Mr Rowan James Connell

Welcome. I'm Rowan Connell and I'm one of the gynaecologists at Benenden Hospital. And today I'm going to be talking to you about heavy periods and how you can manage them and how we can help manage them at Benenden Hospital.

So what are heavy periods? Painful periods are also known as dysmenorrhea and heavy periods are also known as menorrhagia. And the GPs will often use those terms when they're talking to you and when they're referring you on to hospitals and to see consultants, but they can leave you with severe pains either before, during or after your periods and also feeling tired if they're very heavy and they may be making you anaemic. And what I'd like to talk to you today about is how we can help manage and treat heavy painful periods.

So heavy periods may mean that you're changing your pads or tampons every one or two hours. Sometimes you'll have double protection, which is where you use pads and tampons together and there may be bleeding around the side of that, which is called flooding. And of course, sometimes this will mean that you'll be housebound and having to stay at home because the periods are so heavy or painful.

Obviously, if your bleeding is lasting more than seven days and you're feeling very short of breath or very tired, you may have anaemia where your blood count is low. So seeing your GP at that point is often very important. One of the first things they may do is take a history and ask you about heavy painful periods and how they're affecting you. They may well perform a blood test looking for anaemia or a low blood count.

They may well organise an ultrasound scan as sometimes this is because of fibroids which are small growths in the muscle of your womb or polyps where the lining of the womb is growing. Sometimes the GP will put in a Mirena coil, which is a hormone coil, which in most women gives you less painful, less heavy periods. If the simple measures the GP has initiated has not helped, the next stage would be to think about being referred in to see a gynaecologist in our hospital. For example, if the ultrasound scan shows fibroids or polyps, then we may have to perform a small procedure, a hysteroscopy, where we cut out those fibroids or polyps.

Of course, we would then think about a Mirena coil as well. The hormone coil I mentioned to help thin out the lining of the womb and give you less painful, heavy periods. The success rate of the Mirena coil is about 80% at making women with painful, heavy periods better if the cavity is normal inside the womb.

Then another option is an ablation where we burn away the lining of the womb. This also has a success rate of about 80 to 85% of people and can be used in combination with the Mirena coil for women with painful, heavy periods.

Obviously in women where this still doesn't help, another option is a hysterectomy. So a hysterectomy is where you remove the womb itself. We can do this through a cut in the tummy, through the vagina or with keyhole surgery. And that again is something to discuss with your gynaecologist when you see them in the hospital.