Gynaecology
Heavy menstrual bleeding (HMB), also known as menorrhagia, affects approximately 1 in 3 women in the UK at some point in their lives. It is defined as excessive menstrual blood loss that interferes with a woman’s physical, emotional, social, or material quality of life.
Although not always linked to an underlying health issue, it can significantly impact daily activities and wellbeing. Women between the ages of 30 and 49 are most likely to experience heavy blood loss, due to the changes in hormones that result from perimenopause. Blood loss can be so severe that women are at risk of anaemia and fatigue, and can impact on a woman’s ability to carry out daily activities, including work.
Signs you have heavy periods
Causes of Heavy Periods
Hormone changes, such as being in perimenopause are a cause of heavy periods, but PCOS, endometriosis, adenomysis, fibroids and even womb cancer can also cause heavy bleeding. Effective treatments are available, but understanding the cause of the heavy bleeding is key to finding the best option for you.
Diagnosis begins with a detailed medical history, including menstrual patterns, symptoms, and any associated pain. A physical examination may be followed by blood tests to check for anaemia or hormonal imbalances. Pelvic ultrasound scans are often used to identify structural causes such as fibroids, polyps, or endometriosis. In some cases, further investigations may be needed.
Treatment depends on the underlying cause, severity, and a woman’s personal preferences, including future fertility plans. First-line medical treatment often includes tranexamic acid (to reduce bleeding) or non-hormonal anti-inflammatory drugs like mefenamic acid. Hormonal options may include the contraception pill or coil. For some, surgical interventions will be the most effective solution.
Endometriosis is a long-term, often painful condition where tissue similar to the lining of the womb grows outside the uterus. Women with endometriosis can have different symptoms; for some, the pain associated with their endometriosis is so severe they are bed bound for several days every month. Around 1 in 10 women and those assigned female at birth in the UK are affected, typically during their reproductive years.
The exact cause of endometriosis is still unknown, though theories include genetic factors, immune system issues, and hormonal influences. Symptoms vary widely but may include pelvic pain (particularly during periods), painful sex, fatigue, heavy periods, infertility, and bowel or bladder issues.
Diagnosing endometriosis can be challenging and it takes on average 7-8 years to receive a diagnosis in the UK. Women report feeling that their symptoms aren’t taken seriously or may be told their symptoms are part of a normal menstrual cycle. However, having a clear diagnosis is the first step to finding the right treatment option as many of the symptoms could be mistaken for other conditions such as PCOS. A diagnosis of endometriosis involves a detailed medical history, physical examination, and imaging such as pelvic ultrasound. An MRI or laparoscopy may also be advised.
Treatments for endometriosis can involve hormones (the contraceptive pill or coil), other medications to reduce inflammation and suppress the menstrual cycle and pain relief. Some may look at surgical options.
Appointments with one of our Consultant Gynaecologists are often available within a week or so.
Call 01202 110303 to speak to someone today.
Infertility affects approximately 1 in 7 couples in the UK, who have difficulty conceiving after a year of regular unprotected sex .
Common causes of infertility include:
- Lack of regular ovulation (the monthly release of an egg)
- Poor quality sperm
- Blocked or damaged fallopian tubes
- Endometriosis
- Unexplained infertility
Haven Medical offers a range of investigations and tests that will help understand why there are difficulties conceiving. These may include hormone tests, semen analysis for your partner, tubal patency test and an ultrasound scan.
Treatment options will then be discussed with you, tailored to you based on your age or period of infertility. These may involve medications to help ovulation (which can be monitored by ultrasound). Intra-uterine insemination (IUI) or in vitro fertilisation (IVF) may be recommended for some couples and we can help support you through this journey, should this be the right route for you.
PCOS is a common condition which affects how women’s ovaries work. It is caused by abnormal hormone levels in the body, including high levels of insulin. If you have signs and symptoms of PCOS, they will usually become apparent in your late teens or early 20’s. These may include:
- Irregular periods or no periods at all
- Difficulty in getting pregnant
- Excessive hair growth
- Weight gain
- Oily skin or acne
Your Gynaecologist at Haven Medical will advise you on lifestyle changes and may recommend medications to lower the insulin levels, treat abnormal bleeding, and reduce excessive hair growth. She may offer treatment to help with ovulation if you are seeking to become pregnant.
Pelvic organ prolapse is when one or more of the organs (bowel, uterus or bladder) in the pelvis slip down from their normal positions and bulge into the vagina. It is a relatively common condition, with around 50% of women experiencing a prolapse to some degree.
Childbirth, the menopause and pelvic surgery all make a prolapse more common. Only around 1 in 10 women will seek help for their prolapse, but with some experiencing symptoms that can impact hugely on daily life and with effective treatment options available, a diagnosis can be key to getting things back on track.
Symptoms of a prolapse:
Symptoms are normally worse at the end of the day, after prolonged standing or after lifting heavy items or physical exertion. Left untreated, a vaginal prolapse can result in recurrent UTIs, chronic pain, chronic constipation and have a significant impact on someone’s life, allowing them to enjoy activities and lead a more active lifestyle, free of pain and discomfort.
Treatment options for a vaginal prolapse
If you suspect you have a prolapse, then an appointment with a GP or Gynaecologist is the first step to finding the right treatment solution.
Menopause is when your periods stop due to lower hormone levels. Perimenopause is when you have symptoms of menopause but your periods have not stopped. Menopause and perimenopause can cause symptoms like anxiety, mood swings, brain fog, hot flushes, irregular periods and low sex drive. These can have a big impact on your life, including relationships, and work.
At Haven Medical you will be managed by a British Menopause Society accredited Gynaecologist. She will discuss the options and help you decide on the best treatment for you based on the severity of symptoms and your personal preference. In addition to lifestyle modification, you will be offered hormone replacement therapy (HRT), which may include testosterone for low sex drive. You may be offered alternatives to HRT if you cannot have or do not want to be treated with hormone-based medications. Your Gynaecologist will discuss with you if contraception is required and when to stop them.
Menopause is usually diagnosed in women who have not had a period for more than a year. Any bleeding from the vagina after this needs to be investigated. Postmenopausal bleeding is not usually serious but can occasionally be a sign of cancer. Cancer is easier to treat if it is diagnosed early.
Tests may include a vaginal ultrasound scan, hysteroscopy (a thin, telescope-like camera being passed up the vagina, and into the womb) and a tissue sample biopsy.
Cervical screening (a smear test) is a test to help reduce the risk of cervical cancer. During the screening appointment, a small sample of cells will be taken from the cervix. The sample is checked for certain types of human papilloma (HPV) and may need to be analysed for changes in the cells of the cervix. These can be treated before they get a chance to turn cancerous.
Hirsutism is where women have thick, dark hair on their face, neck, chest, abdomen , buttocks or thighs. Hirsutism is linked to hormones called androgens. The condition may be caused by certain medications, some hormonal conditions or less commonly, a tumour affecting hormone levels. Often, there is no obvious cause.
At Haven Medical your Gynaecologist will perform the necessary investigations which may include blood tests and ultrasound scan. She will recommend treatments accordingly, which may include hormone-based medications or creams.
Urinary incontinence is the unintentional passing of urine. There are different types and causes for incontinence. At Haven Medical your Gynaecologist will make the appropriate assessment to reach the correct diagnosis. Treatments will be made accordingly and may involve lifestyle changes, medications, pelvic floor exercises and bladder retraining.
Premenstrual syndrome is the name for the symptoms women can experience in the weeks before the periods. The most common symptoms include mood swings, trouble sleeping, bloating, breast tenderness and headaches. A small number of women may experience more severe symptoms of PMS known as premenstrual dysphoric disorder (PMDD).
Symptoms are much more intense and can have greater negative impact on your daily activities and quality of life. PMDD can make it difficult to work, socialise and have a healthy relationship. It is important that you get the support you need and deserve to help you manage the effects of PMDD on your life. Our Gynaecologist will discuss these with you to allow you to decide on the best approach for you based on the severity of the symptoms and your personal preferences.
Bacterial Vaginosis is a common cause of unusual vaginal discharge. Other causes are Thrush, which is a yeast infection and usually accompanied with itching and vaginal soreness. Your Gynaecologist will examine you and may take a swab to test for infection. You will usually need a treatment with tablets or vaginal pessaries. Sometimes you may need prolonged treatment to prevent recurrence.
Chlamydia is one of the most common sexually transmitted infections (STI) in the UK. If you are sexually active and under 25, it is recommended that you have a Chlamydia test once a year. Most women with Chlamydia do not notice any symptoms and do not know they have it. Sometimes you may experience pain when passing urine, unusual vaginal discharge, abdominal pain, bleeding after sex and bleeding between periods. If you think you are at risk or have Chlamydia symptoms, you should get tested and treated. Chlamydia can be serious if untreated. The infection can spread into the pelvis leading to pelvic inflammatory disease, ectopic pregnancy and infertility.
Lichen sclerosis is a skin condition that causes itchy white patches on the vulva. Treatment can help relieve the symptoms. You may need a skin biopsy taken to confirm the diagnosis. Your Gynaecologist will recommend a potent steroid cream which you may need to use regularly for few months. Lichen sclerosis increases the risk of getting cancer on your vulva. The risk is low, but it is a good idea to be checked regularly.
Vulvodynia (Vulval pain) is persistent, unexplained pain in the vulva. It can be a long-term problem that is very distressing to live with, but much can be done to help relieve the pain. Your Gynaecologist at Haven Medical will discuss with you treatments which may include vulval gels, lubricants or prescription medications to make sex more comfortable.
