This covers a wide range of conditions including heavy periods ( menorrhagia), irregular bleeding, premature menopause, bleeding in between periods (intermenstrual bleeding), bleeding after intercourse (post coital bleeding) or post menopausal bleeding.

There can be a wide variety of reasons abnormal bleeding varying from hormonal alterations, fibroids, cervical lesions and rarely cancers. Your doctor will be able to discuss your condition in detail with you and offer you the most appropriate treatment.

Investigations

These will usually include a gynaecological examination and in most cases a pelvic scan. In some cases additional tests may be needed, for example a :

• Colposcopy (examination of cervix)
• Hysteroscopy (examination of the uterine cavity)

Treatments

Treatment depends on the condition. In some cases, simple reassurance and a conservative approach would suffice. Medical treatments may include tranexamic acid, NSAIDs (non steroidal anti-inflammatory drugs) or hormonal contraceptives like the pill or the Mirena intrauterine system.

Surgical treatments include:

• Endometrial ablation
• Hysteroscopic resection of fibroids or polyps
• Myomectomy (removal of fibroids)
• Hysterectomy

For more information about different conditions please see NHS choice, NICE guideline on heavy menstrual bleeding in the resources section of this page.

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