Menorrhagia

Menorrhagia is a medical condition characterized by abnormally heavy or prolonged menstrual bleeding. It is a type of abnormal uterine bleeding (AUB) that affects women of reproductive age.

Definition and Diagnosis

Menorrhagia is defined as menstrual bleeding that lasts for more than 7 days or exceeds 80 milliliters (ml) in volume. The diagnosis of menorrhagia is typically made based on a woman's medical history, physical examination, and laboratory tests to rule out other causes of abnormal bleeding.

Causes

The causes of menorrhagia can be varied and include:

• Hormonal imbalance: Changes in hormone levels, particularly estrogen and progesterone, can affect the menstrual cycle and lead to heavy bleeding.
• Uterine fibroids: Non-cancerous growths in the uterus that can cause heavy or prolonged bleeding.
• Adenomyosis: A condition where tissue similar to the lining of the uterus grows into the uterine walls, leading to heavy bleeding.
• Endometrial hyperplasia: A condition where the lining of the uterus becomes too thick, leading to heavy bleeding.
• Thyroid disorders: Certain thyroid conditions, such as hypothyroidism, can affect menstrual bleeding.
• Bleeding disorders: Conditions such as von Willebrand disease or platelet function disorders can increase the risk of heavy bleeding.
• Cancer: Rarely, menorrhagia can be a symptom of uterine or cervical cancer.

Symptoms

The symptoms of menorrhagia include:

• Heavy menstrual bleeding: Bleeding that soaks through one or more sanitary pads or tampons per hour.
• Prolonged menstrual bleeding: Bleeding that lasts for more than 7 days.
• Passing large blood clots: Passing blood clots that are larger than a quarter.
• Anemia: Fatigue, weakness, and shortness of breath due to iron deficiency from heavy bleeding.

Treatment Options

The treatment options for menorrhagia depend on the underlying cause and may include:

• Hormonal therapies: Birth control pills or other hormonal medications to regulate menstrual cycles and reduce bleeding.
• Non-steroidal anti-inflammatory drugs (NSAIDs): Medications such as ibuprofen or naproxen to reduce pain and bleeding.
• 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.

Complications

If left untreated, menorrhagia can lead to complications such as:

• Anemia: Iron deficiency from heavy bleeding can lead to anemia and related symptoms.
• Decreased quality of life: Heavy bleeding can interfere with daily activities, social relationships, and overall well-being.
• Emotional distress: Menorrhagia can cause emotional distress, anxiety, and depression.

Prevention

While menorrhagia cannot be completely prevented, certain measures can help reduce the risk of heavy bleeding:

• Maintaining a healthy weight: Excess weight can increase the risk of hormonal imbalances and uterine fibroids.
• Practicing good menstrual hygiene: Using sanitary pads or tampons regularly and changing them frequently can help reduce the risk of infection and heavy bleeding.
• Avoiding certain medications: Certain medications, such as anticoagulants, can increase the risk of heavy bleeding.