Heavy menstrual bleeding medically known as menorrhagia is one of the most common gynaecological concerns among women in Singapore. If your periods regularly soak through a pad or tampon every hour, last longer than seven days, or significantly disrupt your work and daily life, you may be experiencing menorrhagia.
Effective, evidence-based treatments are available — ranging from simple medication to minimally invasive procedures such as endometrial ablation. At Trinity Women’s Specialists, our gynaecologists offer a comprehensive range of options tailored to each patient’s diagnosis, lifestyle, and reproductive goals.
What is Menorrhagia?
Menorrhagia refers to menstrual bleeding that is abnormally heavy or prolonged. While an average period involves a total blood loss of around 30–80 ml over five days, women with menorrhagia may lose more than 80 ml per cycle, sufficient to cause iron-deficiency anaemia, persistent fatigue, and a measurable decline in quality of life.
Menorrhagia is not simply an inconvenience. It can signal an underlying gynaecological condition that warrants prompt investigation and treatment.
Signs You May Have Menorrhagia
You may be experiencing abnormally heavy periods if you:
What Causes Heavy Periods?
Heavy menstrual bleeding can arise from several causes. Accurate diagnosis is essential for choosing the most effective treatment:
- Uterine fibroids – non-cancerous growths in or on the uterus that can significantly increase menstrual blood loss
- Endometrial polyps – small growths on the inner lining of the uterus that may cause irregular or heavy bleeding
- Adenomyosis – a condition where the endometrial tissue grows into the muscular wall of the uterus, causing heavy, painful periods
- Endometriosis – tissue similar to the uterine lining that grows outside the uterus, often associated with heavy or painful periods
- Hormonal imbalance – disruptions to oestrogen and progesterone levels that affect the thickness of the uterine lining
- Thyroid dysfunction – hypothyroidism in particular can cause heavier-than-normal periods
- Bleeding disorders – conditions such as von Willebrand disease that affect blood clotting
- Dysfunctional uterine bleeding (DUB) – heavy periods with no identifiable structural cause, usually related to hormonal factors
When Should You See a Gynaecologist?
Seek a specialist consultation if any of the following apply:
Early assessment allows your specialist to rule out more serious causes — including endometrial hyperplasia or, less commonly, endometrial cancer which can present with abnormal uterine bleeding.
Treatment Options for Heavy Periods
Treatment is guided by the underlying cause, the severity of symptoms, and whether you wish to preserve fertility. A gynaecologist will typically recommend beginning with the least invasive approach and progressing to surgical treatment only when clinically indicated.
Medical Management
Medical treatments are usually the first-line approach for patients without a structural cause, or as a temporary measure while awaiting surgery:
- Tranexamic acid: a non-hormonal tablet taken during your period to reduce blood loss by stabilising clots in the uterine lining. Highly effective for many women without altering hormone levels or affecting fertility.
- NSAIDs (e.g. mefenamic acid) : taken during menstruation to reduce both blood flow and period pain by inhibiting prostaglandins.
- Combined oral contraceptive pill : regulates the hormonal cycle, thins the uterine lining, and significantly reduces menstrual flow. Also provides contraceptive benefits.
- Progestin therapy : oral or injectable progestin thins the endometrium and reduces bleeding. Can be used cyclically or continuously depending on the clinical situation.
- GnRH agonists : used short-term to suppress periods and shrink fibroids before surgery. Not suitable for long-term use due to effects on bone density.
Surgical Treatment
If medical management does not provide sufficient relief, or if an underlying structural cause is identified, surgical options may be recommended:
- Endometrial ablation – a minimally invasive day procedure that destroys the inner lining of the uterus using energy (typically radiofrequency or thermal). This significantly reduces or eliminates menstrual bleeding in most patients. Endometrial ablation is not appropriate for patients who wish to conceive in future.
- Hysteroscopic surgery – a procedure using a thin camera inserted through the cervix to visualise and treat the uterine cavity. Commonly used to remove endometrial polyps or submucosal fibroids that are causing heavy bleeding. This preserves the uterus and, in many cases, fertility.
- Hysterectomy – surgical removal of the uterus, representing the definitive treatment for menorrhagia. Reserved for patients who have not responded to other treatments and do not wish to conceive. Performed laparoscopically where possible to minimise recovery time. Learn more on our fibroid removal surgery page and endometriosis surgery page.
Menorrhagia Treatment Options at a Glance
| Treatment | Type | Suitable For | Preserves Fertility? |
|---|---|---|---|
| Tranexamic acid | Medical | Mild to moderate bleeding; no structural cause | Yes |
| NSAIDs (e.g. mefenamic acid) | Medical | Mild to moderate bleeding with period pain | Yes |
| Combined oral contraceptive pill | Medical | Hormonal imbalance; no contraindications | Yes |
| Progestin therapy | Medical | Various causes including adenomyosis | Yes |
| GnRH agonists | Medical (short-term) | Pre-operative shrinkage of fibroids | Yes (temporary) |
| Endometrial ablation | Surgical – day procedure | Family completed; persistent heavy bleeding | No |
| Hysteroscopic surgery | Surgical – minimally invasive | Polyps or submucosal fibroids causing bleeding | Usually yes |
| Hysterectomy | Surgical | Severe, refractory menorrhagia | No |
Menorrhagia Treatment Options at a Glance
The cost of heavy period treatment in Singapore varies depending on the procedure chosen, the hospital type (private vs restructured), anaesthesia requirements, and whether additional findings are identified during surgery. Below are indicative private hospital cost ranges based on Singapore market data.
Please note: these are approximate estimates only. Your actual costs will depend on your specific diagnosis, procedure complexity, length of stay, and implant or equipment costs where applicable. Your specialist will provide a written cost estimate before any procedure.
Endometrial Ablation Cost in Singapore
Endometrial ablation in Singapore at a private facility typically costs between SGD $4,000 and $8,000 before MediSave and insurance deductions. As a day surgery procedure, it generally involves lower hospitalisation costs than inpatient surgery. MediSave is claimable subject to MOH Table of Surgical Procedures (TOSP) limits, and patients with Integrated Shield Plans (ISPs) may have significantly reduced out-of-pocket costs.
Heavy Period Surgery Cost in Singapore
For patients requiring hysteroscopic surgery (e.g. polyp removal or fibroid resection), costs typically range from SGD $4,000 to $8,000 at private facilities, depending on complexity. Laparoscopic hysterectomy — the most definitive surgical option — generally ranges from SGD $15,000 to $28,000 at private hospitals, with substantial MediSave and MediShield Life coverage applicable.
Procedure | Est. Private Cost (SGD) | MediSave Claimable? | Notes |
|---|---|---|---|
Endometrial ablation | $4,000 – $8,000 | Yes | Day surgery; MediSave claimable under MOH TOSP limits |
Hysteroscopy (diagnostic) | $1,500 – $3,500 | Yes | Inpatient or day surgery; amount subject to TOSP table |
Hysteroscopic polypectomy / myomectomy | $4,000 – $8,000 | Yes | Complexity-dependent; ISP riders may further reduce costs |
Laparoscopic hysterectomy | $15,000 – $28,000 | Yes | Significant MediSave and MediShield Life coverage applicable |
Medical management (tablets) | $30 – $80 / month | No (outpatient) | Outpatient prescriptions typically not claimable under MediSave |
MediSave & Insurance Coverage
MediSave can be used to offset the cost of endometrial ablation and other inpatient or day-surgery procedures for heavy periods, subject to MOH TOSP withdrawal limits. MediShield Life provides additional coverage for hospitalisation costs above the deductible. Patients with Integrated Shield Plans or corporate insurance may have substantially lower out-of-pocket costs.
It is advisable to check your specific insurance plan coverage before scheduling surgery, and to request a pre-authorisation letter from your insurer where applicable. Our clinic team can assist you with cost estimation and insurance documentation.
Why Choose Trinity Women's Specialists?
Dr Samantha Yeo and the team at Trinity Women’s Specialists bring a personalised, evidence-based approach to managing heavy periods. We understand that menorrhagia affects far more than your cycle – it impacts your energy, relationships, work performance, and overall quality of life.
Our clinic offers:
Whether you are exploring non-surgical management or considering endometrial ablation, our specialists will guide you through every option and support you in making an informed decision that suits your circumstances.
Frequently Asked Questions
How heavy is too heavy for a period?
If you are soaking through a pad or tampon every hour for several hours, passing clots larger than a 50-cent coin, or your period is affecting daily activities, it is considered heavy. Periods lasting more than seven days or causing significant fatigue are also a sign to seek assessment.
What happens if menorrhagia goes untreated?
The most common consequence is iron-deficiency anaemia, which causes fatigue, breathlessness, and reduced concentration over time. The underlying cause, such as fibroids or polyps, may also worsen without treatment. Effective options are available and an assessment is the right first step.
What will a gynaecologist do for heavy periods?
Your gynaecologist will assess the cause through a consultation, ultrasound, and blood tests. Treatment options range from medication to minimally invasive procedures such as endometrial ablation or hysteroscopic surgery, depending on findings. The goal is the least invasive approach that gives lasting relief.
Is endometrial ablation suitable for everyone with heavy periods?
No. Endometrial ablation is most appropriate for women who have completed their family and do not wish to conceive in future, as the procedure is not compatible with future pregnancy. It is not recommended for patients with certain uterine abnormalities, active infection, or suspected endometrial cancer. Your gynaecologist will assess suitability through a full pelvic examination and relevant investigations.
Will endometrial ablation stop my periods completely?
Results vary between patients. Many women experience a significant reduction in menstrual flow, and approximately 40–50% stop having periods entirely (amenorrhoea). Some continue to have light periods. In a smaller proportion of cases, the procedure may need to be followed up with further treatment. Your specialist will discuss realistic expectations based on your individual assessment.
What are the non-surgical options for heavy periods?
Non-surgical options include tranexamic acid (a non-hormonal tablet taken during your period), NSAIDs such as mefenamic acid, combined oral contraceptive pills, and progestin therapy. These are usually the first line of treatment and can be highly effective for mild to moderate menorrhagia without a structural cause. If heavy periods are caused by fibroids or polyps, surgical treatment of the underlying cause is often more effective.
How long is recovery after endometrial ablation?
Most patients recover within 2–5 days and can return to light daily activities shortly after the procedure. Some cramping, light bleeding, and vaginal discharge are normal in the days following ablation. Strenuous activity and intercourse are typically restricted for a short period.