Bleeding disturbances

In a woman of child-bearing age, every 4th week one or more eggs will mature in the ovaries. While the egg is maturing, a mucous lining will be developing in the uterus. It’s in this lining that a fertilized egg can burrow itself. But if no egg is fertilized that month, the lining simply perishes. It’s then expelled along with the egg as menstrual bleeding. This process is controlled by the hormones oestrogen and progesterone, and will normally be repeated once a month until the menopause. After menopause, the lining tends to get thinner.
Bleeding irregularities can be nothing more than normal changes related to your age. Irregularities can also be caused by mental stress, weight gain or loss, and hard physical exercise. But you need to be on the alert if you experience any of the changes listed below: 

  • prolonged and heavy periods
  • bleeding after menopause
  • spot bleeding after sex
  • spot bleeding between periods
  • missed periods
  • irregular menstrual cycle.
The symptoms above could indicate that you have a disturbance that requires treatment.

Initial examination

At the first examination, the specialist will ask you about your symptoms. Then you’ll have an ultrasound scan and a gynaecological examination. This may be all that’s needed to establish a diagnosis. But in some cases we need to perform a keyhole examination of your cervix and take a biopsy to rule out cell changes (see Colposcopy); or perform a keyhole examination of your uterus to rule out polyps or fibroids (see Hysteroscopy). Depending on the results of these examinations, we can offer you various treatments, but it is up to you to decide which treatment you prefer. The treatments we can offer include medical treatment (IUS, Cyclical gestagen, Cyklokapron or the Pill - see below). Treatment can also involve surgery (Endometrial ablation, removal of Polyps or Fibroids or Hysterectomy).  

Medical treatment
Once the specialist has ruled out that the irregular and often heavy periods are due to cell changes, fibroids or polyps, it’s possible to treat your symptoms medically. Here are some of the treatments available:
  • IUS/coil : unlike the Pill, the coil only contains gestagen, not oestrogen. Gestagen prevents the uterine lining from thickening, and the bleeding is therefore reduced (see IUS). 
  • Cyclical gestagen : this can be taken for the last 10-12 days of the menstrual cycle if the problem is due to failing progesteron production.   
  • Cyklokapron : a drug that helps blood coagulate, which can reduce the amount of bleeding on days when the bleeding is particularly heavy.
  • The Pill : a good solution for treatment of both irregular and heavy bleeding. However, you’ll need regular check-ups since the Pill in this case is a drug taken as part of a treatment.