Heavy Menstrual Bleeding

Menstrual bleeding or a period is a perfectly natural and very regular occurrence in a woman’s adult life. Nonetheless each woman’s flow is individual and entirely dependent on her. Even within the same woman the amount of blood lost with each cycle can vary greatly. The strict definition of normal blood loss with a period is 30ml. Therefore in theory we define 80ml loss as heavy. In practice however, the determination of a heavy period depends entirely on the individual woman. If her periods have previously been very light and suddenly become heavy or more frequent or incessant, this warrants investigation.

There are many reasons for heavy or irregular menstrual bleeding:

  • Fibroids
  • Polyps (small balls of blood vessels within the cavity of the uterus)
  • Cancers
  • Endometriosis
  • Pregnancy related problems
  • Infections
  • Hormonal abnormalities

Your doctor and Gynaecologist will explore these possibilities through blood tests, an ultrasound, a pelvic examination as well as an observation of your medical history. There are then two diagnostic procedures that may take place to find the source of the problem. A hysteroscopy involves inserting an endoscope (piece of medical equipment with a small camera and light) into the vagina to view the inside of the uterus. Then there is a laparoscopy where the endoscope is inserted via a small incision near the navel to view inside the abdominal cavity. 30% of cases of heavy menstrual bleeding are associated with conditions within the abdominal cavity.


There are both surgical and medical treatment options in dealing with heavy menstrual bleeding, depending on the circumstances of the problem. Medical treatments may be as simple as the oral contraceptive pill or progesterone containing IUD (mirena), where surgical therapy will depend on the specific cause, the woman’s age and desires (e.g. future childbirth).

Surgical options include:

  • Curettage treatment or ‘clean out’ (a scraping of the lining of the uterus)
  • Excision (removal) of all endometriosis in the pelvis
  • Removal of fibroids (myomectomy)
  • Endometrial ablation – microwave or laser to the cavity of the uterus to reduce or stop menstrual flow altogether
  • Hysterectomy

What do I do now?

Every woman is individual and her situation requires an individual plan of management. If you think these issues relate to you, call us at SWEC on 1300 498 448 to arrange a personal consultation and discussion of your case.