Menorrhagia: Heavy Period Bleeding

What is menorrhagia?

Menorrhagia, meaning heavy menstrual bleeding, is defined by menstrual periods with abnormally heavy or prolonged bleeding. Women with menorrhagia usually experience bleeding lasting more than 7 days or lose more blood than a typical menstruation. 

Menorrhagia symptoms

Managing menorrhagia effectively can improve overall health and quality of life. Consult with a healthcare provider if you experience any of the symptoms below:

1. Excessive bleeding: 

Needing to change sanitary pads or tampons every hour for several consecutive hours.

2. Prolonged bleeding:

Menstrual periods lasting longer than 7 days.

3. Large blood clots: 

Passing large blood clots during menstruation or while urinating.

4. Backache and pelvic pain: 

Persistent back pain or pelvic discomfort.

5. Anaemia symptoms: 

Fatigue, weakness, or shortness of breath due to significant blood loss.

Causes of menorrhagia

Hormonal imbalances

• Imbalances in oestrogen and progesterone hormones can cause the endometrium (lining of the uterus) to develop excessively, leading to heavy bleeding.

• Hypothyroidism and hyperthyroidism disorders can contribute to menstrual irregularities.

Uterine conditions

• Fibroids (noncancerous growths) in the uterus can cause heavy bleeding and pain.

• Polyps (small, benign growths) on the lining of the uterus can lead to heavy periods.

• Adenomyosis, a condition where the endometrial tissue grows into the uterine wall, causes heavy bleeding and pain.

Bleeding disorders

• Von Willebrand disease is a genetic disorder that affects blood clotting.

• Platelet function disorders are conditions affecting the blood's ability to clot properly.

Medications

• Anticoagulants, or blood-thinning medications, can exacerbate bleeding.

• Some hormonal medications or treatments can affect menstrual flow.

Pregnancy-related issues

• Heavy bleeding and pain during pregnancy can indicate a miscarriage.

• Ectopic pregnancy (pregnancy outside the uterus) can cause severe bleeding and is classified as a medical emergency.

Menorrhagia, especially when accompanied by backache and blood clots during urination, can significantly impact a woman's life. Understanding the potential causes and seeking appropriate medical care is crucial.

Diagnosis of menorrhagia

• Medical History and Physical Examination — Initial evaluation by a healthcare provider.

• Blood Tests — To check for anaemia and other blood disorders.

• Ultrasound — To examine the uterus, ovaries, and pelvis.

• Pap Test — To screen for cervical abnormalities.

• Hysteroscopy — A procedure to look inside the uterus.

• Biopsy — Endometrial biopsy to rule out cancer or other abnormalities.

Menorrhagia treatment

Medications

• Nonsteroidal anti-inflammatory drugs (NSAIDs) can be prescribed to relieve pain and reduce menstrual blood loss.

• Hormonal therapy such as birth control pills, hormonal IUDs, or progesterone treatments can help to regulate menstrual cycles.

• Tranexamic acid is used to reduce menstrual blood loss.

Surgical interventions

• Dilation and curettage (D&C) procedures are done to remove part of the uterine lining.

• Endometrial ablation surgery destroys the uterine lining and reduces menstrual flow.

• Myomectomy removes the uterine fibroids.

• Hysterectomy involving the removal of the uterus is typically considered as a last resort.

Lifestyle and home remedies

• Iron supplements may be prescribed to prevent or treat anaemia.

• Maintaining a healthy weight through exercise and dieting can help manage symptoms.

FAQ

What is considered a heavy period?

A period is considered heavy if you need to change your pad or tampon every hour for several hours in a row, or if your period lasts longer than 7 days.

Is it normal to have blood clots during my period?

Small clots can be normal, but passing large clots frequently can be a sign of menorrhagia and should be evaluated by a healthcare provider.

Can menorrhagia cause anaemia?

Yes, significant blood loss from heavy periods can lead to anaemia, causing fatigue, weakness, and shortness of breath.

What causes back pain during heavy periods?

Back pain can be associated with the uterus contracting to expel blood, as well as conditions like fibroids or adenomyosis.

When should I see a doctor for heavy periods?

If you experience heavy bleeding, needing to change your pad or tampon every hour, periods lasting more than 7 days, severe pain, or anaemia symptoms, you should seek out a doctor.

Can hormonal birth control help with menorrhagia?

Yes, hormonal birth control can regulate menstrual cycles and reduce heavy bleeding.

What are the surgical options for treating menorrhagia?

Surgical options include D&C, endometrial ablation, myomectomy, and hysterectomy, depending on the cause and severity of the condition.

Are there any home remedies for managing heavy periods?

Maintaining a healthy diet, regular exercise, and taking iron supplements can help manage symptoms, but medical treatment may be necessary for underlying conditions.