Heavy menstrual bleeding - causes and treatment options at gynhealth
About one in five women of childbearing age is affected by heavy menstrual bleeding. They are one of the most common complaints in gynaecology and severely impair quality of life. The good news is that there are effective therapies that can lead to a reduction or even an end to the symptoms. A thorough examination by a gynaecologist is therefore recommended.
Experts speak of excessive or prolonged bleeding if the blood loss exceeds 80 millilitres (the equivalent of approx. 8 tablespoons) or if the period lasts longer than seven days per cycle (menorrhagia). The menstrual blood can also contain many thick blood clots (hypermenorrhoea). They are among the most common complaints in gynaecology and are no reason to panic. But the women affected should definitely take action.
Quality of life suffers
Women with long or heavy periods often have to deal with other symptoms, such as cramp-like abdominal pain or the so-called premenstrual symptom (PMS). This refers to cyclical physical and psychological symptoms such as breast tenderness, mood swings or water retention that occur shortly before the start of monthly bleeding. The increased blood loss can also lead to anaemia and iron deficiency, which in turn can result in leaden tiredness or circulatory problems. In addition, the constant changing of pads and tampons is tedious. Heavy and long periods therefore considerably reduce the quality of life of those affected. Many patients with severe menstrual cramps only come to our consultation years later because they think they simply have to put up with their symptoms. There are various treatment options with good chances of recovery for heavy and prolonged menstrual bleeding. In many cases, the quality of life of our patients can be improved quickly and without major surgery.
Multiple causes and good chances of recovery
The cause and the needs of the patient play an important role in the choice of the individual therapy approach, above all the question of the desire to have children.
A thickened uterine lining is often the cause of heavy menstrual bleeding. Hormonal therapies such as taking the contraceptive pill or inserting a hormonal coil can reduce bleeding by inhibiting the growth of the uterine lining. Pregnancy is not possible during this time, as these preparations also prevent the fertilised egg from implanting. However, women can become pregnant again if they discontinue the treatment. If family planning is complete, surgical therapies such as outpatient sclerotherapy of the uterine lining (NovaSure) or hysterectomy may be considered.
Benign tumours such as fibroids can also hinder the muscle contraction of the uterus. If the muscles do not contract properly, this can increase or prolong the bleeding. The contraction is necessary to loosen the mucous membrane in the uterus and allow some blood to flow out. If the cause of the heavy bleeding is a fibroid, this can be elegantly removed using the minimally invasive Sonata method which Dr Juliette Schmid-Lossberg is the only attending physician in the canton of Zurich to perform. The patient can continue to become pregnant afterwards.
Other causes of heavy periods can be hormonal imbalances, for example before the menopause, or chronic diseases such as endometriosis. Hormonal therapies are also an option here. In any case, it is important to take a close look.
Contact us if you have any questions about heavy menstrual bleeding. Together we can tackle the issue and deal with it effectively and tailored to your needs.
