At Home with Chris Jessen 2018 - 183
A RANGE OF
AVAILABLE FOR HEAVY
You don't have
to put up with it
Heavy periods are not simply a 'normal' part of life. They
can be treated, taking the pain away for many women
mong women aged between
15 and 50, a quarter experience
heavy menstrual bleeding
that often has a serious impact
on their quality of life. This common
problem can lead to debilitating
symptoms, such as severe pain, heavy
blood loss and anaemia. It can prevent
women from carrying out their normal
daily activities, including going to work.
More sinister causes of heavy or
irregular bleeding, such as endometrial
hyperplasia (thickening of the uterus
lining) or cancer, need to be excluded.
The most common symptom of
hyperplasia or cancer is abnormal
vaginal bleeding. This can include heavy
menstrual bleeding, bleeding in between
periods, irregular bleeding while on
hormone replacement therapy (HRT)
and bleeding after the menopause.
Up to 25% of women with endometrial
cancer present before the menopause.
Investigation and treatment
Management of heavy bleeding includes
taking a patient history and examination.
In most cases, a detailed ultrasound
scan examination of the gynaecological
organs is also carried out. This may
reveal the presence of endometrial
polyps, fibroids or other abnormalities,
such as an abnormally thickened
Blood tests to measure haemoglobin
levels may be necessary, along with
other tests as appropriate. In younger
women or those who have had heavy
MEET THE EXPERT
Ms Sadaf GhaemMaghami, MBBS,
PhD, MRCOG, is an
Ms Ghaem-Maghami qualified from
the University of London in 1990
and was awarded a PhD in immunology
in 2001. She treats a wide range of
female gynaecological problems,
including heavy periods, ovarian
cysts, abnormal smears, disease of
the cervix, uterus, vulva, ovary, and
gynaecological cancers. She has
also been an accredited colposcopist
since qualifying in 2004.
bleeding since their periods began,
testing for clotting disorders may
also be considered.
Once a detailed scan has been
carried out, the treatment is tailored to
the findings of the scan and particular
needs of the patient.
An endometrial biopsy may be
necessary to exclude endometrial
hyperplasia or cancer. This can be
carried out in the clinic and anaesthetic
is not usually required.
Occasionally, hysteroscopy (a method
of examining the inside of the womb) is
indicated for the removal of a polyp or
submucosal fibroid. Medical or surgical
treatment for fibroids can be offered,
depending on the size, location and
fertility wishes of the patient.
When appropriate, laparoscopic
(keyhole) and hysteroscopic procedures
are offered to patients in preference to
open surgical procedures, as they usually
result in a faster recovery.
In the absence of histological and
structural abnormality, a range of
pharmaceutical and surgical options
are available for heavy menstrual
bleeding, including the Mirena
system and endometrial ablation
(removal of the endometrium, or
lining of the uterus).
If these treatments fail, or there
is a clinical need such as atypical
endometrial hyperplasia or endometrial
cancer, laparoscopic total hysterectomy
can be offered, as long as the uterus is
not significantly enlarged and there are
no clinical reasons for not doing so.
FOR MORE INFORMATION
Ms Sadaf Ghaem-Maghami is available
for consultation at the following clinics:
132 Harley Street, London W1G 7JX.
The Robert and Lisa Sainsbury's Wing at
Hammersmith Hospital, London W12 0HS.
Platinum Medical Centre, 15-17 Lodge
Road, London NW8 7JA.
Call 07756 339 381