If your period regularly disrupts your work, your sleep, or your plans, that isn't something you simply have to live with. Heavy menstrual bleeding is one of the most common reasons women see a gynaecologist, yet many put off seeking help for years, assuming it's just "how their body is." Dr Mandana Master takes a thorough, practical approach to investigating heavy periods, helping you understand what's driving them and what can be done.
There’s no single test that defines a heavy period. What matters most is the impact it’s having on your life. As a general guide, heavy menstrual bleeding (sometimes called menorrhagia) may involve:
If any of this sounds familiar, it’s worth having your periods properly assessed, rather than assuming heavy bleeding is something you simply need to manage alone.
Heavy periods can have a wide range of causes, and identifying the right one is key to effective treatment. Common causes include:
Benign growths in the muscle wall of the uterus that can significantly increase menstrual blood loss, particularly when they sit close to the uterine lining.
Small, usually benign growths within the uterine lining that can cause heavier bleeding or bleeding between periods.
A condition in which tissue similar to the uterine lining grows within the muscular wall of the uterus, often causing heavy, painful periods.
While more commonly associated with pain, endometriosis can also contribute to heavier menstrual bleeding for some women.
Underlying conditions affecting normal blood clotting, such as von Willebrand disease, are an under-recognised but important cause of heavy periods, particularly when heavy bleeding has been present since the very first period.
Including copper intrauterine devices, thyroid conditions, and other medical conditions that may need to be excluded.
Treatment depends on the underlying cause, your symptoms, and your future fertility plans, and often starts with the least invasive option likely to be effective. In the course of investigations into abnormally heavy periods, you may undergo blood tests, ultrasounds of your uterus or ovaries, or even a hysteroscopy, a minimally-invasive procedure to provide a direct view of the inside of your uterus by inserting tools via the cervix.
A hormonal IUD, the contraceptive pill, or other hormonal therapies, can significantly reduce menstrual blood loss for many women through mechanisms such as stabilising the uterine lining or suppressing ovulation.
Medications such as tranexamic acid or non-steroidal anti-inflammatory drugs such as ibuprofen can be taken during your period to reduce bleeding and abdominal cramping.
If your heavy periods are due to another medical condition, such as uterine polyp or fibroid, this may be treated with surgery, often via hysteroscopy.
Endometrial ablation is a procedure involving controlled destruction of the uterine lining to reduce bleeding. It may be accomplished using heat, an electrical current, or radiofrequency. Endometrial ablation is generally only suitable for women who have completed their family.
A hysterectomy is the surgical removal of the uterus. It is considered in some cases where other treatments haven’t been effective or appropriate, and where future fertility isn’t a consideration.
Dr Mandana will talk through which of these options is likely to suit you best, taking into account your symptoms, your overall health, and whether you’re hoping to conceive now or in the future.
You deserve a gynaecologist who listens carefully, explains things clearly, and treats your concerns with evidence-based, patient-centred management strategies. Get in touch with Dr Mandana Master at Embrace Fertility today to arrange a consultation.
