WHAT IS MENORRHAGIA?

Menorrhagia, or heavy and prolonged menstruation, is the most common menstrual disorder Dr Haider Najjar sees, and he specialises in helping patients relieve the symptoms with minimally invasive surgery or medication.

If you lose more than 80ml of blood during your entire period, or if it lasts longer than seven days, you may have Menorrhagia.

In almost a third of cases, Menorrhagia is caused by gynaecological issues such as fibroids, polyps, Pelvic Inflammatory Disease (PID) or Endometriosis, or more rarely by uterine cancer, or other diseases such as thyroid disease. A single late heavy period may be due to a miscarriage or ectopic pregnancy.

When no pathology is found to account for heavy menstrual bleeding, it is termed Dysfunctional Uterine Bleeding. This is most likely due to a hormonal imbalance and no ovulation occurs, which thickens the endometrium.

HOW DO YOU DIAGNOSE MENORRHAGIA?

Symptoms may include the saturation of pads or tampons every hour for several consecutive hours, the need to use double sanitary protection to control flow and change sanitary protection during the night. Your period may last longer than five days, with large clots and lower abdominal discomfort, and you may have symptoms of anaemia such as fatigue, shortness of breath, palpitations and pallor.

Following a detailed medical and menstrual history and a general physical examination, abdominal examination and internal pelvic examination, Dr Najjar may request the following tests:

  • Blood tests —to rule out thyroid disease and blood-clotting abnormalities and check for anaemia.
  • Ultrasound scan —to visualise the pelvic and reproductive organs for organic gynaecological causes.
  • Hysteroscopy and Endometrial Biopsy — to look inside the uterine cavity for abnormalities such as polyps, fibroids and a thickened endometrium. A sample is taken for further examination.
HOW DO YOU TREAT MENORRHAGIA?

Dr Najjar uses the latest technology and procedures if surgical removal of any fibroids, polyps or endometriosis is required.

Endometrial ablation

This is a minimally invasive day procedure under general anaesthetic. The full thickness of the endometrial lining of the uterus is ablated, and is highly successful with most women reporting minimal or no pain associated with the procedure. You should be able to return to work and normal activities within one or two days of the procedure.

Hysterectomy

This is a definitive cure for dysfunctional uterine bleeding, but is generally performed as a last resort when other treatment options have been trialed and failed, or when other co-existing gynaecological conditions warrant this treatment method (for example, prolapse). Dr Najjar carries out a laparoscopic hysterectomy as it is less invasive, reducing the risk of infection and less traumatic.

You may need to take iron supplements if you have significant anaemia. If any other causes are found, they can be treated with medication such as hormonal treatments.