Treatment of heavy periods (menorrhagia) Pt:2

How can my heavy periods be treated?

The treatment of heavy periods depends on several variables. These include:

• Patient’s current and past state of health

• Available resources within the health care system

• Specific cause of the condition

• Severity of the problem and its impact on the patient’s quality of life

• Age of the patient and how close they are likely to be going into menopause

• Reproductive history and desires of the patient

• Patient’s financial resources

• Patient’s personal preferences

• · How the patient has tolerated previous treatments

Medications

Medical therapy for heavy periods may include:

•  Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications such as ibuprofen, naproxen, diclofenac and others in this class of drugs can reduce menstrual flow by up to 20-40%. Additionally, they also help significantly with “period pain”.

• Tranexamic acid: This reduces menstrual blood loss by 40-65%. This should not be taken by patients who have a history of DVT (Deep Vein Thrombosis) or pulmonary embolism..

• The combined oral contraceptive pills:  These regulate menstrual cycles and can reduce episodes of very heavy or prolonged periods. The added benefit is that they act as contraceptives.

• Oral progesterone: By taking this hormone one reduces the buildup of the lining (endometrium) of the womb (uterus) thereby reducing the amount of bleeding at the time of the period.

• Hormonal IUD (e.g. Mirena). The hormone within the IUD thins the lining of the womb ultimately reducing the bleeding at the time of the period.

If the patient is anemic or their ferritin (iron) levels are low as a result of their excessive monthly blood loss, iron supplements are often prescribed.

Surgical Interventions

In instances where medicines are not working, surgical options may be considered.

• Dilation and curettage (D&C): This is often referred to as a womb scrape. The doctor opens the mouth of the womb (cervix) with a dilator and uses a curettage or suction device to remove the lining of the womb.  .

• Myomectomy: This is whereby the fibroids only are removed surgically. This is generally the preferred option if the patient is desirous of becoming pregnant in the future but needs to have the fibroids removed in the interim in order to reduce the incidence of heavy and prolonged periods.

•  Hysterectomy: This is a major operation which is performed under anesthesia and involves the entire removal of the womb.

When the cervix is also removed it is called a total hysterectomy. When the cervix is left, it is referred to as a subtotal hysterectomy. This is an irreversible procedure which results in permanent sterility.

• Uterine artery embolization: While only available in specialized centers this can be used when fibroids are the cause of the excessive bleeding. This procedure shrinks the fibroids by cutting off their blood supply.

•  Endometrial ablation: Essentially this procedure involves the thinning, removal or destruction the lining of the womb (the endometrium). Ultimately, there is significant reduction in the amount and duration of the monthly periods and in some cases the periods may stop all together.

Author: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale, www.familycaresvg.com, clinic@familycaresvg.com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp)

Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.