Heavy Periods? Doctor Explains Tests and Treatment Options

According to Dr Pranathi Aravind, Senior Consultant, Department of Obstetrics and Gynaecology at Gleneagles BGS Hospital, Bengaluru, heavy menstrual bleeding means losing significantly more blood than normal or bleeding for a longer period than expected.

Many women ignore unusually heavy periods, but persistent or severe bleeding may be a sign of an underlying condition. The good news is that several diagnostic tests and treatment options are available.

When Are Heavy Periods a Cause for Concern?

Heavy menstrual bleeding may need medical attention if you regularly experience:

Soaking through a sanitary pad or tampon very frequently Needing to change menstrual products every one to two hours Using two forms of period protection together Waking up at night to change pads or other menstrual products Passing large blood clots Bleeding for more than seven days Periods that affect work, school, sleep or social activities

If heavy bleeding happens repeatedly, it is important to speak with a gynaecologist instead of simply accepting it as normal.

How Do Doctors Diagnose Heavy Menstrual Bleeding?

Dr Pranathi explains that finding the cause of heavy periods usually begins with a detailed evaluation.

The doctor may ask about your menstrual cycle, including how long your periods last, how often you change pads or tampons and whether you experience large blood clots.

Your medical history and a physical examination may also be part of the evaluation.

Blood Tests

Blood tests can help doctors check for possible health issues linked to heavy bleeding. These may include tests for:

• Haemoglobin levels
• Iron stores
• Thyroid function
• Hormone-related concerns
• Possible bleeding or clotting disorders

Heavy periods can sometimes lead to iron deficiency or anaemia, which may cause tiredness, weakness or reduced energy.

Pelvic Ultrasound Can Help Find the Cause

A pelvic ultrasound is often one of the first imaging tests recommended.

It can help doctors look for conditions such as:

• Uterine fibroids
• Adenomyosis
• Ovarian cysts
• Other structural abnormalities

Hysteroscopy and Endometrial Biopsy

In some cases, doctors may suggest a hysteroscopy, which allows a closer examination of the inside of the uterus.

An endometrial biopsy may also be advised in certain situations to examine the uterine lining more closely.

The exact tests needed depend on factors such as age, symptoms, risk factors and the possible cause of the bleeding.

Treatment Options for Heavy Periods

Treatment is not the same for everyone. According to Dr Pranathi, the treatment plan depends on the cause and severity of the condition, the woman's age and whether she wishes to have children in the future.

Medicines and Hormonal Treatment

Doctors may recommend medicines or hormonal treatments to help reduce heavy menstrual bleeding.

Possible treatment options can include:

Hormonal contraceptive pills Progesterone therapy Levonorgestrel-releasing intrauterine devices, also known as LNG-IUDsWomen with iron

deficiency or anaemia may also be prescribed iron supplements.

The right treatment should always be decided after a medical evaluation.

When Are Surgery or Procedures Needed?

If medicines do not provide relief or there is an underlying structural problem, a doctor may recommend a minimally invasive procedure or surgery.

Depending on the condition, options may include:

Polypectomy to remove polyps Myomectomy to remove fibroids Other minimally invasive procedures Hysterectomy in selected or severe casesA hysterectomy is generally considered only when medically appropriate, as it is a major procedure and permanently ends the ability to carry a pregnancy.

Don't Ignore Extremely Heavy Bleeding

Heavy periods can be more than just an inconvenience. If your menstrual bleeding regularly disrupts your daily life, causes extreme tiredness or continues for longer than usual, it is worth discussing with a gynaecologist.

The most important step is finding out why the bleeding is happening. With proper tests and an individual treatment plan, many causes of heavy menstrual bleeding can be effectively managed.