Problem Periods

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Women's Health London

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Painful Periods


Pain during periods is common. It's caused by the womb contracting to push out the period, or menstrual loss.


Exercise may help to manage the pain, and some women painkillers effective. Your consultant can advise on suitable ones.


Otherwise, you may require contraceptive treatment.




Menorrhagia is the medical name for heavy periods. Menorrhagia can occur by itself or in combination with other symptoms, such as menstrual pain (dysmenorrhoea).


Heavy bleeding does not necessarily mean there is anything seriously wrong, but it can affect a woman physically, emotionally and socially, and can cause disruption to everyday life. One of the causes of menorrhagia is having fibroids.


How much is heavy bleeding?


It is difficult to define exactly what a heavy period is because the amount of blood that is lost during a period can vary considerably between women.


Doctors can measure blood loss during a period and heavy menstrual bleeding is considered to be 60-80ml (millilitres) or more in each cycle. The average amount of blood that is lost during a period is 30-40ml, with 9 out of 10 women losing less than 80ml. However, it is rarely necessary to measure the blood loss so accurately.


Most women have a good idea about how much bleeding is normal for them during their period and can tell when this amount increases or decreases.


Visit your GP if your periods are heavier than usual, or if they are disrupting everyday life. A good indication that your blood loss is excessive is if:

• you feel that you are 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


How common are heavy periods?


It is difficult to measure exactly how many women have heavy periods. This is because different women have different ideas of what "heavy" bleeding is. However, some estimates suggest that one woman in ten has heavy periods.




There are several different medications that can be used to treat heavy periods. Surgery may also be an option.


The medical options consist of hormone based medication and contraception.


Hysterectomy may also be used to reduce symptoms as well as endometrial ablation.




Causes of amenorrhea (or loss of periods) and their treatments are listed below:


Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a condition which can affect a woman's menstrual cycle, fertility, hormones and aspects of her appearance. It can also affect long-term health. This information is about the effects on your long-term health and does not cover specific treatment options for PCOS.

It occurs when at least 12 tiny cysts develop in the ovaries, this also leads to hormone imbalances.


Hypothalamic amenorrhoea

Hypothalamic amenorrhoea (absence of periods caused by extreme weight loss, excessive exercise or stress) can be treated by addressing the underlying cause.


If your symptoms are the result of weight loss, you may be referred to a dietitian, who can advise you on safe ways of regaining a healthy weight.


If your weight loss is the result of an eating disorder, such as anorexia, you will need to be referred to a psychiatrist (doctor who specialises in treating mental health conditions) who has experience in treating eating disorders.


If your symptoms are the result of excessive exercise, you will need to reduce your levels of physical activity. If you are a professional athlete or similar, you may benefit from a referral to a doctor who specialises in sports medicine. They should be able to advise you about how you can maintain fitness and physical performance without disrupting your periods.


If your symptoms are the result of stress, a type of talking therapy called cognitive behavioural therapy(CBT) might help. CBT is a type of therapy that aims to help you manage your problems by changing how you think and act.



The treatment for hyperprolactinemia (where a person has abnormally high levels of a hormone called prolactin) will depend on the underlying cause.


For example, if hyperprolactinemia is the result of a brain tumour, then surgery, radiotherapy or chemotherapy may be required to remove or shrink the tumour. If hyperprolactinemia occurs as a side effect of a medicine, your medication may need to be reviewed.


Thyroid conditions

Treatment options for an overactive thyroid gland include thioamide medication, which helps reduce thyroid activity, and radiotherapy, which can be used to reduce the size of the thyroid gland.


Treatment options for an underactive thyroid gland include a medication called levothyroxine, which can stimulate thyroid activity.