Hi there, miss. From your question, I understand that you are having a heavy menstrual bleed and you are worried of the invasive physical examinations. Firstly, I will explain to you about heavy menstrual bleed. It is defined as menstrual bleed of more than 80 ml or bleeding for more than seven days.

If there is a need to change sanitary pads every hour or the presence of blood clot larger than usual. Heavy menstrual bleeding can be of no reason or it can be caused by an underlying medical condition. If it is untreated, you may get lose a lot of blood and have iron deficiency anaemia.

Symptoms may include difficulty in breathing, general pallor, fatigue and even heart failure in the long run. I understand that you are dreading to visit the doctor as the doctor may perform invasive tests. However, I think it is necessary that you discuss this with your doctor. Insertion of devices is not necessary. Your doctor will ask about your medical history and perform several tests.

Invasive tests will only be done when necessary. Your doctor will rule out the possible causes such as hormonal imbalance that causes the wall of the womb to be thicker giving a heavy period. The presence of growth in the womb be it polyps or fibroid add up pressure to the lining of the womb.

Both of these growths make the lining more vascular, allowing a heavier blood flow when the wall of the womb sheds. If intra-uterine device was newly inserted, it could be a possible reason too. Some medications such anti-coagulants prevent the blood from clotting causing a heavy bleed. Treatment will include medications such as tranexamic acid and surgery such endometrial ablation and hysterectomy. I hope this gives you a better understanding.

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