Suffering from heavy menstrual bleeding?

New NICE Guidelines offers support to 25% of women who suffer from heavy menstrual bleeding

Approximately 25% of women of reproductive age suffer from heavy menstrual bleeding, and it can have a significant impact on their career, relationships and social life. Yet many don’t realise that what they are experiencing is not normal, nor that they might be able to receive treatment. New NICE Guidelines on Heavy Menstrual Bleeding published today (14th March) highlight advances in diagnostic techniques and treatments that mean women should in future receive appropriate tests and treatments to suit their individual circumstance. But before this can happen, doctors need to implement the guidelines and women suffering from heavy menstrual bleeding need to know they can seek help.

A good indication that your blood loss is excessive is if:

  • you feel you’re using an unusually high number of tampons or pads
  • you experience flooding (heavy bleeding) through to your clothes or bedding
  • you need to use tampons and towels together

(Source: NHS Choices)

Alaine’s story:

From the age of 14, when her periods started, to the age of 21, Alaine had very heavy periods that lasted 3 weeks of each month. Her periods were so heavy that at times she had to change a super plus tampon and towel (double protection was necessary) every hour. For 7 years, Alaine was told her periods were normal as they were the same length of time each month, and that they would settle down.

“I used to take a small suitcase whenever I went out, to carry around the menstrual supplies I needed that day, a change of clothes, change of underwear, wipes – and an extra cardigan or jumper I could tie around my waste if I leaked. I wish I’d been taught at school what a ‘normal’ period was, been able to talk about my problems and be believed.

I managed to complete my degree, but wasn’t well enough to continue and had to leave a post graduate course – on top of all the bleeding and having to always be close to a toilet, I couldn’t get much sleep for 2-3 weeks a month as I had to be up through the night. I got a job in retail, but I was told I was going to the toilet too much. One day my manager said there were not enough people on the shop floor and I couldn’t go to the toilet, and that in future I’d only be allowed to go during my lunch break – so once in an 8 hour shift. I was devastated, I was on my period and couldn’t possibly go four hours without changing, I had to change every hour or would leak. I had to leave my job, it was so embarrassing and demoralising.

I couldn’t believe it when I saw a doctor that explained I could get treatment for my periods, it was such a relief to be believed. Now I can’t believe for so long I’d been told I couldn’t get treatment.”

Sonya’s story:

Sonya is 44, and her periods have got increasingly worse over the years.

“I can bleed for two weeks, or sometimes nothing for a couple of months then a massive bleed. It’s so bad that sometimes I wonder if I’ve wet myself. It can be so embarrassing and it’s emotionally draining, I’m always on ‘red alert’.

I’ve had a range of investigations and treatments, and some do provide some help. I’m hopeful that things will improve. We have to get over the embarrassment of talking about these things so women seek help and don’t suffer in silence.”

The cost of heavy menstrual bleeding

Heavy bleeding doesn’t necessarily mean there’s anything seriously wrong, but it can affect a woman physically and emotionally, and disrupt everyday life. It can also be a financial burden: a ‘normal’ period may cost around £5 per month in menstrual products (pads and tampons), whilst a medically defined heavy menstrual bleeding, the costs go up to around £25 per month – or, if like Alaine or Sonya, you bleed heavily and for over a week this rises to over £60/month. This can be a significant financial strain.

What needs to happen

Women suffering from heavy menstrual bleeding need to know what they are experiencing is not normal, and to receive guidance to enable them to make choices about possible treatments. In addition to the new NICE guidelines being implemented, we want:

  • GPs to receive training in Menstrual Wellbeing and a toolkit of resources, to enable them to best support women with Heavy Menstrual Bleeding, as well as a range of other menstrual conditions such as fibroids, endometriosis and polycystic ovary syndrome and pelvic inflammatory disease. Endometriosis UK will be working with the Royal College of GPs to develop this in the year ahead.
  • Menstrual Wellbeing included as part of the new school sex & relationship education curriculum (currently being reviewed), creating an environment where children are able to talk about menstrual issues without fear of ridicule or taboo, and when to seek help when what they are experiencing is not normal. For more details on our menstrual wellbeing campaign please see  https://www.endometriosis-uk.org/stop-treating-periods-dirty-secret-teach-menstrual-wellbeing
  • Employers and occupational health specialists to understand and support those with menstrual wellbeing conditions, as they would with other medical conditions.

In some cases, the cause of heavy periods can’t be identified. But there are a number of conditions and some treatments that can cause heavy menstrual bleeding.

Conditions that can cause heavy bleeding include:

  • polycystic ovary syndrome (PCOS) – a common condition that affects how the ovaries work; it causes irregular periods, and periods can be heavy when they start again
  • pelvic inflammatory disease (PID) – an infection in the upper genital tract (the womb, fallopian tubes or ovaries) that can cause pelvic or abdominal pain and bleeding after sex or between periods
  • fibroids – non-cancerous growths that develop in or around the womb and can cause heavy or painful periods
  • adenomyosis – when tissue from the womb lining becomes embedded in the wall of the womb
  • endometriosis – when small pieces of the womb lining are found outside the womb, such as in the fallopian tubes, ovaries, bladder or vagina (although this is more likely to cause painful periods)
  • an underactive thyroid gland (hypothyroidism) – where the thyroid gland doesn’t produce enough hormones, causing tiredness, weight gain and feelings of depression
  • cervical or endometrial polyps – non-cancerous growths in the lining of the womb or cervix (neck of the womb)
  • blood clotting disorders, such as Von Willebrand disease
  • cancer of the womb (although this is relatively rare)

(Source: NHS Choices)

The new NICE guidelines on Heavy Menstrual Bleeding can be found on the NICE website: https://www.nice.org.uk/guidance/cg44

Further details on Heavy Menstrual Bleeding can be found on NHS Choices https://www.nhs.uk/conditions/heavy-periods/

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