Heavy and/or irregular periods are the commonest gynaecological symptoms that women
complain of to their general practitioner. For the majority of sufferers, there is
significant disruption to their quality of life, and in the most severe cases, women
may require treatments for anaemia including blood transfusions.
There may be a range of causes for these problems which broadly are categorised
into structural problems and hormonal imbalances. Structural problems inside the
womb include fibroids and polyps and these can be a cause for heavy periods. These
can often diagnosed by means of an ultrasound. Some women will require a hysteroscopy
(a minor surgical investigation where a telescope is passed into the uterus via the
vagina) to diagnose any additional problems inside the womb. A few underlying medical
conditions (including clotting abnormalities, thyroid problems and certain medications)
can also be a cause for excessive menstrual bleeding (“menorrhagia”) and these may
often be diagnosed by blood tests. Depending on the underlying causes, the severity
of symptoms, the woman’s age and ultimately her wishes, a range of treatments can
be considered. These include both non-hormonal and hormonal tablets, a Mirena intrauterine
system (a hormone releasing system inserted into the womb rather like a “coil” device),
or surgery designed to treat an underlying structural or anatomical problem accounting
for the heavy periods (including removing fibroids or in some cases a hysterectomy).
