Heavy Menstrual Bleeding
At one time or another in their lives, most women experience some sort of irregular or heavy bleeding during their menstrual periods. This isn’t unusual. But for some women, the bleeding is so severe that it causes interruptions in their daily activities. They may carry an extra set of clothes with them or find themselves changing their pad or tampon every hour. Some women may not even leave the house during this time. This abnormally heavy menstrual bleeding is known as menorrhagia.
Definition of Menorrhagia
Normal menstrual cycles occur every 24 – 35 days, last four to seven days, and produce an average of two to three total tablespoons of blood loss. Most women, despite feeling their periods may be particularly heavy, do not suffer from menorrhagia. Menorrhagia involves losing five and a half tablespoons of blood during a complete menstrual cycle.
Here are some other criteria doctors consider when diagnosing the condition:
- Soaking through one or more sanitary pad or tampon in a one hour period, lasting for several hours
- Having to change protection during the night
- Needing to use twice the protection, meaning two sanitary pads or both a pad and a tampon
- Producing large blood clots (the size of a quarter or bigger) during the menstrual cycle
- Experiencing interruptions in daily life due to the heavy period Feeling extremely tired or fatigued and experiencing shortness of breath, which are signs of anemia
There may be numerous causes of heavy menstrual bleeding. Some are little cause for concern while others may be more serious. Always consult your physician if you are concerned about your symptoms. Some causes seen regularly include:
- Hormone Imbalance – This is the most common cause of heavy menstrual flow. The hormones estrogen and progesterone are produced during a normal period. An imbalance of these hormones causes the uterine lining to become thicker than usual. This occurrence is most common shortly after beginning menstruation and close to the approach of menopause.
- Fibroid Tumors – These are usually non-cancerous tumors, and most women over the age of 30 have them without even knowing it. In addition to heavy bleeding, other symptoms of fibroids may include painful intercourse, slight pain in the pelvic region, or lower back pain.
- Ovarian Dysfunction – Absence or lack of ovulation can cause a hormone imbalance, which we know often leads to menorrhagia.
- Polyps – Polyps are small growths on the lining of the uterine wall and are benign. They are harmless and are often seen during women’s reproductive years due to high hormone levels.
- Intrauterine Device – An IUD may often be the cause of excessive bleeding during menstruation. This is a known side effect, and it is possible that the device may need to be removed in cases where it is problematic.
- Adenomyosis – This often painful condition comes from the endometrium, or uterine lining, becoming embedded in the muscle of the uterus. Middle-aged women who have birthed numerous children are prone to developing adenomyosis.
- Cancer – Though it is rare and the word strikes fear in the heart of everyone, it must be mentioned here that ovarian or cervical cancer can be the cause of abnormal menstrual bleeding.
- Pregnancy Complications – If the heavy bleeding is a one-time occurrence, it’s possible that a miscarriage or ectopic pregnancy (in which the fertilized egg is implanted in the fallopian tubes rather than the uterus) could be to blame.
- Bleeding Disorder – A disorder in which the blood does not coagulate could cause menorrhagia. A bleeding disorder commonly seen in women is von Willebrand’s disease (VWD. In cases of VWD, there is too little blood clotting factor.
- Medications – Some medications can have side effects of heavy menstruation. Both anti-inflammatory and anticoagulant drugs are known to cause this problem.
- Lifestyle Choices – Excessive use of alcohol as well as extreme diet and exercise can cause periods to be heavy.
- Thyroid Problems – Hyperthyroidism is known to be linked to heavy menstrual flow. Any change in regular menstrual patterns should be cause for thyroid examination by your physician.
- Sexually Transmitted Disease – Some STD’s carry excessive menstrual bleeding as symptoms.
- Other Medical Conditions – Kidney and liver diseases, as well as lupus, are known causes of menorrhagia.
While this list is extensive, it contains only a small number of possible causes related to heavy menstrual bleeding. It is imperative that you see your doctor if you are experiencing abnormal periods.
Menorrhagia can lead to further medical complications if left untreated. The most common of these is anemia, or low iron levels in the blood. Anemia is serious and can cause extreme fatigue, headaches, and irritability. It can even cause damage to the heart. Heavy periods are the most common reason for anemia in women prior to menopause.
Heavy menstruation can also cause severe cramps. Sometimes the pain is so bad that it requires treatment with prescription medication or even surgery. It’s possible that menorrhagia can lead to infertility.
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Seeing Your Doctor
Don’t wait to see your doctor. There are treatments for menorrhagia. Drugs may be used, depending on your condition. Such treatments often include:
- Iron Supplements – These are given to either postpone or treat iron deficiency due to anemia.
- Nonsteroidal Anti-Inflammatory Drugs – Also known as NSAIDs, over-the-counter medicines like acetaminophen and ibuprofen can lessen menstrual flow and provide relief for painful cramps.
- Oral Contraceptives – Birth control pills are a means of regulating menstrual cycles as well as blood flow.Hormones – The hormone progesterone can be given orally during the menstrual period to deal with hormonal imbalance and regulate menstrual flow, while a hormonal IUD can be put in place to make the uterine wall thinner, thereby reducing menstrual flow and cramping.
There are other treatments available if drug therapy is not effective or if your doctor advises against it for medical reasons. Dilation and curettage (D and C) is a procedure in which the cervix is dilated and tissue from the uterine lining is removed. Polyps can be surgically removed. Performing a complete hysterectomy, or removal of the uterus, is a possibility in extreme cases.
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Regardless of cause or treatment, it is important that you get adequate rest and keep a record of your periods if you are experiencing heavy menstrual bleeding. Also, avoid aspirin, as it can interfere with blood clotting. Your doctor will work with you to determine the best course of action for your individual case.