A Primer on Menorrhagia, or Heavy Menstrual Bleeding
Heavy bleeding is a concern menstruating individuals worldwide are familiar with, but it could mean a lot more than a bad period. Here’s what you need to know about menorrhagia, a condition that involves abnormally heavy menstrual bleeding:
What is menorrhagia?
While the average period leads to 4 tablespoons (60 ml) of blood loss, people who suffer from heavy menstrual bleeding, or menorrhagia, lose more than 80 ml — which can go up to double the amount or more. Though heavy menstrual bleeding is a common concern, most menstruating individuals do not experience blood loss severe enough for a menorrhagia diagnosis, according to the Mayo Clinic. Due to the severe bleeding and cramping caused by this condition, it is extremely hard to maintain one’s regular routine during their period.
While menorrhagia may sound similar to dysmenorrhea, the latter is characterized by menstrual pain, nausea, diarrhea, hypersensitivity and more — while the former is mainly categorized by abnormally large blood flow.
What are the causes of menorrhagia?
“Hormonal imbalance due to polycystic ovarian syndrome [PCOS], obesity, insulin resistance or thyroid problems results in heavier bleeding than usual. If there’s a hormonal imbalance, there is excessive development of [the] endometrium, which is eventually shed through heavy menstrual bleeding,” Dr. Shelly Singh, senior consultant, Obstetrics and Gynecology, at Paras Bliss Hospital, New Delhi, told India Today.
An imbalance of estrogen and progesterone, bleeding and uterine disorders like non-cancerous fibroids, pregnancy complications (miscarriages, ectopic pregnancies) and using intrauterine devices (IUDs) are the main causes of menorrhagia, according to Johns Hopkins Medicine. Thyroid, kidney and liver disorders could also lead to heavy bleeding, and so can consumption of anti-inflammatory, hormonal and anti-coagulant medication.
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What are the symptoms of menorrhagia?
The symptoms of menorrhagia, according to the Mayo Clinic, are a combination of:
- Heavy bleeding (soaking through tampons/pads every 1-2 hours or needing heavy protection).
- Disturbed sleep due to waking up at night to change menstrual sanitary products
- Bleeding for seven days or more
- Spotting or bleeding more between periods
- Frequently passing coin-sized blood clots
- Tiredness, fatigue, and shortness of breath (anemia due to heavy blood loss)
- Any vaginal bleeding post menopause
How is menorrhagia diagnosed?
Healthcare providers will ask for details about medical history, and the number of sanitary products used. Doctors may also recommend blood tests, pap smears, endometrial biopsies, and ultrasounds to diagnose menorrhagia.
How is menorrhagia treated?
Treatment for menorrhagia, according to Johns Hopkins Medicine, depends on the cause of the abnormally heavy bleeding. Doctors might recommend progesterone, birth control pills, non-steroidal anti-inflammatory medicines, iron supplements for anemia, or in serious cases, surgical procedures like ablation (destroying the endometrium), resection (removing the endometrium) or even a hysterectomy.