Heavy Period
I am a 40 year old female. I am in good physical condition, and healthy.

I am having difficulty with my period each month. It seems to have gotten worse in the past year to 2 years. It is very heavy, irregular and lasts a full 7 days. There is very heavy flow with large “clots” about the size of a quarter. On the first 2-4 days I sometimes have to get up 2-3 times in the night to change my tampon and my maxi-pad. I am very tired and cranky during my cycle. I can sleep about 12 hours a day during my period. This is frustrating for me as well as my family.

I have been Seraphym for about 2 years for pre-menstrual problems, for (moodiness, cramping etc.) That seems to be less effective than in the beginning. I have migrain type headaches and terrible cramping for about 3 days prior.

Is there something that can be done to reduce the severity of my cycle? I am not going to be having anymore children and I would be totally happy to never have my period again!

Dr. Joshua’s Answer:

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It seems that you are suffering from heavy period, or menorrhagia (excessive duration and flow) and dysmenorrhea (pain, moodiness, and other such symptoms).

I am now assuming that all the proper investigations have been done by your gynecologist, and the diagnosis is settled. So I am not going to go into detail of the possible causes and required examinations.

There is a wide variety of treatments available for heavy period:

Fluoxetine (Serofem) is an effective therapy for the dysmenorrhea.

For heavy periods (bleeding), tranexamic acid (Cyklokapron) is a good treatment. It significantly reduces bleeding, and there is good clinical evidence of its effectiveness and safety.

Hormone treatments are available, including oral contraceptives, progestin, GNRh agonists and Danazol.

Since you are not going to have any more children, surgical treatment is also a good option. Endometrial ablation is the procedure of choice, with success rates of up to 85%. Other procedures, such as hysterectomy, may be considered on a case-by case basis.

All of the above carry risks, and should be discussed with your gynecologist. Good luck!

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