In a woman of child-bearing age, every 28 days or so one or more eggs will mature in the ovaries. While the egg is maturing, a mucous lining will be developing in the uterus. It’s in this lining that a fertilized egg can burrow itself. If no egg is fertilized that month, the lining simply perishes. It’s then expelled along with the egg as menstrual bleeding. This process is controlled by the hormones oestrogen and progesterone, and will normally be repeated once a month until the menopause. After the menopause, the lining tends to get thinner.
Bleeding irregularities can be nothing more than normal changes related to your age. Irregularities can also be caused by mental stress, weight gain or loss, and hard physical exercise. But you need to be on the alert if you experience any of the changes listed below:
- Prolonged and heavy periods
- Bleeding after menopause
- Spot bleeding after sex
- Spot bleeding between periods
- Missed periods
- Irregular menstrual cycle
The symptoms above could indicate that you have a disturbance that requires treatment.
At the first examination, the specialist will ask you about your symptoms. Then you’ll have an ultrasound scan and a gynaecological examination. This may be all that’s needed to establish a diagnosis.
However, in some cases we may need to perform a keyhole examination of your cervix (colposcopy) and take a biopsy to rule out cell changes.
Likewise, we may need to perform a keyhole examination of your uterus (hysteroscopy) to rule out polyps or fibroids.
Depending on the results of the examinations, we can offer you various treatments – but it’s up to you to decide which treatment you prefer. The treatments we can offer include medical treatment, e.g. birth-control pills, an IUS/coil, cyclical gestagen or Cyklokapron.
The treatment can also involve surgery, e.g. removal of the lining of the uterus, removal of polyps or fibroids or removal of the uterus.
If the specialist has ruled out that the irregular and often heavy periods are due to cell changes, fibroids or polyps, it’s possible to treat your symptoms medically. Here are some of the treatments available:
Birth-control pills - Birth-control pills can be a good solution for treatment of both irregular and heavy bleeding. However, you’ll need regular checkups since in this case birth-control pills are drugs taken as part of a treatment.
IUS/coil - Unlike birth-control pills, the IUS/coil only contains gestagen, not oestrogen. Gestagen prevents the uterine lining from thickening, and the bleeding is therefore reduced. You can read more about IUS here.
Cyclical gestagen - Cyclical gestagen can be taken during the last 10-12 days of the menstrual cycle if the problem is caused by failing progesteron production.
Cyklokapron - Cyklokapron is a drug that helps the blood coagulate, which can reduce the amount of bleeding on days when the bleeding is particularly heavy.