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Heavy or Painful Periods

Periods are different for every woman. On average, a period will see between 30 to 40 ml of blood lost. And last around five days.

Heavier or more uncomfortable periods can occur at any age and can be incredibly painful. In many instances, the increased loss of blood each month happens over a longer time. Whether it happens gradually, or seems like a one-off episode,  or you start having painful or heavier than normal periods, you should consult with a Gynaecologist like Dr Guy Skinner.

Some women lose more blood each month. Some periods last longer. It’s important to know that this, on its own, does not constitute a heavy period. Certainly, if your period causes you to feel weak or dizzy, or you need to change your tampon or sanitary pad every hour, please get in touch.

There are a number of tests available to determine the cause of a heavy or painful period. Tests may include:

  • Pelvic examination – painless and private, are done in the rooms
  • Ultrasound – can be used to identify polyps or fibroids
  • Blood tests – if required can be used to investigate possible hormonal irregularities, blood disorders and iron deficiency.
  • Hysteroscopy – a camera is inserted into the uterus to examine the lining of the uterus and possibly remove polyps and small fibroids.
  • Biopsy – during a hysteroscopy, a small part of the lining of the uterus is taken to see if there are any signs of abnormalities.

There are a number of different causes to heavy or painful periods. These can include:

There are a number of different medical or surgical treatments.

Each option depends on what your tests reveal about the cause of the heavy period.

Hormone treatments can include things like going onto or off a hormone-based contraception. These can include the pill, the ring, a monthly injection or a skin patch. These can reduce the amount of blood lost in your period each month, and reduce the number of days your period lasts.

There are other treatments such as a medicated IUD (a Mirena) which can be inserted into the uterus, or tablets that assist clotting of the blood. These options can work to reduce the amount of blood loss, but may not affect how long your period lasts or the regularity of your cycle.

A number of surgical options are also available, from keyhole surgery to remove polyps or fibroids to more permanent options such as a hysterectomy or an endometrial ablation. These last two options are only recommended if you have finished with child bearing and have exhausted all other simple options.

Guy will take you through each option and talk with you to help you determine which one is right for you. Guy will take into consideration your personal circumstances but also things such as  your age, whether you need birth control or if you wish to have children in the future.

Change in hormone levels

Hormones help determine how your body functions. Changes in your hormone levels usually result in changes to how you feel – and painful or heavy periods can be a sign your hormone levels have changed. This can be caused by any number of things including age, weight, diet or changes to particular glands or the way your body produces hormones.

Change in structure of the uterus

These can be caused by any number of issues including fibroids, polyps, unusual muscle structure around the uterus or cancer. Guy will take you through each of these and talk through the procedures and options available to you.

Blood clotting problems

One of the main ways your body stops heavy bleeding every month is through releasing specific proteins which help clot the blood and stop the walls of your uterus from bleeding. If there has been a change in the way these proteins are produced, you may experience a heavy or painful period.

FAQ’s

Yes. 

Heavy periods can occur in around 20% of all women. They have different causes and can very different effects.

They can simply occur as a once-off thing. Or can be the symptom of something like endometriosis or fibroids.

If you have more than two or three heavy periods in a row, it’s important to have your symptoms checked.

Dr Guy Skinner has a huge breadth of experience in all known conditions which contribute to heavy periods and will be able to talk you through what the likely cause is, and what your options are for treating your heavy period.

Sometimes it just happens.
For around 50% of all women, there will be no identifiable reason for their heavy period – and regular periods will soon recommence.

Sometimes there is an easily identified cause. These can include:

  • fibroids  
  • endometriosis 
  • adenomyosis 
  • pelvic inflammatory disease (PID) 
  • endometrial polyps 
  • cancer of the womb 
  • polycystic ovary syndrome (PCOS) 

It varies from woman to woman. Every woman is different and what might be normal for one woman might be a lot for another. It’s simply a matter of whether the period is heavier than normal.

The average woman will lose, on average, between 6 to 8 teaspoons of blood (30 to 40ml) with every period. This can be as much as 16 teaspoons and as little as 3 teaspoons.

If you’re losing more than 80ml of blood with every period, or your period lasts longer than seven days, it would be good to see a gynaecologist.

While it can be hard to measure the exact amount of blood loss, signs can include:

  • needing to change your tampon or pad every one or two hours
  • needing to use pads and tampons
  • passing blood clots larger than a 20cent piece
  • bleeding through your clothes

There are a number of treatment options for heavy periods.

Each treatment depends on what is causing the extra blood loss. Other considerations include your health, and what you believe you need – once you’ve discussed your options with your specialist. Your first port of call should be your family doctor or your general practitioner. They will start investigating what is causing your heavy period. If they determine you need specialist help, they’ll refer you to a gynaecologist. 

If you have a preferred and trusted gynaecologist, simply ask your doctor to refer you to them.

Treatments can include:

  • hormonal treatments to manage the blood flow. These range from oral contraceptive pills to progestogen tablets to having an IUD (or intrauterine device) inserted into your womb
  • non-hormonal treatments which can include a program of tranexamic acid or a course of a non-steroidal antiflammatory drug
  • endometrial ablation – the endometrium is the lining of the womb which fills with blood every month. This procedure removes the lining of the womb. (Please see the next section for information on endometriosis)
  • removal of fibroids – also called a myomectomy. This is done through keyhole surgery and is usually a day procedure.
  • uterine artery embolisation – a procedure to shrink fibroids by reducing the blood flow to the fibroids themselves
  • hysterectomy – in some cases, especially if you have decided you will not be having any more babies, your gynaecologist will recommend surgery to remove to the womb