Menorrhagia – Definition
The medical word for exceptionally heavy or protracted menstrual cycles is menorrhagia. People who are designated female at birth (AFAB) frequently have heavy flow days and cramps during their menstrual cycle. However, menorrhagia—very heavy menstrual bleeding or bleeding for seven days—affects roughly 1 in 5 women.
You might need to replace your tampon or pad every hour for at least a whole day if you have menorrhagia since your flow might be so thick. Additionally, your cramps may be so bad that they prevent you from carrying out your daily tasks.
In addition to bleeding disorders and cancer, other illnesses like uterine or hormonal issues can also be the cause of heavy periods. See your doctor if you routinely soak through a pad or tampon every hour or so. They could be of assistance.
Menorrhagia during puberty
During puberty, it is not unusual to experience irregular menstrual cycles, wherein one month you may have a mild period and the next a heavy one. However, teens typically do not experience heavy enough periods to qualify as menorrhagia. If so, you should consult your physician to determine the possible cause of your unusually heavy periods.
Typically, your doctor will discuss your medical history, menstrual cycle, medications, past sexual experiences, and pregnancy history with you. Additionally, your doctor might want you to keep a journal of your periods, including the frequency and number of days you experience heavy bleeding.
If the doctor feels that a pelvic exam—during which the internal reproductive organs are examined—is required, you will also have a physical examination. In addition, your doctor might prescribe blood work and an ultrasound, which creates images of inside organs using sound waves.
Most teenagers can address severe menstrual bleeding without surgery. To treat pain and stop bleeding, your doctor will typically recommend a nonsteroidal anti-inflammatory medicine (NSAID), such as ibuprofen. In addition, they might recommend hormones, contraception, or tranexamic acid, which lessens bleeding during your menstrual cycle.
Symptoms of Menorrhagia
You can be experiencing excessive menstrual bleeding after decades of regular cycles, or you might have experienced heavy periods since your very first menstrual flow.
Discussing your heavy periods with your doctor is usually a good idea, particularly if this is a new issue for you. Low red blood cell counts, or anaemia, could result from it and leave you feeling weak, exhausted, or short of breath.
Should menorrhagia be present, you might need to:
a. Change pads or tampons at least once an hour for a day or more
b. Change pads in the middle of the night
c. Wear two pads at a time to manage heavy flowYou could also:
a. Skip things you like doing because of painful crampsb. Pass blood clots that are the size of quarters
c. Have periods that last longer than 7 days
d. Feel tired or short of breath
f. Bleed between periods
e. Bleed after menopause
Causes of Menorrhagia
Typical reasons for extended periods include:
Hormone issues: During your menstrual cycle, a lining inside your uterus, or womb, accumulates and sheds once a month. Your body may produce an excessively thick lining if your hormone levels are out of balance, which can cause severe bleeding when the thicker lining sheds. Your body’s hormone balance may be upset if you don’t ovulate, which can also result in a thicker lining and a heavier menstrual cycle.
Growths in the uterus: Polyps are expansions in the uterine lining. During the reproductive years, benign (noncancerous) tumours called fibroids grow inside your uterus. Both may significantly increase the weight or duration of your periods.
Specific intrauterine devices: A lot of women utilise birth control with small intrauterine devices (IUDs). Your periods may become heavier if your IUD lacks hormones.
Obstetrical problems: Rarely, the developing ball of cells implants itself outside the uterus rather than inside after the sperm and egg contact. We refer to this as an ectopic pregnancy. It cannot be a healthy pregnancy and could result in major health issues like severe bleeding that could be mistaken for a strong menstrual flow. Moreover, severe bleeding may be the result of a miscarriage, or the death of a baby in the womb.
A few malignancies in women: Rarely, excessive bleeding that mimics a heavy menstrual flow may be caused by cancer of the uterus, cervix, or ovaries.
Bleeding disorders: Although rare, bleeding disorders such as Willebrand’s disease run in families and make it difficult for a person to stop bleeding after being cut. Additionally, they may lengthen and make your menstrual flow thicker.
Adenomyosis: This condition results in painful periods and profuse bleeding because the glands lining the uterus expand into the wall.
Some drugs might produce heavy periods: anti-inflammatory drugs like NSAIDs; blood thinners like warfarin and apixaban; and some hormonal treatments like birth control pills.
Other health problems including:
Endometriosis
Thyroid problems
Pelvic inflammatory disease (PID)
Kidney disease
Liver disease
Polycystic ovary syndrome (PCOS)
Obesity
Insulin resistance
Diagnosis of Menorrhagia
Your doctor will inquire about your medical history and ask you to describe your symptoms in order to diagnose menorrhagia. They could also ask you to keep a journal in which you record the duration of your periods, the amount of blood that bleeds, and the days that you are bleeding and are not.
After a physical examination, they might need to order certain tests, such as:
a. An ultrasound produces images of your internal organs, including your uterus.
b. A Pap test (if you are over 25) checks for inflammation, precancerous abnormalities, and the human papilloma virus using cells from your cervix.
c. Blood tests to screen for blood-clotting disorders, thyroid disorders, and anaemia
d. Using material from your uterus, a biopsy can reveal precancerous or cancerous cells.
e. Pelvic exam, which enables the physician to look for tumours or fibroids.Comparing menorrhagia to metrorrhagia
Prolonged or extremely heavy menstruation is known as menorrhagia. Excessive bleeding beyond the typical menstrual cycle is known as metrorrhagia (small spotting between periods is very common during puberty and sometimes even later in life). It’s also possible to experience both heavy periods and interspersed bleeding. We call this menometrorrhagia.
Menorrhagia Treatment
Menorrhagia Medication
Your doctor will typically recommend medication as the first line of treatment to lessen heavy monthly bleeding. Among them are:
Hormonal drugs: By changing the hormone balance in your body, progesterone or birth control pills can stop heavy periods.
IUDs: Certain IUDs release hormones that could help your menstruation become lighter.
Anti-inflammatories: NSAIDs, such as naproxen sodium, help lessen the severity of cramps and the volume of blood lost throughout the menstrual cycle.
Antifibrinolytics: To reduce blood loss during your menstrual cycle, take tranexamic acid. This drug inhibits the enzymes that break up clots in the uterine lining.
Agonists and antagonists of the gonadotropin-releasing hormone: These, also referred to as GnRH medicines, assist in minimising menstrual haemorrhage. Relugolix and Elagolix can be administered with or without hormones to lessen endometriosis and fibroids-related bleeding.
Medical Procedures
Your doctor may suggest one of several types of medical treatments if your menstrual flow is still unpleasant or if excessive bleeding is interfering with your daily activities even after you have tried medicines.
Ultrasound: Your doctor may be able to use ultrasonic waves to target and shrink fibroids.
Uterine artery embolization: During uterine artery embolisation, a catheter will be inserted into an artery in your leg by your doctor. They inject microscopic beads via the catheter to close blood vessels and cause fibroids to contract.
Surgery: You can have fibroids or polyps reduced in size or removed if your doctor discovers them. Maybe this will stop the severe bleeding.
Dilation and curettage (D&C): Your doctor will dilate, or open, your cervix during a D&C. Next, a portion of the outermost layer of your uterus’ lining will be scraped or suctioned away. Although the surgery frequently ends heavy periods, some women require many procedures. You can also use a D&C to explain to your doctor the reason behind your heavy periods.
Other procedures like endometrial excision and ablation permanently remove or destroy the uterine lining. Women either don’t have any period thereafter or get considerably milder ones. Physicians urge women who have undergone endometrial ablation or resection not to become pregnant. These treatments do not provide contraception, therefore you will still require birth control.
Hysterectomy: This procedure, which involves removing your uterus, may be necessary in extreme circumstances. Not only will you not get your period back, but you won’t be able to conceive.
Menorrhagia Complications
Menorrhagia-related bleeding might result in further issues, such as:
Blood loss anemia
Iron deficiency
Pale skin
Weakness
Fatigue
Severe pain
Consult your doctor about treatment options for menorrhagia and associated symptoms if you are experiencing difficulties.
Does menorrhagia pose a threat?
Usually, menorrhagia is not a hazardous condition. It may be more difficult to conceive in cases of endometriosis, uterine fibroids, and PCOS, among other disorders that produce heavy menstrual bleeding. Consult your doctor about your options for therapy if menorrhagia is being caused by one of these disorders and you wish to become pregnant.
Natural Remedies
Home remedies do not take the place of physician-provided healthcare. However, there are a few things you can try to lessen the agony and lessen the amount of blood you shed when you menstruate.
Water: Keeping your blood volume up will help prevent it from dropping during a very heavy menstrual cycle.
Iron: Consuming meals high in iron can help lower the risk of anaemia. You can eat lentils, beans, oysters, leafy greens like spinach, and fortified cereal.
Herbal teas: Raspberry leaf, cinnamon, ginger, and licorice teas are believed to help balance hormones and lessen uterine inflammation.
Hot or cold packs: An ice pack may lessen excessive blood flow, while hot packs can aid with cramping.
Vitamin C: Consuming foods high in vitamin C may help absorb iron and build blood vessels. Strawberries, tomatoes, citrus fruits, and bell peppers are a few healthy choices.
Conclusions
Though it might cause disruption to one’s life, menorrhagia, or excessive menstrual flow, is not a serious disorder. Additionally, it may result in anaemia, which may make getting pregnant challenging and leave you feeling weak and exhausted. A nutritious diet, heated pads, and herbal tea are a few at-home therapies that can help lessen discomfort. However, medical intervention may be necessary to lessen your menstrual flow and ease cramping.
Frequently asked question
Q. Which meals are best to avoid when you have menorrhagia?
A. There aren’t many foods that can affect heavy menstrual bleeding, but you might want to stay away from alcohol, which can dehydrate you; spicy foods (if they make you queasy, that could just make your cramps worse); and red meat, which contains prostaglandins, which can exacerbate cramps even though it contains iron.
Q. The frequency of menorrhagia?
A. Approximately one in five women experience heavy periods to the point where they need to contact a doctor.
Q. For menorrhagia, how long is too long?
A. If your menstruation is heavy and lasts more than seven days, consult your physician.