Menstrual Problems: Heavy Periods

Heavy periods

Heavy periods, also known as menorrhagia, can happen at any stage of a woman’s life. Most times there is an

• fibroids
• adenomyosis
• endometrial polyps
• endometriosis
• ovarian cysts o
• hormonal imbalances.

Sometimes there is no apparent cause and this condition is called Dysfunctional Uterine Bleeding (DUB).

Treatment of heavy periods

The treatment of heavy periods aims to treat the underlying cause. In the case of DUB measures to decrease or stop the bleeding include:

• hormone based medication such as the pill
• non-steroidal anti-inflammatory medications such as Ibuprofen, Implanon®, progesterone injections, a progesterone containing IUD – Mirena®, Endometrial Ablation
• and in a few cases hysterectomy.

Non-steroidal anti-inflammatory medication such as Ibuprofen, when used regularly with menstruation, can reduce the flow by up to 30 percent.

Mirena is a low dose progesterone plastic intra-uterine device that has revolutionised the management of menstrual problems. Most people with a Mirena inserted will have little or no bleeding within 12 months of use. It has certainly decreased the need for hysterectomy in many cases. Mirena can also be used to improve symptoms while awaiting a hysterectomy. It is also an ideal option for contraception.

Endometrial ablation is where the lining of the uterus is removed or superheated so that it no longer sheds and bleeds during menstruations. The result is that the majority of people have no or significantly decreased menstrual bleeding after this procedure. This is done vaginally using a hysteroscope which is a minimally invasive procedure and therefore requires minimal recovery time.

Hysterectomy is the definitive management for menstrual problems. It can generally be performed in one of three ways, these include:

• Vaginal hysterectomy
• Laparoscopically- assisted vaginal hysterectomy
• Abdominal hysterectomy via a laparotomy

The vaginal hysterectomy and laparoscopically-assisted vaginal hysterectomy are minimally invasive procedures and thus have a more rapid recovery time and are the preferred option.