Heavy menstrual bleeding, or heavy periods are a very common presentation for women who see a gynaecologist. This can happen to anyone but is more common in women in their late teens or early twenties as well as peri-menopausal women.
Often hard to say? How do you measure it?
There are some good rules of thumb to follow here, if you generally dread your period and find it difficult to manage your daily duties, having to always run to the bathroom, then this would be considered too heavy. Also, if you are passing large clots or have episodes of ‘flooding’ where by blood may spill through to your underwear or clothing, this would also be considered quite heavy.
Well, that really depends on the cause.
Initially a gynaecologist will take a thorough history to try and best identify the underlying problem. You may require an examination and it is routine to arrange a detailed pelvic ultrasound. This ultrasound will examine your uterus, tubes and ovaries and can identify any structural abnormalities, as well as a assess the nature of the lining of the uterus.
There are a range of medical treatments that can treat heavy menstrual bleeding. Some are hormonally based and others are non-hormonal therapies. Some therapies include oral medications, subcutaneous implants or intra-uterine devices.
A common diagnostic procedure is a hysteroscopy, this is a minor surgical procedure that involves a small camera looking inside the uterus and it allows a gynaecologist to visually look inside the uterus. This procedure will typically take 10-15 minutes in duration. It allows a macroscopic examination of the lining of the uterus to determine if it looks normal or abnormal, it also allows us to look for structural abnormalities and confirm the presence or absence of a polyp or fibroid. This procedure also allows for sampling of the uterine lining to send to the laboratory for microscopic assessment and this provides us with even further information.
If further surgery is needed this could include:
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