Heavy periods Melbourne

Heavy periods
You may have questions about what defines your periods as heavy. No matter your age, we are here to help investigate if there are underlying causes that need attention. And we work out the best management plan for your personal circumstances.
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Definition heavy periods Melbourne Mothers

What are heavy periods?

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Key points
  • In reality, very few women measure how much blood they lose during their period. If your periods are bothersome and are interfering with your enjoyment of life, there are some simple steps which we can take to rectify this.
  • Periods are defined as heavy if you lose more than 80ml of blood in total (80ml = 16 teaspoons)
  • If menstruation takes longer than 7 days then we also define this as heavy periods.
  • Speak to your gynaecologist when you experience large clots during your period or if you need double layers of protection
Heavy periods or menorrhagia can disrupt your daily life. If your period takes longer than 7 to 8 days, you need to change your tampon or pad every hour, or overnight, have large blood clots (larger than 2.5cm), have period pain that doesn’t go away after taking pain killers, we recommend making a booking to discuss your symptoms.
“The main goal when I plan a gynaecological investigation is to help you exclude some of the underlying conditions. These conditions may need attention to avoid other health problems or fertility challenges at a later stage.”
It is not just about the symptoms or underlying conditions. The social challenges that you may experience if you have heavy periods are real and they affect your quality of life. We will take the time to talk about those challenges and then explore your treatment options.

Causes heavy periods Melbourne Mothers

Causes heavy periods

There are many possible causes for heavy periods. As always, when you book a consultation, we will look at your personal circumstances to make a diagnosis.

Endometriosis is a condition that occurs when tissue similar to that found in the lining of the uterus grows outside of it.

Adenomyosis causes heavy periods because tissue similar to the uterus lining now grows within the uterus muscle. It makes the uterus larger, so there is more surface and that causes heavier periods. Adenomyosis will also increase the level of prostaglandin and that makes uterine contractions (or period cramps) more painful. Because of the increased size of your uterus, many women will experience lower back pain and they are often surprised that after a number of normal x-rays of the spine that their back pain is coming from the uterus.

Polycystic ovary syndrome (PCOS) is a common health issue caused by an imbalance of reproductive hormones. Women with PCOS often have irregular cycles, and periods can be heavy.

Fibroids are benign growths in the uterus, made up of muscle cells. It changes the lining and there is now a larger surface when you have your period. The closer the fibroid is to the lining of the uterus – or when it is inside it – the heavier the bleeding can be.

Polyps are also benign growths of the uterus lining. They are a common cause of heavy periods and when they have been surgically removed, the heavy bleeding is usually reduced. Particularly in older women, the symptoms of cancer could mimic the symptoms of a polyp and therefore it is important for post-menopausal women to always seek help from a specialist should they experience bleeding.

Puberty or perimenopause
At the start of your period or towards the end of it, you may experience heavy bleeding. It is caused by infrequent egg release, with too much oestrogen simulation and a failure in your progesterone production. That then causes an overgrowth of your uterine lining and you may suffer from erratic bleeding over a longer time.

Inherited conditions
Conditions such as Von Willebrands disease or Von Willebrands disorder can influence your period and the level of bleeding. The condition is a bleeding disorder, and if you have it it means that the level of clotting protein in your blood is too low. With this condition, the control of bleeding from the uterus lining is weaker than normal and you would experience heavier blood loss.

Physiological changes after childbirth
If you have had children and you are over 40, then your uterus will be larger than before you had children. In simple terms, it means that there is now a larger surface area when the lining of your uterus sheds and starts the bleeding.

heavy periods Melbourne
heavy periods Melbourne

Managing heavy periods Melbourne Mothers

Managing heavy bleeding

When you experience heavy bleeding, we will always want to exclude any serious underlying conditions first. If that is the conclusion, most patients I see will not require further management.
“But about half of the women with heavy menstrual bleeding have no underlying condition. In these cases, heavy bleeding may be related to hormonal or chemical levels in the endometrium.”

A number of treatment options are available if you are diagnosed with consistently high bleeding volumes and heavy periods (menorrhagia):

If you have anemia, it means that you do not have enough healthy red blood cells, to carry the right amounts of oxygen to your body’s tissues.

At the start or at the end of your reproductive years, you may experience what we call ‘dysfunctional bleeding’ or abnormal bleeding. It means that there is oestrogen production happening even when no egg is released. Progesterone stops the growth of your uterine lining and when there is no pregnancy, the progesterone support drops, and the lining is shed. Gynaecologists sometimes prescribe progesterone tablets to stabilize the uterus lining. Problematic bleeding is then treated with the use of this medication for two weeks of each month.

Tranexamic/mefenamic acid:
This medication reduces the amount of bleeding by accelerating the clotting in the blood vessels in your uterus. The treatment is known to significantly reduce blood loss and it is only used during your period. So in other words, you can still use it and try to conceive.

Contraceptive pill:
When we prescribe oral contraceptives, that is because the oestrogen and progesterone in the pill suppress the natural flow of your menstrual cycle. Contraceptives are often better than a treatment based only on progesterone. Oestrogen stimulates the uterus lining so it grows, and progesterone stops that growth. The pills have a dominating progesterone effect, so the end result is a thinner lining and a lighter period.

Hormonal intrauterine devices
Intrauterine devices such as the Mirena IUD are highly effective in controlling heavy periods. After a few months, periods become much lighter or they stop completely. It is a contraceptive method and you can only use it if you are not hoping or trying to conceive.

Endometrial ablation
This is a gynaecological procedure that uses extreme cold or microwave energy to destroy the lining of your uterus. It reduces or stops the menstrual flow. Falling pregnant after this procedure could be hazardous so ensuring pregnancy does not occur becomes very important after endometrial ablation.

A definitive way to treat heavy periods is the removal of the uterus. It must be done only after careful consideration of your intentions to have children. If you have serious underlying conditions (endometriosis, fibroids, or adenomyosis) then this may be the most appropriate option.

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Adolescents and heavy periods Melbourne Mothers

Heavy periods in teenagers

Irregular cycles and poor cycle control are challenges for young girls when their period starts. Some experience heavy and long periods and in those first years, they may require management by a gynaecologist.
“This can have a huge impact on your daily lives: sports, social life, or study performance. There is a concern that the easy solution is often the use of hormone birth control pills to treat heavy periods in girls or young women. Taking the time to really investigate any underlying conditions at this age is important, because it may impact a girl’s future gynaecological health and fertility.”

If you are a teenager reading this, or a concerned mum, we welcome you to make a booking. Talking about periods may seem daunting, but our main goal is to help relieve your symptoms and take away the stigma around menstrual bleeding.

Over 40 and heavy periods Melbourne Mothers

Over 40 and heavy bleeding?

As you reach your 40s, and/or after multiple pregnancies, you will have a larger uterus than before you had children. That means there is now a larger surface or lining area and that may cause heavier periods after 40.

Our consultation will always focus on your personal circumstances. We will discuss whether you still want to conceive – and if fertility is not relevant, then the use of contraceptive pills or hysterectomy may be part of the conversation.

Personal care at Melbourne Mothers

Individualised care

There are many ways that we can address heavy bleeding. And what is acceptable bleeding for one woman might not be for somebody else, for example working women and women who are travelling a lot to different time zones, or those engaged in sports. Therefore at Melbourne Mothers we believe that individualising care and providing each woman with the best options for them whilst informing about other treatment modalities is of paramount importance. Large doses of hormones and medication are not suitable for everyone and similarly, hysterectomy is not the most desired option for others. Finding the right solution each time is what makes our role in your care rewarding.