Q: My periods are regular but very heavy. It makes life tricky for a week every cycle. Is there anything I can do?

A: One in every four or five women suffers from a condition called heavy menstrual bleeding (HMB, or menorrhagia), where you lose about twice as much blood as normal, with a tendency to flood (bleeding through to clothes or bedding), pass lots of clots and/or need to change your protection very frequently. It’s a distressing problem that can really interfere with normal life.

Possible causes: these include hormonal imbalance (usually in teenagers or approaching menopause), fibroids, endometriosis, pelvic inflammatory disease and abnormal blood clotting, but often there seems to be no specific cause. Although effective treatments are available, a recent report from the Royal College of Obstetricians and Gynaecologists found that not all NHS clinics follow the latest guidelines for treatment. So consultant gynaecologist Mr Michael Dooley advises:

Consult your doctor: the GP should take a thorough history and examine you for fibroids (non-cancerous tumours in the muscle of the womb). A smear test can rule out cervical abnormalities. You may need an ultra-sound scan to check for a polyp (small growth in the womb lining). Any reader with irregular heavy periods should ask about endometriosis. You may be referred to a gynaecologist.

Get tested for anaemia: the blood loss may cause low levels of iron. If so, take a gentle supplement (try Spa-Tone).

Eat well: HMB can be linked to being overweight, so a sensible diet may help. Everyone should eat plenty of vegetables (particularly dark green), some protein at every meal and cut down on starchy carbs. And exercise daily!

Drug treatments: the Mirena coil releases levornogestrel, a form of the hormone progestogen, which prevents the womb lining growing too quickly and is also a contraceptive. Tranexamic acid (now available OTC as Cyklo-F Heavy Period Relief Tablets by Boots Pharmaceuticals) reduces blood loss, and you only need to take it when bleeding. Mefanamic acid (Ponstan, a type of non-steroidal anti-inflammatory) can also be effective.

If none of these help, your doctor may advise endometrial ablation (where the womb lining is removed), or as a very last resort, a hysterectomy.

A fun way to get fit….ZUMBA

Tired of the gym? My colleague Catherine is addicted to the dynamic workout that’s taking the UK by storm: ‘Zumba incorporates salsa dance steps, hip hop and kick boxing into an aerobic workout to fabulous Brazilian music – you can also do it to bangra rock, flamenco or even Britney Spears. It takes a few sessions to get the moves right but the music is so upbeat and infectious I hardly notice an hour slip by – and it’s really toning up my body, especially my arms. I enjoy it so much I actually look forward to my twice-weekly classes, which is a first!’ For information and classes nationwide, zumbauk.co.uk

The truth about… butter

It won’t make you fat
Not on its own anyway. Your body can’t store fat without carbohydrate, so it’s hot buttered toast that piles on the pounds. Cut down on teatime treats, but add a little butter to your veg because….

It makes veg more nutritious
Vegetables contain vitamins A, D, E and K, which need fat to be utilised – but stick to butter-topped greens rather than high-carb potatoes and root veg.

It won’t raise blood cholesterol levels
Most cholesterol is made by our bodies so, as I explain in my book The Obesity Epidemic, you can enjoy butter (also eggs, prawns and other cholesterol-containing foods) without a problem.

Should I bin my low-fat spreads?
Yes! Margarines, spreads and spreadable butters are vegetable oils, which heat-treated (killing any nutrients), bleached, deodorised and emulsified into a colourless paste. Then the manufacturers add some vitamins plus butter-yellow colouring. Real butter doesn’t go through these denaturing processes and is rich in vitamins A and D, the sunshine vitamin which most people are deficient in.

by Zoe Harcombe, nutritionist and obesity expert

Have A Heart

Avoid slipping-on-a-banana-skin-type accidents with stick-on Red Heart Shoe Sole Grips by Original Sole. (For heels or flats – so Louboutin!)

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