, experience and sub-speciality interests. We should ensure that you are aware of all the options so that you can make an informed choice.
Heavy and irregular periods may respond to progestogens, particularly at the extremes of the reproductive years. Women with menopausal symptoms commencing cyclical hormone replacement therapy often report improvement in their periods. This probably relates to the fact that they are having anovulatory cycles (eggs are not being released) and the cyclical progestogen in the HRT is replacing the progestogen deficiency.
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Please click on the required question.
- 1 Are heavy periods a common problem?
- 2 What is in my menstrual flow?
- 3 What range of menstrual cycle length is considered to be normal?
- 4 How can menstrual blood loss be measured?
- 5 How can I tell if my periods are abnormally heavy?
- 6 What could be the cause of my very heavy menstrual periods?
- 7 I have been sterilised. Could this be the cause of my heavy periods?
- 8 Should I have tests to find the reason for my heavy periods?
- 9 How will my heavy period problems be investigated?
- 10 What is meant by anaemia due to heavy periods?
- 11 What is intermenstrual bleeding?
- 12 What is a hysteroscopy and D and C?
- 13 What is cervical cautery?
- 14 What happens after the D and C?
- 15 What treatments are available for my heavy periods?
- 16 What are the medical treatments available for heavy periods?
- 17 How do the various medical treatments for heavy periods work?
- 18 What would be reasonable initial treatment for a teenager or young woman with heavy periods?
- 19 What is a hysterectomy?
- 20 What are the indications for hysterectomy?
- 21 What are the risks (complications) of hysterectomy?
- 22 What is vault granulation?
- 23 What are the different types of hysterectomy?
- 24 Is it essential to remove the neck of the womb at hysterectomy?
- 25 Should my ovaries be removed or conserved during hysterectomy?
- 26 How long will I be in hospital when I have my hysterectomy?
- 27 I have had a hysterectomy. Do I still need to have smear tests?
- 28 What are the other surgical alternatives to hysterectomy?
- 29 How do endometrial ablation and hysterectomy compare?
- 30 Are there any psychological effects following hysterectomy?
- 31 How do we decide the best treatment for my period problems?
- 32 Could I have some recommended hysterectomy support groups?
- 33 Are there any support groups?
- Intermenstrual Bleeding - Bleeding between periods.
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This is the personal website of David A Viniker MD FRCOG, Consultant Obstetrician and Gynaecologist at Whipps Cross University Hospital, London - Specialist Interests - Reproductive Medicine including Infertility, PCOS, PMS, Menopause and HRT.
I do hope that you find the answers to your women's health questions in the patient information and medical advice provided.
