Many women have Heavy Menstrual Bleeding (HMB) i.e. heavy periods, which interfere with their daily lives.
The normal menstrual cycle, which is controlled by the pituitary and ovarian hormones, begins at the onset of menstruation (typically between the ages of 11 and 14) and ends at the onset of menopause (typically between the ages of 45 and 55). A period occurs when the lining of the uterus is shed every month. This lining, called the endometrium, builds up each month in preparation for pregnancy, sheds if no pregnancy occurs, and then regenerates for another 28-day cycle. Shedding of the endometrial lining of the uterus results in menstrual bleeding which usually lasts four to seven days within a 28-day cycle. In roughly half of HMB cases there is no obvious explanation for heavy periods. In other cases there may be an abnormality of the uterus or there may be a hormone problem.
Abnormal menstrual bleeding includes menstrual bleeding in excess of the normal amount, prolonged bleeding beyond seven days duration at the expected time of menstruation or bleeding more frequently than 28-day intervals.
It is a fairly common condition and it is commonly accepted experience that approximately 20% of all menstruating women in their 30's, 40's and 50's perceive their menstrual bleeding to be excessive (including women who are clinically diagnosed with menorrhagia). A heavy period to one woman might be a moderate period to another. A woman's perception of the amount of menstrual bleeding can often mean that bleeding at a lower rate than the clinical definition is unacceptable to her. Menorrhagia results in exceptionally long and heavy periods, which can be severely debilitating because, in addition to the general distress and inconvenience which heavy bleeding causes, the blood loss often leads to iron deficiency anaemia.
Studies show that up to 30% of all menstruating women feel they have excessive menstrual bleeding and eventually seek treatment when the condition interferes with their work, family, social commitments and quality of life. The World Health Organisation has reported that HMB affects over 18 million women in the developed world alone. Of over 600,000 hysterectomies performed each year in the United States alone, approximately 30% are performed specifically to relieve excessive menstrual bleeding. It is the most common cause of iron deficiency in healthy fertile women.
Heavy periods can be treated medically or surgically. Medical options include hormonal or non-hormonal treatment to reduce the menstrual blood loss. Surgical options include hysterectomy or endometrial ablation. If you experience HMB then the info on the No More Periods website can help you with your choices.
