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Heavy Menstrual Bleeding


Dr Sheela Purkayastha - Female Gynaecologist


Also referred to as menorrhagia, heavy periods lead to excessive blood loss each month and may be accompanied by painful menstrual cramps. The bleeding is not only difficult to control, which can affect you emotionally and socially, but it is also a common cause of anaemia. While heavy menstrual bleeding is not necessarily the sign of a serious problem, it is important you receive an expert opinion on the cause of your problem periods, so you can receive treatment for an underlying cause and reduce the disruption that excessive blood loss has on your daily life.


Causes of Heavy Menstrual Bleeding


Although there is no identifiable cause in up to 60% of women with menorrhagia, there are a range of conditions and treatments that may cause heavy bleeding during your period. If you suffer from excessive bleeding, the following may explain your symptoms:


- A benign growth in your cervix or uterus, known as a polyp

- Endometriosis, where small sections of uterine tissue grow outside your womb, possibly in your vagina, fallopian tubes, ovaries or bladder

- Non-cancerous growths in your uterus, known as fibroids

- Pelvic inflammatory disease, where pelvic inflammation causes pain and a high temperature, as well as bleeding between periods, and is often caused by an infection

- Polycystic ovary syndrome, where multiple small cysts form on your ovaries, though other symptoms include absent or irregular periods, weight gain, excessive hair growth and acne

- An underactive thyroid, though tiredness, intolerance to the cold, weight gain and changes to your hair and skin are also common

- A blood clotting disorder

- A problem affecting your liver or kidneys

- Rarely, this may occur with uterine cancer

- Using a contraceptive coil can increase blood loss by as much as 50%

- Blood thinning drugs

- Chemotherapy


Diagnosing Heavy Menstrual Bleeding


As assessment of your menstrual history and any other symptoms you have is the first stage in the diagnosis of your excessive bleeding. Depending on your history, you may need further tests to reveal the gynaecological cause of your heavy periods. For example, a pelvic examination will show whether you have signs of unusual bleeding or discharge from your vagina or cervix. Meanwhile, a pelvic ultrasound scan can reveal polyps, fibroids and any other growths in your uterus, and a biopsy may be necessary to examine the lining of your uterus. However, your gynaecologist will arrange the most suitable tests to allow an accurate diagnosis of your heavy menstrual bleeding.


Treating Heavy Menstrual Bleeding


Although a hysterectomy was often offered to manage heavy periods previously, this treatment option is now only used when absolutely necessary, giving women more choice in how they manage their excessive blood loss. For instance, one new treatment option that Dr Sheela Purkayastha offers is endometrial ablation, which destroys the lining of your uterus. During this procedure a fluid filled balloon is inserted into your uterus and takes on its shape before being heated to a high temperature. Endometrial ablation is a quick, safe and effective procedure, of which Dr Purkayastha has significant experience and achieves excellent results with her patients. The procedure also carries the advantage that it has a quick recovery time, so there is no need for a lengthy absence from work, unlike a hysterectomy.


Similarly, if a fibroid within the cavity of your uterus is the cause of your heavy menstrual bleeding, Dr Purkayastha is often able to offer removal of this via your uterus rather than using a more invasive operation known as a myomectomy. This is beneficial, as blood loss is typically high during a myomectomy and carries other risks such as a blood clot in your leg or lung, infection and heavy bleeding shortly after the operation. There is also a small chance that undergoing a myomectomy will necessitate a hysterectomy at the time of the operation, so avoiding this is another benefit of less invasive surgery.


However, even if you have several fibroids, they are within the muscles of your uterus or are growing outside of your uterus, Dr Purkayastha can recommend an alternative procedure, known as embolisation, which can reduce your fibroids by 60% in size. While Dr Purkayastha doesn't perform this procedure herself, she can refer you to an experienced colleague for embolisation.


A newly introduced drug is also used by Dr Purkayastha to reduce the size of large fibroids significantly and you may not need any invasive procedure in that case.


All these various options can only be discussed in detail with Dr Purkayastha and she will guide you which is the best treatment for you.


For expert advice on managing heavy menstrual bleeding, don't delay making an appointment with Dr Purkayastha.

A Specialist Women's Healthcare Clinic in London working closely with women of all ages.

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