Heavy periods |
What causes heavy periods? Should heavy periods be treated? What tests will I need? What treatments are available? Help yourself |
About 5 per cent of women between the ages of 30 and 49 see their doctor
each year because of heavy periods. However, in one national survey, 31
per cent of women described their periods as heavy. Most women lose
between 30 and 40ml (six to eight teaspoonfuls) of blood during each
period. It is very difficult to know whether your own period is heavier or
lighter than this, as it is impossible to measure blood loss accurately.
However, if you are passing large clots, or find that you need to change
towels or tampons more than every two hours, you may want to ask your
doctor for advice.
Some women find that their periods come more or less frequently than every
four weeks, or that they bleed for more than five to seven days. This can
be quite normal. However, if you get bleeding or spotting (very light
bleeding or brownish discharge) between your normal periods, or after
intercourse, or after you have reached the menopause and stopped having
periods altogether, you should see your doctor.
Most women get cramping pain with heavy bleeding, particularly when
passing large clots. Some women find that their heavy periods are
painless.
In many women who have heavy periods, no cause can be found. Some women with heavy bleeding have one or more fibroids (muscular swellings in the lining of the womb). Sometimes heavy periods are caused by a coil (IUD), or by having been sterilised previously. Heavy periods also seem to be more common in overweight women.
If you are coping well with your periods then no treatment is usually
needed. However, if your periods are disrupting your life you should
discuss them with your doctor.
Heavy periods can cause anaemia, as more iron is lost than can be replaced
each month during a heavy period. If this happens, you might feel very
tired, dizzy, or you may even faint. Usually it comes on very gradually,
so you may not notice. If this happens, as well as giving you iron
tablets, your doctor will try to cut down on the amount of blood you are
losing.
Your doctor wi II want to do an i nternal exam i nation to check your
womb and ovaries and a smear test if you are due for one. If your doctor
thinks you may be anaemic, then he or she will do a blood test to check
this for you.
If you have had irregular bleeding as well as heavy periods, your doctor
may refer you for a test to look at the lining of the womb. However, the D
and C (Dilatation and Curettage) operation is not used as often nowadays.
If necessary, a small sample of the lining of your womb can now be taken
in the clinic or surgery.
Usually your doctor will start by recommending tablets that you take
only during your period (or you may start them the day before) to cut down
the flow. There are two types of these and both work in different ways, so
if one is not suitable, your doctor may prescribe the other.
Sometimes the heavy bleeding is helped by giving extra progestogen, one of
the hormones which controls your periods. You will only need to take these
tablets for part of the month, usually starting around the middle and
stopping before your period is due. These can also help if your periods
are coming too close together.
Many women find that their periods are much lighter when they are on the
combined oral contraceptive pill. There is also a new type of
contraceptive coil which slowly releases a very small amount of
progestogen i nto the womb. This keeps the lining thin and makes the
periods very light, often stopping them altogether.
If none of these treatments help your heavy periods, your doctor may then
recommend an operation to cut down the bleeding or stop it altogether.
A hysterectomy removes the womb, often with the ovaries as well. This will
cause your periods to stop altogether. A newer treatment either scrapes
out the lining of the womb (endometrial resection) or treats it with a
laser - this should cut down the amount of blood lost each month. In some
women, this stops the periods altogether.