Heavy Periods are common across all age groups of women.
Young teenagers may have heavy periods because the ovaries have not started working properly, leading to a build up of the womb lining. In some young girls, blood clotting disorders may present with heavy periods.
Older women may have heavy periods due to fibroids, which either enlarge the womb or distort the cavity of the womb. These can easily be treated by surgery.
Some women with polycystic ovarian syndrome have irregular periods which are heavy because they occur less frequently than normal. Irregular bleeding can be regulated by the oral contraceptive pill.
Women in their 40s often have heavy periods because the ovaries are starting to fail. This leads to a thickening of the womb lining and prolonged irregular bleeding. An ultrasound scan may show the lining of the womb to be thickened and may identify a fibroid or polyp (benign growth of the womb lining). The womb lining should be checked in these women to rule out abnormalities in the cells of the womb lining. Either a hysteroscopy will be performed under General Anaesthesia or as an outpatient to examine the womb lining in depth, or an endometrial biopsy will be taken in clinic to check for abnormalities.
Heavy periods can be treated very successfully in a number of ways:
Medical treatments such as Tranexamic Acid and Mefenamic Acid or the combined contraceptive pill work well for many women and can reduce the amount of bleeding by around 50%.
The Mirena Intrauterine System is a hormone coil which is easily inserted in clinic or following hysteroscopy. This coil lasts for 5 years and releases a hormone called progesterone into the womb cavity, which keeps the lining thin. It is a very good treatment for heavy periods and is a very good contraceptive as well. The Mirena can also be used to treat period pain, endometriosis, and as part of Hormone Replacement after the menopause. Around 80-90% of women with heavy periods will achieve a good result (light periods or no periods) with the Mirena.
Endometrial Ablation is a quick, minor procedure that can be done under General Anaesthetic or Local Anaesthetic. The aim of the procedure is to burn and destroy the lining of the womb in order to reduce period bleeding. This is achieved with heat/microwave or radiofrequency energy. Around 90% of women, who are suitable for endometrial ablation, will achieve a good result (their periods will be lighter or will have stopped altogether).
Endometrial ablation is not a contraceptive method, although pregnancy is unlikely following the procedure. It is only suitable for women who do not wish to get pregnant. Contraception should be used following the procedure.
Endometrial ablation is a very safe procedure with less than 1:1000 chance of serious complications, such as perforation of the womb.
Some women who have had no success with these conservative measures require a hysterectomy in order to treat their heavy periods or period pain. If large fibroids are present, a myomectomy may be advised to treat period problems while retaining the womb in younger women who desire pregnancy in the future.
The Holly Nuffield Private Hospital
Clinics Thursdays 8.30-12.00
Tel: 0208 936 1201
London Independent Hospital
Clinics Thursdays 13.00-16.30
Tel: 0207 780 2400
Surgery is also performed at Spire London East Hospital, Redbridge IG4 5PZ 02087097878