Other Information
Mirena & Heavy Periods (Menorrhagia)
Anyone who has suffered heavy and prolonged periods knows how unpleasant, disabling and frightening it can be. Sometimes the bleeding is so heaby that it's necessary to miss work, school or social activities.
Menorrhagia is defined as excessively heavy or prolonged bleeding. The average amount of blood loss during a normal menstrual period is 40 to 50 ml. With Menorrhagia,, a woman may lose 80 ml or more.
Menorraghia is abnormal bleeding from the uterus, which may be caused by medical problems or hormone imbalances.
In a normal menstrual cycle, there is a balance between oestrogen and progesterone, two hormones in the body. These hormones regulate the build-up of endometrium (the lining of the uterus or womb), which is shed each month during menstruation.
Menorrhagia can occur because of an imbalance between oestrogen and progesterone. As a result of the imbalance, the endometrium keeps building up. When it is eventually shed, there is heavy bleeding. Because hormone imbalances are often present in adolescents and in women approaching menopause, this type of menorrhagia (known as dysfunctional uterine bleeding) is fairly common in these groups.
Another frequent cause of menorrhagia is uterine fibroids (growths). Together, hormone imbalances and fibroids account for about 80% of menorrhagia cases.
Other causes include
- Endrometrial Pathology
- Inflammation or infection of the vagina, cervix or pelvic organs.
- Polyps (small growths on the cervical or uterine wall).
- Thyroid Conditions
- Liver, Kidney or Blood Diseases and the use of blood thinning drugs.
Signs & Symptoms of Menorrhagia
- Excessive Menstrual Flow (will vary greatly from woman to woman).
- Menstrual Periods last more than 7 days
- Large Clots may be passed.
- Paleness and fatigue (anaemia)
Risk Factors:
- Obesity
- Estrogen Administration (without progestogen)
- Women approaching the menopause
- Young women who do not have an established ovulation cycle
What is Mirena (IUS)?
Mirena is an intrauterine system (IUS), which is inserted by a trained doctor into the womb. It consists of a small, plastic, T-shaped frame, surrounded by a tiny cylinder, which contains the hormone, levonorgestrel. Levonorgestrel is a type of progestogen. This hormone is released slowly into the uterus over an interval of 5 years.
Mirena (IUS) in the treatment of Heavy periods (menorrhagia)?
The intrauterine system releases a small amount of hormone locally into the womb. This hormone has the effect of supressing the lining of the womb (endometrium), so that there is no build-up. this means that there is then very little endometrial lining to be shed.in the monthly period. The result is that there is a dramatic decrease in the volume and duration of the period. Because of this, many gynaecologists now suggest the Mirena as a treatment for heavy periods.
Studies show that after 3 months use, the average blood loss is reduced by 80%, and by 12 months the blood flow is reduced by 95% every cycle. About one third of women using the Mirena will not have any period at all. Although women initially find it a bit unusual not having periods, it doesn't cause any problems. There is no "build up" of blood because the hormone in the IUS prevents the lining of the womb from building up at all. Often it is the excessive thickening of this lining that is the cause of the problems in the first place.
How does Mirena compare to other treatments available for heavy periods?
There are a number of medical and surgical treatments used to treat heavy menstrual bleeding.
Medical Treatments:
Many studies have shown Mirena to be more effective in long term use than some of the medical treatments (e.g. Tranexamic Acid, non-steroidal anti inflammatory drugs).
Surgical Treatments:
Endometrial Ablation: There are different types of this procedure available which your doctor will be able to discuss with you. There is a similar satisfaction rate and treatment success between Endometrial Ablation and Mirena, although many women would view endometrial ablation as a much more invasive procedure.
Hysterectomy:
In some individual cases Mirena may reduce the need for a Hysterectomy. One study showed that 65% of women who had a Mirena inserted while waiting to have a hysterectomy, decided not to go ahead with the operation.
Who Can Use Mirena?
Most women can use Mirena, but as with other treatments, it will not be suitable for everyone. You can discuss this with your doctor.
What about the side effets?
The level of hormone released into the blood stream is very low, so that side effects such as breast tenderness, headaches or acne are rare. If they do occur, they will uually disappear after the first few months. Many women experience spotting or light bleeding in addition to their periods for the first 6 to 12 weeks after the system is fitted.
How is Mirena fitted?
Only a specially trained doctor can fir the system. this is usually done during your period (days 3-7). Your doctor will give you a pelvic examination to find the position and size of your womb before the Mirena is fitted.
Most women find that fitting causes only a little discomfort (a little like a smear test). Afterwards, you may feel a little cramping, like a period pain, but this should disappear after a few hours.
Preparations for fitting usually take about 5 minutes, but the actual fitting of the system only takes a few seconds.. |
