What is heavy period?
The most accurate medical definition of heavy periods is the loss of more than 80ml of blood in each period. However, it is unrealistic or practical to measure the loss of blood in such a way and the doctor should be based on the description given by the woman about her period.
Periods are considered heavy when:
- A woman bleeds for more than eight to ten days, or needs more than eight compresses a day, especially if this is repeated month after month.
- A woman bleeds so much that it is difficult for her to attend her work. The woman may be forced to plan her vacation and free time according to the dates of her periods.
- The bleeding is continually so intense that the woman becomes anemic.
- The presence of small clots for more than one or two days suggests heavy periods.
The following conditions are associated with heavy periods:
- In young women, heavy periods are almost always due to temporary hormonal imbalances (lack of ovulation) that eventually correct themselves.
- In the years ahead of menopause, (over 45 years) the heavy periods are generally a sign of hormonal imbalance. However, the possibility of heavy periods caused by an underlying disease increases with age.
Is it necessary to consult with the doctor?
If a woman experiences heavy or irregular periods that interfere with her quality of life, she should consult the GP or more appropriately the gynecologist to diagnose the cause of the disorder and indicate the most appropriate treatment.
What steps will the doctor take?
The diagnosis of menorrhagia due to hormonal imbalance is made after discarding other benign or malignant causes capable of provoking the same disorder. To do this, the doctor will do some actions.
If a diagnosis is not reached after these tests, a biopsy of the endometrial mucosa will sometimes be necessary to rule out abnormalities in the cells. This test can be done in the consultation itself and without anesthesia (microlegrad) or in an operating room with anesthesia (curettage).
Other times, an examination called hysteroscopy is suggested. This involves insertion into the uterus through the vagina and cervix of a small telescope to study the condition of the inside of the uterus, allowing even direct biopsy if deemed necessary. This test is performed normally without requiring anesthesia or remaining in the clinic.
Sometimes a hormonal study will be the one that contributes the diagnosis.
Practice of a gynecological pelvic examination consisting of: Inspection of the vagina and cervix, which reports the origin of the bleeding as well as the presence or absence of lesions. Examination of the uterus and ovaries by placing one hand on the abdomen and the other heart and index fingers inserted into the vagina. Request blood tests that include the study of coagulation. It is advisable to perform an ultrasound if possible abdominal, and vaginal (for its greater precision in general) for the study of the uterus, its cavity, the tubes, ovaries and pelvis in general.
How are heavy periods treated?
Regardless of the cause, there will be times when the severity of the anemia caused by this disorder is of such a magnitude that blood transfusion is necessary.
If there are no signs of an underlying abnormality, treatment is not absolutely necessary but most women prefer to have something that helps them cope more easily each month.
If the problems are severe, bleeding can be regulated by treatment with pills, which may be hormonal or non-hormonal.
Hormonal treatments include:
Progestogens (hormones similar to those produced in the ovary in the second phase of the cycle) are effective in making the periods of the woman more regular, but they do not reduce the menstrual flow.
Non-hormonal treatments include:
If heavy bleeding is produced by a particular cause that is diagnosed, treatment will be adapted to that cause. If the woman is anemic, supplements of iron and folic acid are adequate.
Surgical alternatives include the destruction of the matrix coating with a handle, with a laser or by applying heat treatment to the matrix coating with hot water in a balloon. Hysterectomy (removal of the uterus) is performed frequently for heavy periods. These two surgical procedures are only suitable for women who do not wish to have more children.