Managing heavy periods: What you need to know

Heavy periods affect around one in four women – and they can have a devastating impact on emotional, social and physical wellbeing.

Getting effective treatment can be a challenge – with some women even turning to hysterectomy in a desperate bid to end the discomfort and pain.

But the first nationally agreed standard of care for managing heavy menstrual bleeding, developed by the Australian Commission on Safety and Quality in Health Care, recommends that a range of gentler treatments should be offered to women before hysterectomy.

“Hysterectomy used to be one of the few options for women with heavy menstrual bleeding, but there are now several less invasive treatment options,” says Professor Anne Duggan, the Commission’s senior medical advisor.

But the number of hysterectomies being performed in Australia for heavy periods suggest other treatments may not be as widely as they could be, and women may not always be fully aware of other options.

What is heavy menstrual bleeding?

Heavy periods can include losing more than five to six tablespoons of blood, passing clots larger than a 50c coin, or having to change a pad or tampon every hour, according to the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Bleeding for more than eight days a month is also a sign of heavy menstrual bleeding.

Heavy period causes

Heavy monthly bleeding can be caused by fibroids – benign growths in the uterus, and polyps which are small tissue growths in the uterus lining.

A thickening of the lining of the uterus, hormonal changes during perimenopause, polycystic ovarian syndrome or an underactive thyroid can also lead to heavy periods.

To confirm the cause a doctor or specialist will examine the cervix and an ultrasound of the uterus and ovaries may be needed to identify polyps or fibroids.

A hysteroscopy to examine the inside of the uterus may also be recommended.

Treatment choices for heavy periods

  • The intrauterine device (IUD): This small plastic device releases progesterone into the uterus and reduces the thickness of the uterus lining and monthly bleeding. It can be kept in the uterus for up to five years and also prevents pregnancy.
  • Medication: Some medications help reduce blood loss by up to 50 per cent, but they don’t lessen the number of days of bleeding. GPs may also recommend taking the contraceptive pill to reduce blood loss each month, or taking the pill continuously to avoid having a period.
  • Endometrial ablation: This procedure uses heat to remove the uterus lining and reduce bleeding.
  • Fibroid removal: Fibroids are removed in surgery under general anaesthetic.
  • Hysterectomy: Removes the uterus and sometimes the cervix, ovaries and fallopian tubes.

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Written by Sarah Marinos.