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Heavy Periods

Heavy periods may be associated with regular (ovulatory) cycles, or irregular (anovulatory) cycles but in one in two women no cause is established.

Symptoms and Causes of Heavy Periods

- normal loss, dysfunctional uterine bleeding, oestrogen dominance, 'stress', anaemia, poor diet, coil, smoking, overweight, bingeing, approaching menopause

- fibroids, endometriosis in the womb, pelvic inflammatory disease

- underactive thyroid, food sensitivity, lupus, clotting or bleeding disorder, certain drugs, womb cancer

Medical treatment for Heavy Periods

Your doctor will treat any identified cause. If the cause isn't obvious and self-help hasn't worked then, if your cycle is regular (which means you're almost certainly ovulating), non hormone treatments will probably work. In contrast, if your cycle is irregular, you may need hormones. It's important to control the heavy bleeding that's associated with anovulatory cycles, since this shrinks the associated thickening of the womb lining that could, at worst and if continued for a long time, encourage womb cancer.

Your doctor will probably start by recommending a non-hormonal drug such as tranexamic acid, to be taken only during your period. This 'antifibrinolytic' agent helps when blood isn't clotting properly, and halves blood loss in four in five women. Try it for three months; if it helps, you can continue as long as you like. Another possibility is mefenamic acid, a non-steroidal anti-inflammatory drug (NSAID) that can rebalance a disturbed prostaglandin balance. You take it only during a period, and it's worth trying it for three months, or longer if it helps. It reduces heavy bleeding by up to 40 per cent in three in five women, and can be especially useful if your periods are painful, or if heavy periods are due to a coil you want to keep in.

If you would like your treatment to provide contraception, there are four possible drug therapies (and they are particularly appropriate for an oestrogen dominant hormone imbalance that you can't overcome with lifestyle changes):

. A progestogen-releasing intra-uterine system is the most effective, reducing blood loss by 95 per cent in over nine in 10 women.

. The combined Pill is a useful alternative, halving blood loss in four in five women and regularizing periods. If necessary, you can take mefenamic acid as well. If you are nearing your menopause, you can stay on the combined Pill until 51, then try coming off it for three months to see if you've had your menopause. ; Progesterone vaginal gel, from day 15 to day 25.

Progestogens taken for 21 days in each cycle (from days 5 to 25) reduced blood loss by 87 per cent in one study but many volunteers stopped because of the side effects.

If drugs don't work, your doctor may recommend endometrial ablation to remove your womb lining. Hysterectomy, though obviously effective, should be a last resort. One UK study found that less well educated women were more likely to have a hysterectomy than to use drugs for heavy periods (and other period problems). Always go on asking questions until you feel confident you are in a position to make an informed choice.



Medical Conditions

Gynae cancers
Oestrogen dominance
Oestrogen deficiency
Period pain
Mid cycle pain
Heavy periods
Polycystic ovary syndrome
Ovary cancer
Ovarian Cysts
Cervix cancer

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