Menstrual Disorder Management
Heavy periods, pain and irregular cycles are among the commonest reasons women see a gynaecologist, and among the most often endured for years first. Most have a cause that can be found and a treatment that works, frequently without surgery.
- Ultrasound and blood tests at the first visit
- Medical treatment tried before surgery
- Anaemia checked and treated
- Hysteroscopy available where needed
Stay
Outpatient
Duration
About 30 minutes
Anaesthesia
Not applicable
About Menstrual Disorder Management
The pattern of the problem points to the cause. Heavy regular bleeding often means fibroids or a thickened lining. Irregular cycles suggest hormonal causes such as PCOS or thyroid disease. Pain with heavy bleeding raises endometriosis or adenomyosis. Investigation is targeted at that rather than ordering everything, and most women are treated medically.
- The pattern of bleeding points to the likely cause
- Anaemia from heavy periods is common and often missed
- Most causes are treated medically rather than surgically
- A hormonal coil treats heavy bleeding without an operation
Before you read on
Everything here is general information about menstrual disorder management. Whether it suits you, and how it would be done in your case, is a decision for your doctor after examining you.
Your consultant's instructions always take precedence over anything written on this page.
When is it recommended?
Situations in which a doctor may suggest menstrual disorder management.
- Heavy periods soaking through protection
- Periods lasting more than seven days
- Bleeding between periods or after intercourse
- Irregular or absent periods
- Severe period pain
- Periods that have changed from your normal pattern
- Tiredness with heavy periods, which may be anaemia
Procedure details
The usual sequence, from first consultation through to follow-up.
History and examination
The pattern, duration and heaviness of bleeding, its effect on daily life, and examination where appropriate.
Investigation
Blood count for anaemia, thyroid and hormone tests where indicated, and a pelvic ultrasound.
Treatment
Tranexamic acid, hormonal treatment or a hormonal coil for most women. Iron where anaemia is present.
Further steps
Where medical treatment fails, hysteroscopy to examine the cavity, and surgical options discussed.
How to prepare
What to sort out before you come in.
- Keep a record of your cycles for two to three months, including heaviness and pain
- Note how many pads or tampons you use on the heaviest day
- Bring previous scans and blood tests
- Note any medication including blood thinners, which affect bleeding
- Book the appointment for a time when you are not bleeding heavily, if possible
Recovery
What to expect afterwards, and roughly when.
- Medical treatment usually shows an effect within one to three cycles
- A hormonal coil can cause irregular spotting for the first three to six months before settling
- Iron treatment continues for several months after the blood count normalises
- Keep recording cycles so the response can be judged objectively
- Return if there is no improvement after three cycles rather than continuing
Why choose Humayun for period problems
Most heavy bleeding is treatable without an operation, and that should be tried first.
- Medical treatment offered properly before surgery is discussed
- Anaemia checked and treated, since it is common with heavy periods and often missed
- Ultrasound at the first visit rather than at a second appointment
- Hysteroscopy and laparoscopic surgery available where medical treatment does not work
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