This section aims to help women with problem menstrual bleeding (periods). It describes the common causes of abnormal menstruation, how we investigate the problem, and also illustrates the commonly available treatments for this condition. The information is intended to help you understand why you may have a problem, and what we can do to help you. This section cannot tell you what is the best treatment for you. That is best decided in consultation with your family doctor or your gynaecologist. For pain and bleeding in early pregnancy please click here.
Menorrhagia (meno = periods, agia ~ heavy)
Is the medical term used to describe heavy periods.Technically you have heavy periods if you bleed more than 80 mls each month. In reality if you notice that your periods become more heavy or painful, you will not be happy. If you become anaemic (low blood count) from heavy periods, you should seek medical attention, whatever the cause of your bleeding. Advancing age and having children are common causes of periods becoming heavier. There are also a number of pathological causes for menorrhagia, particularly when there is associated secondary dysmenorrhoea.
Dysmenorrhoea (dys = pain, menorrhea = bleeding)
Is the medical term for painful periods. Many women experience period pains or cramps on the first couple of days into the period. This is often called primary or spasmodic dysmenorrhoea, and is not usually linked to any problem with the womb (uterus). There may also be general discomfort associated with other premenstrual symptoms e.g. swollen breasts, abdomen, genitals, wrists and ankles. If the pain is worst before or after the heaviest days of the period, we often describe this as secondary dysmenorrhoea. We commonly find problems (e.g. endometriosis, infection, ovarian cysts, fibroids) when a woman complains of this type of period pain.
Polymenorrhea (poly = many, menorrhea = bleeding) (Frequent Periods)
Frequent or irregular periods are typically due to problems with the way you produce hormones, or because there is a lump or bump in the pelvis (e.g. fibroids, polyps, ovarian cysts. If your periods or pain has changed it is important that you visit your doctor so that some simple tests can be carried out. These may include a high vaginal swab (to look for infection), a cervical smear test, an ultrasound scan.
What can go wrong?
Periods can become heavy with advancing age and having children. Investigations listed above will help confirm that there is no physical defect, or problems with your menstrual cycle (see anatomy and physiology, see the menopause). Listed below are common physical problems that can lead to problem bleeding.