Prolonged or abnormally heavy bleeding is known as menorrhagia. It is a medical term for menstrual periods that are heavy. It is one of the most commonly reported health issues of women. One in five women has heavy menstrual bleeding during her lifetime.
Abnormal and heavy bleeding may also be due to some hidden (underlying) gynaecological health issues – which could be serious. Even if you don’t have any serious health issues, it could lead to other health concerns and complications. One such condition can make you feel weak and tired all the time. Untreated heavy or prolonged bleeding can stop you from living your life to the fullest.
Signs and Symptoms of Menorrhagia
- Bleeding requires double sanitary protection to manage
(Need to double up on pads to control your menstrual flow)
- Frequent sleep disturbance during the night to change sanitary protection.
- Bleeding for longer than a week
- Passing larger blood clots
- Frequent change of sanitary pads throughout the day
- Tiredness, fatigue and shortness of breath due to anaemia
- Disturbance and restricted daily activities due to heavy flow
Hormonal imbalance (Estrogen and progesterone) may lead to the development of excess endometrium that eventually sheds as heavy menstrual bleeding. Thyroid problems, insulin resistance, obesity and polycystic ovarian syndrome (PCOS) can cause hormonal imbalances.
Adenomyosis: This condition can cause heavy bleeding and painful periods.
Uterine polyps (a small benign growth on the uterus lining) may cause heavy or prolonged bleeding.
Uterine fibroids may cause prolonged or heavier than normal menstrual bleeding
It may also lead to menorrhagia. When your ovaries don’t release an egg (ovulate), it is known as anovulation, the hormone progesterone is not produced. The condition may result in menorrhagia.
Cervical and uterine cancer can cause heavy menstrual bleeding. This may occur in postmenopausal or middle-aged women or in women who had an abnormal PAP test in the past.
Pregnancy complications such as miscarriages and also the unusual location of the placenta during pregnancy including placenta previa (low-lying placenta) are the causes of heavy bleeding during pregnancy.
An ectopic pregnancy can also cause abnormal bleeding.
Pelvic inflammatory disease can also cause menorrhagia.
A nonhormonal intrauterine device (IUD) for birth control may cause heavy bleeding (menorrhagia) as a well-known side effect. If you are using any such device, ask your gynaecologist for alternative management options.
Certain medications including hormonal medicines (progesterone and Estrogen, anti-inflammatory medications, and anticoagulants like warfarin (Coumadin) may cause prolonged or heavy bleeding.
In some cases, liver and kidney diseases may also be associated with menorrhagia.
In rare cases, inherited bleeding disorders may also cause abnormal bleeding in women.
What are the complications of menorrhagia?
Abnormal bleeding can lead to other conditions such as dysmenorrhea (painful menstrual cramps). Severe cramps associated with pain may require medical intervention.
Anaemia – Excessive blood loss can lead to anaemia as menorrhagia can deplete iron stores in the body. Decreased iron levels can increase the risk of iron deficiency anaemia.
When to See a Gynaecologist?
Heavy bleeding should be medically evaluated by an experienced gynaecologist as it could be due to several underlying causes. If you get heavy and abnormal menstrual bleeding, then get it checked by your gynaecologist. You should not delay in seeking medical help if your bleeding is irregular or between periods or if you experience any vaginal bleeding after menopause.
How is menorrhagia diagnosed?
Bleeding may last for 7 days or more. Your gynaecologist may ask you the following questions:
Do you have weight problems?
Are you facing any stress?
Since how long have you been having heavy periods?
What is the usual length of your menstrual cycle?
What was your age when you got your first period?
What medicines are you taking?
And then she will do the following:
Your gynaecologist will perform the following exams to diagnose menorrhagia:
She will order blood tests to detect thyroid problems, check for anaemia and blood clots.
And perform a pelvic examination and PAP test to check the cells from the cervix for abnormalities.
She will also perform an ultrasound to look for abnormalities.
The other tests to determine the cause of uterine bleeding include hysteroscopy (to check for polyps and fibroids) and sonohysterogram to check for the problems in the lining of the uterus.
Treatment for Menorrhagia
Dilation and Curettage (D&C) is a simple procedure or a test used to detect and treat the cause of bleeding. Gynaecologists perform this procedure to know the cause of bleeding and treat it by looking inside the lining of the uterus and scrapping it. A gynaecologist performs this procedure in an operating room under general or local anaesthesia. After the procedure, the patient can leave the hospital the same day.
In this procedure, gynaecologists remove fibroids and polyps and the lining of the uterus.
Another surgical procedure is operative hysteroscopy. It uses a special device to look inside the uterus and to help remove fibroids and polyps. This procedure is helpful in correcting the abnormalities of the uterus and removing the lining of the uterus to treat heavy and abnormal bleeding.
Endometrial ablation or resection: This surgical procedure uses different techniques to remove a part or all of the lining of the uterus to control heavy menstrual bleeding. Some women may stop having periods altogether while others continue to have menstruation but the flow will be lighter than before.
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If you dread your period because you have such heavy menstrual bleeding, talk to me by fixing an appointment here: 99636 89895
There are several effective treatments for menorrhagia based on your condition, and health status.