A woman knows if her periods are a problem to her and will usually know when to seek help and advice.
The commonest problems with periods include heavy flow, painful flow or irregular periods. There may be abnormal bleeding including bleeding between the periods and/or after sex.
Period problems often involve a completely normal womb but sometimes there can be fibroids, polyps or endometriosis accounting for the heavy or painful bleeding. Very rarely abnormal bleeding can be due to abnormal cells in the womb and these certainly must be excluded in women over 40 years of age.
The cause for a woman’s period problems can usually be diagnosed by either doing an ultrasound scan and/or having an out-patient hysteroscopy which involves a 20 minute procedure to look inside the womb with a tiny camera and taking a biopsy from the lining of the womb.
There are many simple out-patient or daycase treatments for period problems including drugs like the pill or a Mirena device. Day surgery to perform an endometrial ablation and remove just the lining of the womb cavity usually results in no periods and significantly less pain.
Some women may request or occasionally require a hysterectomy and the majority of these procedures can be performed with keyhole surgery (laparoscopic hysterectomy) allowing faster recovery with less pain and quicker return to normal activity.