Dr. Fella Sadi
Consultant Obstetrician & Gynaecologist
Irregular periods, heavy bleeding, or severe pain are not something you need to live with. Here are the five most common causes — and how we treat them.
Painful, irregular, or heavy periods are common — but they're not something you need to accept as inevitable. Behind these symptoms are almost always identifiable, treatable causes. Here are the five we see most frequently in our gynaecology clinic.
First: PCOS (Polycystic Ovary Syndrome). This hormonal condition affects up to 10% of women of reproductive age and is the leading cause of irregular periods. Elevated androgens drive the irregular cycles, acne, and often weight challenges. Management is highly individualised — from lifestyle changes and metformin to hormonal contraception.
Second: Endometriosis. Tissue similar to the uterine lining grows outside the uterus, causing pelvic pain that is typically worst around menstruation. It can affect fertility. Diagnosis is often delayed because severe pain is normalised. If your periods are consistently very painful, please say so at your consultation.
Third: Uterine fibroids — benign muscle tumours of the uterus that can cause heavy, prolonged periods and pelvic pressure. They're common (up to 70% of women will have them by 50), usually not dangerous, and managed based on symptoms and fertility goals.
Fourth: Thyroid dysfunction. An underactive or overactive thyroid disrupts the hormonal signalling that drives the menstrual cycle. A simple blood test is diagnostic. Treatment — thyroid hormone replacement or suppression — typically restores normal cycles within a few months.
Fifth: Adenomyosis — similar to endometriosis, but the tissue grows into the uterine muscle wall. It causes heavy, painful periods and an enlarged, tender uterus. It's more common after age 30 and in women who have had children. Ultrasound is usually diagnostic. Management ranges from hormonal therapy to, in severe cases, hysterectomy.
If your periods are disrupting your quality of life, please book an appointment. Suffering silently is never the answer — and the right treatment often transforms things completely.
