{"id":1156,"date":"2019-09-11T23:44:24","date_gmt":"2019-09-11T23:44:24","guid":{"rendered":"http:\/\/dr-hanan.com\/ws\/?p=1156"},"modified":"2021-02-28T23:10:46","modified_gmt":"2021-02-28T23:10:46","slug":"heavy-period","status":"publish","type":"post","link":"https:\/\/dr-hanan.com\/ws\/en\/heavy-period\/","title":{"rendered":"Heavy Period"},"content":{"rendered":"\t\t
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Heavy Period<\/strong><\/p>

What is considered heavy period?<\/strong>
1. Need to use two pads or both pad and a tampon together.
2. Soak the pad every 1 – 3 hours.
3. Heavy bleeding for more than 7 days.
4. Passing large blood clots.
5. Need to change pads during sleep.<\/p>

Heavy period can affect every day life. Also it may cause anemia resulting in weakness and fatigue, severe pain and cramps.<\/p>

Causes:<\/strong>
1. Fibroids<\/a><\/span>
2. Adenomyosis
3. Anovulation: common with young girls at the beginning of menstruation or women near menopause.
4. Polyps
5. Endometritis
6. Endometrial cancer
8. Overgrowth of uterus lining
9. Use of copper IUD<\/a><\/span>
10.Thyroid diseases
11. Blood clotting disorders
12. Some medications like blood thinners
13. Uterine arteriovenous malformation. Rare<\/p>

Tests:\u00a0<\/strong>
1. Blood test to check for iron level and the underlying causes.
2. Ultrasound of uterus, ovaries and pelvis
3. Collecting cells from the uterus (endometrial biopsy).
4. Hysteroscopy: through the vagina and cervix into your uterus.
5. Sonohysterography: fluid is injected into the uterus, then check for any abnormalities in the linings with ultrasound.<\/p>

\u00a0<\/div>
Treatment options of heavy period depend on:<\/strong><\/div><\/div>
1. The cause of heavy bleeding.<\/span><\/div><\/div>
2. Planning to get pregnant or not, as most effective treatments limit the ability to get pregnant.<\/span><\/div><\/div>
3. Not having children in the future permanently or not.<\/span><\/div><\/div>

\u00a0<\/span><\/span><\/p>

<\/div><\/div>
Treatment:<\/strong><\/div><\/div>
If the bleeding does not cause anemia, it does not necessarily needs treatment.<\/span><\/div><\/div>
\u00a0<\/span><\/div><\/div>
It is advised to check with doctor if soaking two pads in one hour for 2 consecutive hours.<\/span><\/div><\/div>
\u00a0<\/span><\/div><\/div>
Changes in lifestyle and diet do not reduce heavy bleeding, but can ease the symptoms, like:<\/span><\/div><\/div>
1. Treating underlying cause.<\/span><\/div><\/div>
2. Drinking more water.<\/span><\/div><\/div>
3. Eating food rich in vitamin C such as citrus fruits, as it helps in absorbing iron.<\/span><\/div><\/div>
4. Eating food rich in iron such as beans and spinach.<\/span><\/div><\/div>
\u00a0<\/span><\/div><\/div>
<\/div><\/div>
\u00a0<\/span><\/div><\/div>
1. Medications:<\/strong><\/div><\/div>
A. Oral contraceptive pills.<\/span><\/div><\/div>
Combination of estrogen and progestin taken for 21 days each cycle, followed by one week when bleeding happens.<\/span><\/div><\/div>
\u00a0<\/span><\/div><\/div>
Reduce bleeding and cramps.<\/span><\/div><\/div>
This method may take 3 months to start showing benefits.<\/span><\/div><\/div>
Hold some side effects such as nausea, breast tenderness or headache.<\/span><\/div><\/div>
\u00a0<\/span><\/div><\/div>
Combination pills are not suitable for:<\/strong><\/div><\/div>
a. Age greater than 35 and smoking. (more than 15 cigarettes a day)<\/span><\/div><\/div>
b. Complicated valvular heart diseases<\/span><\/div><\/div>
c. History of CVA<\/span><\/div><\/div>
d. High blood pressure<\/span><\/div><\/div>
e. Migraine with aura<\/span><\/div><\/div>
f. History of blood clots<\/span><\/div><\/div>
g. Current or history of breast cancer<\/span><\/div><\/div>
h. Less than 6 week postpartum<\/span><\/div><\/div>
i. Cirrhosis<\/span><\/div><\/div>
j. Liver Adenoma or hepatoma<\/span><\/div><\/div>
k. Nephropathy<\/span><\/div><\/div>

\u00a0<\/span><\/span><\/p>

<\/div><\/div>
B. Progestin pills:<\/span> <\/span><\/div><\/div>
Taken 10 to 14 days each cycle, or continuously.<\/span><\/div><\/div>
Option for women prefer to avoid estrogen or who are trying to get pregnant.<\/span><\/div><\/div>
It is less effective, and may cause bleeding between periods or bloating<\/span><\/div><\/div>

\u00a0<\/span><\/span><\/p>

<\/div><\/div>
C. IUD, releases progestin hormone.<\/span><\/div><\/div>
Prevents pregnancy and reduces bleeding for up to 5 years.<\/span><\/div><\/div>
Possible side effects such as irregular periods, spotting, acne (possibility of 15%), and breast tenderness.<\/span><\/div><\/div>
Side effects improve in few months. <\/span><\/div><\/div>

\u00a0<\/span><\/span><\/p>

<\/div><\/div>
D. Shot:<\/span><\/div><\/div>
Progesterone-like hormone.<\/span><\/div><\/div>
Given once every three months.<\/span><\/div><\/div>
Prevents pregnancy.<\/span><\/div><\/div>
Side effect: spotting, specially in the first few months.<\/span><\/div><\/div>

\u00a0<\/span><\/span><\/p>

<\/div><\/div>
E. Tranexamic acid tablets (Lysteda)<\/span><\/div><\/div>
It works by helping the blood in the uterus to clot.<\/span><\/div><\/div>
An options for patients who are not welling to take hormones treatments.<\/span><\/div><\/div>
Taken in few days per month as soon as period starts, and it does not affect pregnancy.<\/span><\/div><\/div>
1300 mg three times daily for as long as five days during menstrual period.<\/span><\/div><\/div>
Consult the doctor first before taking them with birth control pills as there is a risk of stroke and blood clots.<\/span><\/div><\/div>
Holds some side effects but not common: headaches, tiredness and muscle cramps.<\/span><\/div><\/div>

\u00a0<\/span><\/span><\/p>

<\/div><\/div>
F. NSAIDs such as ibuprofen:<\/span><\/div><\/div>
Non-hormonal.<\/span><\/div><\/div>
Less effective in reducing bleeding.<\/span><\/div><\/div>
Taken only during period.<\/span><\/div><\/div>
Started on the first day of bleeding and continued for 4 – 5 days.<\/span><\/div><\/div>
Does not prevent pregnancy, but should be stopped upon conception as it might be associated with miscarriage and congenital anomalies.<\/span><\/div><\/div>
Possible side effects: stomach problems, nausea, vomiting, headaches and drowsiness.<\/span><\/div><\/div>

\u00a0<\/span><\/span><\/p>

<\/div><\/div>
G. (GnRH) agonists:<\/span> <\/span><\/div><\/div>
When the cause of heavy bleeding is fibroids.<\/span><\/div><\/div>
injection given once every one to three months<\/span><\/div><\/div>
Works by blocking the production of estrogen and progesterone, causing a temporary menopause, to make fibroids shrink.<\/span><\/div><\/div>
It can cause hot flashes.<\/span><\/div><\/div>
Not used for more than 3 – 6 months as long term use may cause bone loss.<\/span><\/div><\/div>
They might be used before surgery, to shrink them and making it easier to be removed.<\/span><\/div><\/div>
\u00a0<\/span><\/div><\/div>
<\/div><\/div>
\u00a0<\/span><\/div><\/div>
In addition, it is advised to take iron supplementation if anemic. The side effects are stomachache and constipation.<\/span><\/div><\/div>
\u00a0<\/span><\/div><\/div>
<\/div><\/div>
\u00a0<\/span><\/div><\/div>
2. Surgeries:<\/strong><\/div><\/div>
A. Endometrial ablation or resection: thinning or removing the lining of the uterus.<\/span><\/div><\/div>
May cause nausea, vaginal discharge, cramping. Light bleeding may occur for a 2 – 4 weeks after the surgery.<\/span><\/div><\/div>
If the patient got pregnant after the surgery, there is a risk of miscarriage and other complications. <\/span><\/div><\/div>
Not an option for:<\/span><\/div><\/div>
– Women planning to get pregnant in the future<\/span><\/div><\/div>
– The underlying cause of heavy bleeding is anovulation.<\/span><\/div><\/div>

\u00a0<\/span><\/span><\/p>

<\/div><\/div>
B. Removing fibroids from the wall of the uterus.<\/span><\/div><\/div>

\u00a0<\/span><\/span><\/p>

<\/div><\/div>
C. Uterine artery embolization (UAE):<\/span><\/div><\/div>
If heavy bleeding is caused by fibroids.<\/span><\/div><\/div>
Cutting off blood supply to the fibroids which makes them shrink.<\/span><\/div><\/div>
Done under X-ray.<\/span><\/div><\/div>

\u00a0<\/span><\/span><\/p>

<\/div><\/div>
D. Hysterectomy: removing uterus and cervix. It is a permanent solution.<\/span><\/div><\/div>
It is an option if the other options failed or already discussed.<\/span><\/div><\/div>
Longer recovery time comparing with the other procedures.<\/span><\/div><\/div>
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Heavy Period What is considered heavy period?1. Need to use two pads or both pad and a tampon together.2. Soak the pad every 1 – 3 hours.3. Heavy bleeding for more than 7 days.4. Passing large blood clots.5. Need to change pads during sleep. Heavy period can affect every day life. Also it may cause […]<\/p>\n","protected":false},"author":2,"featured_media":2759,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"ocean_post_layout":"","ocean_both_sidebars_style":"","ocean_both_sidebars_content_width":0,"ocean_both_sidebars_sidebars_width":0,"ocean_sidebar":"0","ocean_second_sidebar":"0","ocean_disable_margins":"enable","ocean_add_body_class":"","ocean_shortcode_before_top_bar":"","ocean_shortcode_after_top_bar":"","ocean_shortcode_before_header":"","ocean_shortcode_after_header":"","ocean_has_shortcode":"","ocean_shortcode_after_title":"","ocean_shortcode_before_footer_widgets":"","ocean_shortcode_after_footer_widgets":"","ocean_shortcode_before_footer_bottom":"","ocean_shortcode_after_footer_bottom":"","ocean_display_top_bar":"default","ocean_display_header":"default","ocean_header_style":"","ocean_center_header_left_menu":"0","ocean_custom_header_template":"0","ocean_custom_logo":0,"ocean_custom_retina_logo":0,"ocean_custom_logo_max_width":0,"ocean_custom_logo_tablet_max_width":0,"ocean_custom_logo_mobile_max_width":0,"ocean_custom_logo_max_height":0,"ocean_custom_logo_tablet_max_height":0,"ocean_custom_logo_mobile_max_height":0,"ocean_header_custom_menu":"0","ocean_menu_typo_font_family":"0","ocean_menu_typo_font_subset":"","ocean_menu_typo_font_size":0,"ocean_menu_typo_font_size_tablet":0,"ocean_menu_typo_font_size_mobile":0,"ocean_menu_typo_font_size_unit":"px","ocean_menu_typo_font_weight":"","ocean_menu_typo_font_weight_tablet":"","ocean_menu_typo_font_weight_mobile":"","ocean_menu_typo_transform":"","ocean_menu_typo_transform_tablet":"","ocean_menu_typo_transform_mobile":"","ocean_menu_typo_line_height":0,"ocean_menu_typo_line_height_tablet":0,"ocean_menu_typo_line_height_mobile":0,"ocean_menu_typo_line_height_unit":"","ocean_menu_typo_spacing":0,"ocean_menu_typo_spacing_tablet":0,"ocean_menu_typo_spacing_mobile":0,"ocean_menu_typo_spacing_unit":"","ocean_menu_link_color":"","ocean_menu_link_color_hover":"","ocean_menu_link_color_active":"","ocean_menu_link_background":"","ocean_menu_link_hover_background":"","ocean_menu_link_active_background":"","ocean_menu_social_links_bg":"","ocean_menu_social_hover_links_bg":"","ocean_menu_social_links_color":"","ocean_menu_social_hover_links_color":"","ocean_disable_title":"default","ocean_disable_heading":"default","ocean_post_title":"","ocean_post_subheading":"","ocean_post_title_style":"","ocean_post_title_background_color":"","ocean_post_title_background":0,"ocean_post_title_bg_image_position":"","ocean_post_title_bg_image_attachment":"","ocean_post_title_bg_image_repeat":"","ocean_post_title_bg_image_size":"","ocean_post_title_height":0,"ocean_post_title_bg_overlay":0.5,"ocean_post_title_bg_overlay_color":"","ocean_disable_breadcrumbs":"default","ocean_breadcrumbs_color":"","ocean_breadcrumbs_separator_color":"","ocean_breadcrumbs_links_color":"","ocean_breadcrumbs_links_hover_color":"","ocean_display_footer_widgets":"default","ocean_display_footer_bottom":"default","ocean_custom_footer_template":"0","ocean_post_oembed":"","ocean_post_self_hosted_media":"","ocean_post_video_embed":"","ocean_link_format":"","ocean_link_format_target":"self","ocean_quote_format":"","ocean_quote_format_link":"post","ocean_gallery_link_images":"off","ocean_gallery_id":[],"footnotes":""},"categories":[34],"tags":[],"class_list":["post-1156","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-english","entry","has-media"],"yoast_head":"\nHeavy Period - Heavy Menstrual Bleeding<\/title>\n<meta name=\"description\" content=\"\u0627\u0644\u0645\u0648\u0642\u0639 \u0627\u0644\u0631\u0633\u0645\u064a \u0644\u0644\u062f\u0643\u062a\u0648\u0631\u0629 \u062d\u0646\u0627\u0646 \u0627\u0644\u0634\u0645\u0631\u0627\u0646\u064a. 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