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Heavy Painful Periods...

Heavy Painful Periods

Heavy Periods (menorrhagia)

This is defined as menstrual loss of greater than 80 mls with each period. It affects more than 1 in 5 women. Heavy periods is one of the most common causes of iron deficiency anaemia in western women.

Periods are considered to be heavy when:

  • Menstrual flow that interferes with your regular activities e.g. becoming house bound due to the heavy periods
  • Periods that last longer than eight days
  • Menstrual flow that soaks through one or more tampons or napkins every hour for several consecutive hours
  • Menstrual flow that includes large blood clots
  • Anaemia causing tiredness

Causes of heavy periods

The commonest cause in the younger age group is due to an hormonal imbalance or dysfunctional uterine bleeding (DUB)

Pelvic pathology

  • Fibroids
  • Endometriosis
  • Pelvic inflammatory disease
  • Uterine Polyps


  • Blood tests - to exclude anaemia
  • Ultrasound scan - To exclude uterine polyps or fibroids. Assessment of the ovaries are also made
  • Endometrial biopsy - a sample of endometrial tissue that is obtained to be examined under a microscope
  • Hysteroscopy- Assessing the lining of the uterus


This is based on the patient's age, contraceptive wishes and the severity of the heavy periods.


  • Oral contraceptive pill
  • Tranexamic acid
  • Mirena coil


  • By removing the lining of the uterus by ablation ie. Novasure Endometrial ablation. This procedure has a high success rate and may be performed under sedation with local anaesthetic.


  • Laparoscopic (key hole surgery)
  • Abdominal
  • Subtotal or partial (conserving the cervix)
  • Vaginal