Investigation & treatment
If you are worried about your periods visit your GP. You are likely to be referred a gynaecologist.
The gynaecologist will generally do the following:
- ask you questions about the history of your health
- do a blood test
- examine your vagina and cervix, using special tongs (called a speculum). At the same time, they may take a tiny sample of your cervix for testing (called a Pap test)
- take an ultrasound of your pelvis. This usually involves putting a small wand (called a transducer) inside your vagina to take a picture of your cervix, uterus, endometrium and ovaries. If you haven’t had sex before, it is more likely that an external ultrasound will be done. Gel is put on the outside of your belly and a small handheld transducer is moved over the skin.
Further investigations may include a hysteroscopy and/or a curette.
A hysteroscopy uses a long thin telescope or camera (called a hysteroscope) that allows the doctor to see inside the uterus. The hysteroscope can show polyps, fibroids and endometrial thickening. A sample of the endometrium can also be taken for testing. A curette involves removing the top layer of your endometrium for testing and can be done at the same time as a hysteroscopy.
A hysteroscopy can be done under local or general anaesthetic. A curette is usually done under general anaesthetic.
There are a number of treatment options for heavy periods, including medication, surgery and radiology. Your doctor will recommend the best option for you based on your medical history and the reasons for your heavy periods.
Your treatment options will depend on:
- your age, health and medical history
- whether you want to have any (more) children
- how successful other treatments have been for you.
There are three main types of treatment.
- Medication to reduce or control the bleeding and pain. This usually involves taking tablets but sometimes an IUD is placed inside your uterus, which slowly releases the medication into your body.
- Surgery aims to stop the heavy bleeding by removing potential causes like the lining of your uterus (called an endometrial ablation), fibroids in your uterus (called a myomectomy) or your whole uterus (called a hysterectomy).
- Radiology and ultrasound treatments aim to reduce or stop heavy bleeding and pain by reducing and destroying fibroids.
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