NEW YORK (Reuters Health) - Among women who complain of heavy periods, it's often the pain that accompanies menstruation -- not the heaviness itself -- that bothers them the most, UK researchers report.

Given that some treatments can exacerbate other potentially problematic aspects of menstruation, such as irregularity, it's important for women to think carefully about what aspects of menstruation are most bothersome for them, Dr. Miriam Santer of the University of Edinburgh Medical School, the study's lead author, told Reuters Health.

"Sometimes people haven't thought that through in their own minds, they haven't made the distinction themselves," Santer said in an interview. "It's important when it comes to making treatment decisions."

Many women have heavy bleeding during menstruation, but some experience this as a problem while others don't, she and her colleagues note in their report. To better understand the concerns of these women, they surveyed 2,833 women ages 25 to 44 years, 906 of whom reported heavy or very heavy periods. They also conducted in-depth interviews with 32 of these women.

When asked what bothered them the most about their periods, the women who menstruated heavily reported pain most frequently, followed by heaviness, moodiness or tiredness, irregularity and other timing problems, such as unpredictable duration and spotting.

The type of work women did played a major role in how problematic heavy menstruation was for them, Santer and her colleagues noted; specifically, how easily they were able to access toilet facilities and to rest if necessary. "The impact varies enormously," Santer said.

Non-steroidal anti-inflammatory drugs (NSAIDs) can help women with both period pain and menstrual heaviness, Santer noted, while a new type of progesterone-releasing birth control device that is implanted into the uterus can reduce menstrual heaviness, but may increase irregularity.

Women should "make sure they have really thought through what is bothering them the most and to be as aware as possible of the different treatment options," Santer added, noting that for many, a simple strategy such as taking NSAIDs for pain relief during menstruation may be enough.

SOURCE: BMC Women's Health, June 2, 2007.

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