Heavy Cycles - Consider Your Options

Heavy menstrual periods. Can you relate? For some of you, it has been a cross borne since your teens. For others, it started after having children or even later in life. Sometimes, women have a difficult time determining what’s “okay” in terms of heavy periods. Often when I see women for their “Well Woman” exams, it’s only after asking very pointed questions that I find out about very heavy bleeding with periods.

Here are a few ways to determine if your periods require evaluation:

• Bleeding lasting for more than 7 days
• Wearing dark clothes during your period to conceal “accidents”
• “Doubling up” on pads/tampons
• Fatigue during your period
• Planning your social or work activities around your periods
• Waking at night to change pads/tampons
• Anemia found on a routine physical

Any of these may indicate that what you thought were just heavy menstrual cycles may actually be a condition called menorrhagia. Menorrhagia is defined as the loss of more than 80 milliliters (2½ ounces) of blood loss during an entire period or having periods that last longer than 7 days. Since it is generally difficult to measure exactly how many milliliters of bleeding someone has during a period, the above checklist is helpful in determining if this condition exists.

Sometimes there is no obvious cause for menorrhagia, but there are several things that a doctor will need to rule out. Menorrhagia may be caused by a variety of conditions such as tumors (uterine fibroids), growths inside the uterus (polyps) and an overabundance of uterine glands in the muscle of the uterus (adenomyosis). Less common causes include uterine cancer and diseases where the blood doesn’t clot well.

Treatment options can be considered only after a thorough evaluation of menorrhagia has been performed. In the past, the only available options were birth control pills and, if the pills failed, hysterectomy. Today, there are simple procedures that can significantly reduce the volume of bleeding during periods. These procedures all fall under the general term “Endometrial Ablation”. Sometimes they can eliminate periods altogether. Remember, in this case the absence of periods is due to the treatment. Endometrial ablation does not cause early menopause or affect your ovarian hormones. The endometrium is the lining in the uterine cavity that sheds as a period every month. Ablation is surgical removal. Endometrial ablations are typically very quick procedures lasting no longer than 20 minutes and with recovery times usually 1-3 days. They generally have minimal associated pain and some types of ablation can even be done in a gynecologist’s office with minimal sedation.

Menorrhagia can be a very debilitating condition that is often overlooked. In order for it to get the attention it deserves, the first step is yours. Schedule an appointment with your gynecologist to discuss it today