Every woman experiences a unique menstrual cycle, and what’s considered ‘normal’ varies from person to person. However, prolonged menstrual bleeding, a common issue, can disrupt your lifestyle and lead to significant anxiety.
If your period is heavy, lasts longer than usual, or follows an irregular pattern, it’s time to pay attention. Some women may also experience bleeding between periods (intermenstrual bleeding) or after sexual intercourse (postcoital bleeding). In such cases, seeking guidance from a doctor or an expert private gynaecologist is crucial for a thorough investigation.
What Causes Heavy Menstrual Bleeding?
Menorrhagia (in simple terms called heavy periods) is the medical term describing when periods are unusually heavy or too long. While many women worry about heavy menstrual bleeding, most don’t face such intense cramps and blood loss that it disrupts their regular activities during their period.
● Hormonal Imbalance
Sometimes, high levels of oestrogen in your body or an excess of the hormones responsible for shedding your uterus lining can lead to heavy periods.
The cells of your uterus lining can grow outside the uterus, spreading in your abdomen or other parts of your body.
● Fibroids
Benign growths can develop in and around the uterus in the abdominal cavity. They vary in size, from microscopic to taking up significant space in your abdomen.
● Pelvic Inflammatory Disease
Long-standing bacterial infections can cause this condition, spreading to the organs of the upper genital tract, such as your fallopian tubes, ovaries, and uterus.
● Polycystic Ovary Syndrome (PCOS)
A hormonal imbalance triggers the ovaries to produce small cysts instead of eggs, leading to various symptoms, including excessive hair growth and infertility.
Symptoms of heavy periods
The insertion of an intrauterine contraception device (IUD) can also lead to heavy periods. In rarer cases, heavy periods may result from blood clotting disorders, liver or kidney disease, thyroid gland issues, or endometrial cancer.
Experiencing heavy periods involves notable symptoms that can impact a woman’s menstrual cycle. Typically lasting around five days, a woman sheds approximately 30-40 ml (about two tablespoons) of blood during this time.
The definition of heavy periods varies from one woman to another, contingent upon individual hormone levels. If you’re experiencing heavy periods, it means you’re dealing with one or more of the following factors:
- Experiencing a blood loss of over 80 ml during your menstrual cycle.
- Having a period that extends beyond seven days
- Noticing the passage of sizable blood clots during your menstrual flow.
If you notice any of these signs during your menstrual cycle, it’s essential to consult with a healthcare professional to explore potential causes and appropriate management.
Diagnosing Heavy Periods
If you’re dealing with heavy periods, your doctor will conduct tests to identify the underlying cause. Here are the tests they might perform:
● Ultrasound Scan
Gynaecologists use a scan that employs sound waves to check for the presence of fibroids and endometriosis.
● Pelvic Examination
Doctors physically inspect your vagina and cervix to detect any abnormalities in the pelvic region.
● Biopsy
They’ll extract a small tissue sample from the inside of your uterus. And examine it under a microscope to identify any abnormalities.
● Laparoscopy
Skilled gynaecologists introduce an endoscopic camera, a laparoscope, into your abdomen. It allows your gynaecologist to examine the uterus, fallopian tubes, and ovaries and look for signs of disease in other organs.
● Measuring Menstrual Blood Loss
You might be requested to weigh each tampon or sanitary pad after use. It helps doctors estimate the actual amount of blood you are losing.
● Blood Tests
They’ll test your blood to check for iron deficiency anaemia. This condition is more common in women experiencing heavy periods over an extended period.
How are heavy periods treated?
In menorrhagia treatment, the focus is on effectively managing and reducing heavy menstrual bleeding. Various treatment options are available, ranging from medication to lifestyle changes.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These can reduce menstrual blood loss and also provide relief from painful menstrual cramps (dysmenorrhea).
- Tranexamic Acid (Lysteda): Take these only during the bleeding to reduce menstrual blood loss effectively.
- Oral Contraceptives: Besides offering birth control, these can regulate menstrual cycles and decrease excessive or prolonged menstrual bleeding.
- Oral Progesterone: Correct hormone imbalance with the help of progesterone.
- Hormonal IUD: These intrauterine devices release levonorgestrel, thinning the uterine lining to decrease menstrual blood flow and cramping.
- Iron Supplements: If you’re suffering from anaemia, these supplements can help.
If these treatments prove unsuccessful, your consultant may recommend surgical options:
- Dilation and Curettage (D&C): Dilate the cervix to scrape away the uterine lining. This general procedure effectively treats acute or active menstrual bleeding.
- Uterine Artery Embolisation: Shrink uterine fibroids by blocking uterine arteries and cutting blood supply.
- Focused Ultrasound Surgery: Shrink fibroids with ultrasound waves without incisions.
- Myomectomy: Surgically remove uterine fibroids. The procedure may involve open abdominal surgery, small incisions (laparoscopy), or entry through the vagina and cervix (hysteroscopy), depending on size, number, and location.
- Endometrial Ablation: Destroy the uterine lining using heat, a laser, or radiofrequency. Keep in mind that getting pregnant afterwards can lead to complications. We recommend using reliable or permanent contraception until menopause.
- Endometrial Resection: Use an electrosurgical wire loop to eliminate the uterine lining. However, it’s advisable to avoid pregnancy following this procedure.
- Hysterectomy: This involves the surgical removal of the uterus and cervix, resulting in sterility and the end of menstrual periods. If the ovaries are also removed (bilateral oophorectomy), premature menopause may occur.
Final Verdict
Severe menstrual bleeding can cause both physical and emotional discomfort, disrupting your daily routine.
Anaemia, an iron deficiency in your body, can result from heavy periods. If you notice bleeding between periods, experience post-sex bleeding or have heavy menstrual bleeding, it may indicate a more adverse condition. Consult your doctor promptly.
Seek medical advice if you:
● Experience abnormally long periods (lasting more than half the month).
● Sense constantly tired.
● Feel faint, dizzy, or light-headed.
● Have difficulty sleeping well.
● Find it hard to catch your breath.
