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Many women will have problematical periods. It is normally a very treatable issue and so in most cases, it is unlikely that there will be anything to worry about. I suggest that women seek advice when there is a change in their cycle, e.g. the cycle becomes heavier or irregular, or there is bleeding after intercourse. An indicator to know when to seek help is when the issue is interfering with your life, for example, if you are having to change your social plans or take time off work.
Unfortunately, there can be issues when periods first start and issues can also develop over time. Some problems tend to be more common at different ages. For instance, periods are more likely to become an issue in the 7 or 8 years before the menopause. In some women, there can be a hormonal cause, whilst in other women, there will be a physical cause such as fibroids or polyps. Heavy, painful periods can also be caused by the copper coil. There will be no obvious cause in others, which can be frustrating. The good news is that there are many treatment options.
I would normally examine a patient and look at the cervix. The investigation starts with blood tests to check for low blood counts or iron levels as well as hormone imbalances. The womb and ovaries should be looked at by ultrasound to rule out polyps and fibroids. This can all be done in a single visit with the ultrasound undertaken at the consultation.
Although problematical periods are a significant issue for many, there is a range of options to deal with these.
The treatment options depend on what is found but start with a discussion about lifestyle and diet.
Tablet medication (non-hormonal) is the first treatment option with tranexamic acid and then moving onto the birth control pill. The Mirena Coil (IUS) is an excellent option that is very popular and often results in significant improvements to a woman’s quality of life.
There are very effective day case surgical procedures such as Novasure (endometrial ablation) that will make big differences to most women with heavy periods. Endometrial ablation is not reversible and is only useful in women who have completed their family.
The development of the Mirena Coil and endometrial ablation mean that removing the womb (hysterectomy) is now a much rarer procedure. If a hysterectomy is required then this can be performed through a keyhole approach, which has benefits from a recovery point of view.
Mr Gidon Lieberman is a Consultant Gynaecologist at Highgate Private Hospital, specialising in menstrual disorders (including day case surgical treatment for heavy periods), pelvic pain, early pregnancy complications, menopause complications, gynaecological ultrasound and laparoscopic and hysteroscopic surgery (minimally invasive surgery).
A private initial consultation with Mr Lieberman at Highgate Private Hospital costs £250 if you are self-funding your treatment. The hospital is approved by all major health insurers, and so welcomes patients with private health insurance.
To book an appointment click here, or see below for contact details:
T: 0208 341 4182