While the amount of blood each women passes during a period varies significantly, some women experience extremely heavy periods – this is characterised by passing more than 80ml of blood each period. Naturally, the ability to measure how much blood each woman passes is not practical or realistic, but doctors can usually ascertain whether this is a possibility from the description the woman gives. A period is considered heavy if a woman bleeds for more than 8 to 10 days, particularly if this is repeated month after month; if she bleeds so much that it is difficult to attend her job, or make holiday plans; if she bleeds continuously and so heavily that she becomes anaemic; if she notices the presence of small clots for more than one or two days, or if ‘flooding’ is a problem she suffers with regularly. The causes for prolonged heavy periods are one of two problems, generally – in younger women, it is caused by the temporary hormone imbalance, which usually corrects itself. In the years close to the menopause, heavy periods are generally a sign of a hormone imbalance, or a sign of an underlying disease which increases with age. Heavy periods, or menorrhagia, could also be a symptom of fibroids, endometriosis, polyps in the lining of the womb, pelvic inflammatory disease, or dysfunctional uterine bleeding (DUB) which is the most common cause of heavy periods. If you believe that you may be suffering with heavy periods you should consult your GP who can advise if there is an underlying problem. They will do this with a pelvic examination which is usually necessary, and in women over 40 there will also be a pelvic ultrasound scan or a biopsy to rule out any problems with the lining of the womb. Most medical professionals also suggest an examination known as a hysteroscopy, which involves putting a fine telescope through the neck of the womb in order to examine the lining of the womb – these can usually be performed without the need for general anaesthesia.
If your examination results come back clear and there is no underlying abnormality, there is no need for treatment – however, most women prefer to have something to help them cope with the symptoms each month. You may be able to take a tablet in order to cope with your problem if your symptoms are severe, which may or may not be a hormonal form of treatment. Hormonal treatments include the contraceptive pill and danazol – progesterones are effective in making periods more regular, but they don’t help to combat heavy flow. Non-hormonal treatments include tranexamic acid, which reduces your blood loss by up to half. Non-steroidal anti-inflammatory drugs can also achieve this by reducing your blood loss by about a third. If you’re anaemic due to heavy periods you will be prescribed iron or folic acid supplements, if necessary, or you will be given treatment if an underlying condition is discovered. You can also opt for other treatments, which include the contraceptive coil which is suitable for most women, or the surgical route, which means destroying the lining of the womb. This is either with a procedure which uses a laser or heat treatment with hot water in a balloon, or through a hysterectomy which is the removal of the uterus. The latter of these treatments are only suitable for women who don’t wish to have any more children. Your GP will be able to talk through your options with you to determine which route would be best for your circumstances.