Heavy Periods

Painful periods are a common reason to request a gynaecology ultrasound. Your doctor might be worried about fibroids, endometriosis, or other conditions visible to ultrasound. 

Heavy periods can also be caused by these conditions, as well as by changes in the lining of the uterus, such as polyp growths or abnormal thickening. Some women have more than one purpose for the request: apart from heavy or painful periods, they might also be experiencing bleeding between periods, pelvic pain or other symptoms.

The visual information from an abdominal and/or vaginal ultrasound will help your referring doctor diagnose any abnormality, linked to heavy or painful periods.

If you have been requested to get an ultrasound in regards to painful or heavy periods, and you are menstruating regularly, the best time of the cycle for the ultrasound is usually from day 5 to day 11 (counting from the first day of your period).

If endometriosis is the specific concern, later in the cycle is sometimes more helpful. During the period is a good time to avoid as this is likely to be a more uncomfortable time to be scanned. When preparing for your ultrasound, please make note of the first day of your last menstrual period as closely as you can, so you can let us know.

If there is bleeding between your periods, the timing can be difficult to work out. If you are bleeding all or most of the time, do not delay your ultrasound appointment. If you are using the oral contraceptive pill, the stage of the cycle is not important for your scan. It is recommended to bring the packet or provide the name of the pill you use.

A gynaecological ultrasound may consist of 2 different scans: an abdominal ultrasound and a vaginal ultrasound.

If you expect to be having a vaginal ultrasound, two glasses of any liquid is enough to drink, ideally 3/4 of an hour before. A brief abdominal scan will be done first, but then the bladder can be emptied.  

With a vaginal ultrasound, a narrow probe is inserted after bladder emptying. Most of the scan information comes from the vaginal pictures, so it’s not necessary for the bladder to be over-full beforehand.

If you only want to have an abdominal ultrasound, bladder filling is even more important because it adds clarity to the scan. Usually 3 large glasses of fluid 3/4 of an hour before your appointment is realistic.

Also allow for extra time at your visit: if the bladder is not full enough, we may require you to wait and fill your bladder more. It can take a long time, and for this reason young girls and adolescents are not booked late in the day.

If using hormone therapy or vaginal estrogen, do not cease purely for the ultrasound. If anything, they make the ultrasound easier for you.

A gynecologist will most likely ask about your medical history and menstrual cycles to investigate the causes of your heavy periods. Based on your symptoms and age a gynecologist might reccommend one or more of the following tests: Ultrasound exam; Hysteroscopy; Endometrial biopsy; Sonohysterography; Magnetic resonance imaging (MRI).

Your doctor may be able to treat your heavy period with medical treatments, such as: – Nonsteroidal anti-inflammatory drugs (NSAIDs), which help reduce menstrual blood loss and related pain, and oral contraceptives (birth control pills) which by stopping ovulation will make your period lighter. Should medical treatment be unsuccesful, surgical options incude: Dilation and curettage (D&C). In this procedure your doctor opens (dilates) your cervix and then scrapes or suctions tissue from the lining of your uterus to reduce menstrual bleeding.

Tranvaginal ultrasounds are safe and painless procedures that can be performed whether you’re pregnant, going through the menopause or menstruating. If you are menstruating and wearing a tampon, you will need to remove the tampon before the test.

Altough there is no common definition of heavy period, as it varies from woman to woman, a sign that your periods are heavy is if you:
-have to change your tampon or pad after less than 2 hours
– are passing blood clots larger than 2.5cm (about the size of a 10p coin)
– are bleeding through to your clothes or bedding
– need to use 2 types of sanitary product together (for example, tampons and pads) – feeling very tired and short of breath.