The medical term for heavy periods is menorrhagia.The amount of blood lost during periods differs from person to person. Some women experience more blood loss than others. Heavy periods may be accompanied by pain.
Menorrhagia may be defined as excessive blood loss during several consecutive menstrual cycles. Excessive bleeding does not mean something very serious but may affect a woman emotionally and cause disruption in everyday activity.
Causes
Generally 40 to 60% of cases of menorrhagia do not have any underlying cause. Some causes of menorrhagia are as follows:
– endometriosis: This happens when the lining of womb attaches itself to the stomach, pelvis or other organs
-cervical or endometrial polyps: The lining of the womb cavity or cervix has benign growths.
-uterine fibroids: These are non cancerous growths in the womb that can cause dysmenorrhoea.
-chronic pelvic inflammatory disease (PID): Fever, bleeding and pelvic pain may be caused between periods or after sexual intercourse or due to ongoing infection in the pelvis.
– Intrauterine contraceptive device (IUD): After insertion of IUD the blood loss may increase by 40 to 50%.
– Polycystic ovarian syndrome (PCOS): In this case multiple cysts develop in the ovaries.
– Hypothyroidism: Constipation, fatigue, hair and skin changes may be caused due to an under active thyroid gland.
– Coagulation disorders: menorrhagia may be due to blood clotting disorder.
– Cancer of the womb
– Liver or renal disease
Medical treatments in some cases may result in menorrhagia.Some of them are listed below
– Chemotherapy
– Anticoagulant medicines
– Sterilisation
Treatment
In case menorrhagia is detected, your GP will give full information about
-how effective will be the treatment
-the likelihood of side effects caused by the treatment
-the implication of treatment on fertility
-if there is any necessity for contraception
Treatment of menorrhagia is done aiming for the following
-to decrease or stop excessive menstrual bleeding
-to correct iron deficiency caused due to heavy bleeding
-to provide comfort to women who suffer from heavy bleeding
Medication
Some women have no symptoms that show that cause for menorrhagia is serious. Some women might be suggested to wait for the result of further investigation. In such cases medication is recommended. Some of the medications used for the treatment of menorrhagia are listed below
– Levonorgestrel-releasing intrauterine system (LNG-IUS): It is a small plastic device placed on the womb that slowly releases progestogen preventing the lining of the womb to grow quickly. The possible side effects of using LNG-IUS are as follows
>irregular bleeding
>headaches
>acne
>breast tenderness
>no periods at all
This kind of treatment reduces blood loss by 71 to 90 % and is the most preferred treatment.
-Tranexamic acid
Tranexamic acid tablets may be recommended in case LNG-IUS is unsuitable. These tablets reduce the blood loss by 29 to 58%.These tablets help the blood in the womb to clot. One should stop taking the tablets if the symptoms do not improve within three months. These tablets are not a form of contraception. The side effects that may be caused due to intake of these medicines are as follows
– diarrhoea
-indigestion
-headaches
-Non-steroidal anti-inflammatory drugs (NSAIDs)
-Combined oral contraceptive pill
-Oral progestogen
-Injected progestogen
Surgical procedures
If medication is not effective, surgery is recommended.