What is Menorrhagia?
Heavy menstrual flow is a common disorder in most women. It is medically termed menorrhagia. Heavy menstrual flow can be so much that you just have to change a pad or replace menstrual cup every 2 hours and may last for over 7 days. It can be so bad that sleep is lose. It is usually accompanied with weakness and inability to perform ones daily activity for living. There is thereore need to contact a medical provider for management options as soon as possible in severe cases.
What are the signs and symptoms ?
Signs of menorrhagia may include some of the followings:
- Having to replace sanitary pads every hour or less for many consecutive hours
- Menstrual periods that last over 7 days
- Menstrual period that keeps you from performing activities of daily living
- Constant lower abdominal pain
- Weakness and shortness of breath
- Doubling sanitary pads in order to prevent menstrual overflow
- Changing pads or tampons during night time
- Passing larger blood clots
Possible causes fall into the following three areas:
- Growths or tumors in the uterus, that are called uterine fibroids or polyps.
- Cancer of the uterus or cervix
- Intra-uterine devices
- Bleeding-related disorders such as platelet function disorder
- Other medical conditions such as thyroid disease or pelvic inflammatory disease
- Some drugs such as aspirin, can cause increased bleeding
- The menopause transitions
- Hormonal imbalance
- Dysfunction of the ovaries
- Pregnancy complications such as ectopic pregnancy
- Inherited bleeding disorders
- Medications such as anti-coagulants and vasodilators
Diagnosis of Menorrhagia
For menorrhagia to be diagnosed by your doctor, s/he would ask you some questions about your past and present medical history and menstrual cycles, and run some investigations on you.
- Comprehensive history taking
- Your menarche. That is, the age you started menstruation
- Typical length of your menstrual cycle
- Usual number of days your period lasts
- Number of days your period is heavy
- Quality of life during your period
- History of heavy menstrual bleeding in the family
- Your stress patterns
- Any problem with gain. Such as weight gain or loss
- Current use of any drug
- Physical examination
- Blood test to rule out anemia and thyroid problems
- Pap test to test for infection, inflammation or cancerous changes
- Endometrial tissue biopsy to examine uterine tissue for any form of pathology
- Pelvic ultrasound to detect any abnormality with the pelvic organs
Specific management of menorrhagia is dependent on several factors which include a comprehensive history taking, assessment and investigations.
Pharmacotherapy for menorrhagia may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): they help by reducing menstrual blood loss and relieving painful menstrual cramps
- Tranexamic acid.
- Oral contraceptives.
- Oral progesterone: this may be needed to correct hormone imbalance and reduce menorrhagia. However, if menorrhagia is hormone-induced, there is a need to speak with one’s medical provider about changing or stopping it.
- Hormonal IUD. It releases levonorgestrel, which thins the uterine lining and decreases menstrual blood flow and cramping.
- Iron supplement may be prescribed to reduce the chances of anemia
Complications of Menorrhagia
Excessive or prolonged menstrual bleeding can lead to other medical conditions such as
- Anemia: Severe bleeding decreases iron levels. This increases the risk of iron deficiency anemia.
- Severe pain: painful menstrual cramps usually accompany menorrhagia. This may require urgent medical attention
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