Heavy Menstrual Bleeding

Heavy menstrual bleeding, also known as menorrhagia, is a condition characterized by abnormally heavy or prolonged menstrual bleeding. It is a common problem that affects many women of reproductive age.

Definition and Diagnosis

Heavy menstrual bleeding is defined as menstrual bleeding that lasts for more than 7 days or results in the loss of more than 80 milliliters (ml) of blood per cycle. A normal menstrual period typically lasts between 3-7 days, with an average blood loss of around 30-40 ml.

Causes

There are several potential causes of heavy menstrual bleeding, including:

• Hormonal imbalance: Changes in hormone levels, particularly estrogen and progesterone, can affect the thickness of the uterine lining and lead to heavy bleeding.
• Uterine fibroids: Non-cancerous growths that develop in or around the uterus can cause heavy menstrual bleeding.
• Adenomyosis: A condition where tissue similar to the lining of the uterus grows into the uterine walls, leading to heavy bleeding and pain.
• Endometrial polyps: Growths on the lining of the uterus that can cause heavy bleeding.
• Cervical or uterine cancer: In rare cases, heavy menstrual bleeding can be a symptom of cervical or uterine cancer.
• Bleeding disorders: Conditions such as von Willebrand disease or platelet function disorders can increase the risk of heavy menstrual bleeding.
• Medications: Certain medications, including anticoagulants and anti-inflammatory drugs, can increase the risk of heavy menstrual bleeding.

Symptoms

The symptoms of heavy menstrual bleeding may include:

• Prolonged or heavy menstrual bleeding
• Passing large blood clots
• Soaking through one or more sanitary products per hour
• Wearing multiple sanitary products at once
• Restricting daily activities due to heavy bleeding
• Anemia or fatigue due to excessive blood loss

Treatment Options

Treatment for heavy menstrual bleeding depends on the underlying cause and may include:

• Hormonal therapies: Birth control pills, progesterone, or other hormonal medications can help regulate hormone levels and reduce bleeding.
• Non-steroidal anti-inflammatory drugs (NSAIDs): Medications such as ibuprofen or naproxen can help reduce bleeding and pain.
• Tranexamic acid: A medication that helps reduce bleeding by stabilizing blood clots.
• Surgical options: Procedures such as dilation and curettage (D&C), endometrial ablation, or hysterectomy may be necessary in some cases to treat underlying conditions or remove the uterus.

Complications

If left untreated, heavy menstrual bleeding can lead to complications such as:

• Anemia: Excessive blood loss can lead to iron deficiency anemia, which can cause fatigue, weakness, and shortness of breath.
• Restrictive daily activities: Heavy bleeding can limit a woman's ability to participate in daily activities, work, or social events.
• Emotional distress: Heavy menstrual bleeding can cause emotional distress, anxiety, and depression.