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Dr. AnnaBurrows - Medical Specialist in Gynaecology

Bleeding Problems

Heavy Periods – Medical Or Surgical Management

Heavy periods can be caused by many factors- this includes fibroid growths (see multimedia patient education on the website), adenomyosis (a form on endometriosis where the uterine lining goes deep into uterine wall, creating a larger area of uterine lining, thus more bleeding), uterine polyps, tumors (including uterine lining or endometrial cancer) and some is simply called dysfunctional uterine bleeding – with no real cause found.

Investigations include:

  • A pelvic examination by Dr Burrows
  • A pap test to exclude cervical causes for bleeding
  • A pelvic ultrasound examination
  • In many cases a day surgery procedure “Hysteroscopy with dilatation and curettage” may be required to diagnose and often treat any disease such as removal of small polyps or fibroid growths. This procedure entails a light anaesthetic, insertion of a telescope and fluid to expand and investigate uterine wall lining, with the ability to remove any growths, polyps or fibroids in the lining

Management options: will depend on the woman’s preference, but also the clinical situation.

Common treatments:

  • Heavy Menstrual Bleeding - Clinical Care StandardHeavy Menstrual Bleeding – Clinical Care Standard
  • Hormonal – oral contraceptive pill
  • MirenaMirena
  • Endometrial Ablation (Novasure Endometrial Ablation or Rollerball Endometrial Ablation) – This is a day surgery procedure where a hysteroscopy is performed to check the lining of the uterine wall. The ablation procedure follows immediately, where the uterine lining is exposed to heat which turns the lining into scar tissue, thus limiting or ending the bleeding. This procedure does not affect your hormone production, however it destroys the lining, and is only suited to those who do not wish to have children after the procedure. It is also not contraceptive, thus your individual health circumstances would need to be assessed by Dr Burrows to determine your suitability
  • MirenaNovasure Patient Brochure
  • Hysterectomy – A hysterectomy is a surgical procedure to remove the uterus. It offers a complete cure from menstrual bleeding, but involves major surgery and a period of recovery. If a hysterectomy is performed, the ovaries can be left in, thus creating no immediate hormonal side effects or need for hormone replacement therapy. The ovaries can be removed at the time, however individual risk factors including age, family history and past medical history would need to be factored into any decision re the ovaries and Dr Burrows will guide you through all the options.

Novasure Endometrial Ablation Operations

NovaSure® is a quick, safe, and simple procedure to lighten or stop your periods, without the side effects of hormones or the risks of hysterectomy.

For more information please visit

Bleeding After The Menopause

Investigations may include

  • Physical examination
  • Pap test
  • Ultrasound scan of the pelvic organs
  • Dilatation and curettage with hysteroscopy (day surgery to diagnose any tumors causing the bleeding, and to remove any polyps or fibroid growths in the lining)

Mid Cycle Bleeding

Investigations may include

  • Physical examination
  • Pap test / and or colposcopy (see section on normal and abnormal pap tests)
  • Ultrasound scan of the pelvic organs
  • Dilatation and curettage with hysteroscopy

Bleeding After Intercourse

Investigations may include

  • Pap test and colposcopy (see section on normal and abnormal pap tests)
  • Swabs to exclude infection
  • Ultrasound scan of the pelvic organs to exclude any uterine wall polyps/ fibroids or problems

For All Bleeding Problems:

Treatment will vary depending on the cause of the bleeding, desire for fertility, and naturally patient choice.