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Bleeding Problems: Treatments

Much of the time simple reassurance is all that is required. If, however, your periods are extremely heavy you may benefit from one of the following options:

  1. Cyclokapron or Tranexamic Acid. This is a drug which affects the formation of clotting within the vessels in the womb and reduces blood flow. You can take up to 12 tablets a day and it is often very effective. There are no real side effects, and this can be taken while you are bleeding. It is non hormonal.

  2. Mefenamic Acid or Ponstan. This is an anti-prostaglandin agent and is again helpful for heavy bleeding. It also reduces period pains

  3. Mirena Coil. This is a small device which fits inside the womb like an intrauterine conceptive device. It can usually be fitted in an out-patient clinic with minimal discomfort. Not only is it a contraceptive, but also it releases a small amount of progestogen hormone to the womb lining, making it thinner and hence making heavy periods lighter. At first it can sometimes be associated with irregular spot bleeding, which can be irritating, but this nearly always settles. If you subsequently take HRT while the Mirena is still in place, the Mirena will provide the progestogen part of the HRT, making your HRT regimen simpler while continuing to provide contraception and control bleeding.

  4. Cyclical progestogen hormones. These are progestogen containing tablets which are taken for part of the month. They are particularly useful when you have occasionally missed periods and then go on to have a very heavy period. It means you will have periods regularly, once a month making life much less socially inconvenient. The progestogen can also help with flushing and sweating.

  5. Surgical treatments-Endometrial ablation or resection. Your doctor may suggest, assuming the womb lining is normal or only has small fibroids, that you undergo a procedure which will ablate the womb lining. This can be performed under either a local or general anaesthetic as a day case procedure in hospital. The intention is to make the periods very much lighter and many women will find their periods go away, or at least are significantly reduced.

  6. Hysterectomy. This can either be performed through your abdomen if you have large fibroids, or vaginally if the womb is fairly normal in size. The vaginal route is particularly helpful if you also have a prolapse. Hysterectomy, both abdominal and vaginal, should be considered as a major surgical procedure. It will require about four days in hospital and up to three months of recovery time. It is the most effective treatment for heavy periods, but also quite radical, and while for the majority of women it is a very safe operation, very rarely unexpected complications can arise which can on occasion be very serious. With more very effective, safer options now available, hysterectomy is performed less often for period problems than it was in the past.

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