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> Menorrhagia
Menorrhagia means heavy periods. These are not unusual, especially as you approach the menopause. Heavy periods can mean different things to different people; this may mean that you are using more or larger sanitary towels. You may notice flooding or soaking through your towels or a sudden heavy loss of clots of blood. If you have to get up during the night to change your sanitary protection, you probably have heavy periods.

What are the causes of menorrhagia?

One or more of the following may be the cause:
> a hormone imbalance
> fibroids
> polyps - small lumps of skin tissue that are not cancer, found in the lining of the womb
> having a copper contraceptive coil (intra-uterine device)
> infection in the pelvis (around the womb)

You may have an ultrasound scan, and/or a biopsy from the lining of the womb. Sometimes a hysteroscopy is performed; this is a way of looking inside the uterus, and can be done either with local or general anaesthetic.
What is the treatment for menorrhagia?

Medical treatment is possible: the combined oral contraceptive pill may help heavy periods. Tablets such as tranexamic acid act to reduce the bleeding - these are not hormones, and are only taken when you are bleeding heavily. A Mirena intra-uterine device, which is a contraceptive coil with progesterone hormone, may be helpful, as may the Implanon device (a contraceptive inserted just under the skin in the arm).

Surgical treatment may be required: an endometrial ablation may be suitable.
This is a straightforward procedure, usually performed as a day case with a general anaesthetic. A device is used which vaporises the lining of the uterus, leading to a substantial reduction in bleeding in the majority of women. Removing fibroids may be of help. If all other treatments are unsuccessful, hysterectomy may be considered.

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The Portland Hospital
212 Great Portland Street
London W1W 5QN

020 7390 8079
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