Do you also experience heavy bleeding during your monthly period? Let's talk about Menorrhagia!

For many women, menstruation is not a pleasant experience. Some people find it difficult to get through these few days of the month with things like stomach aches, feeling weak, and mood swings. But if you are bleeding a lot more than usual, if you are bleeding for several days in a row, or if you are passing large blood clots, it could be a medical condition called Menorrhagia . This can even disrupt your daily life. So, let's talk about this in a little more detail today.

What is Menorrhagia? Do you also have these symptoms?

Simply put, menorrhagia is the bleeding that is heavier than normal during menstruation or that continues for several days. If you suspect that you have this condition, consider these symptoms:

• Does your period last longer than seven days ?
• Do you sometimes bleed so much that you have to change a pad or tampon at least once an hour ?
• Do I have to use two pads at once to stop the bleeding?
• Do you have to get up at night to change your pad even when you're sleeping?
• Do you pass blood clots the size of a coin or larger several times a day?
• Do you feel so uncomfortable during your period that you can't do your normal activities ?

Many people don't like having their period. But if you have it (menorrhagia), it can be a very distressing and painful experience. Not being able to go to work or school, using a lot of pads and staying at home can be really frustrating.

If you experience any of these symptoms, see a doctor immediately . He or she can examine your symptoms and determine the cause of your heavy bleeding. Then, they can prescribe the right treatment.

How common is this condition?

In fact, heavy menstrual bleeding is not as uncommon as you might think . It affects between 27% and 54% of women who menstruate. This means you are not alone.

How do you know if you are losing too much blood?

There are several symptoms of heavy bleeding. We've talked about them a little bit before. In other words:

• Menstruation lasting more than seven days.
• More than one blood clot the size of a coin passes. This blood can be red, pink, brown, or even rust-colored.
• Bleeding for about two hours at a time, wetting more than one pad or tampon per hour.
• Having to get up at night to change the pad even when you want to sleep.
• Using two pads together for fear of blood leakage.
• Normally, 2-3 tablespoons of blood is lost during menstruation. However, if more than 5 tablespoons of blood is lost (this is difficult to measure, but it is usually said to be so), that is also heavy bleeding.
• Having severe stomach pain or menstrual cramps.
• Excessive bleeding can cause weakness, fatigue, and shortness of breath . This can lead to anemia .

How do you know for sure if you have Menorrhagia? What should it be like under normal circumstances?

Heavy menstrual bleeding can affect your quality of life . Many people think that menstruation is something that has to be uncomfortable and troublesome. Perhaps they have seen their family members suffer from heavy menstruation and not seek treatment for it, and they have become accustomed to living the same way. But menstruation does not have to stop your daily activities or endure discomfort.

Normally, this is what happens during menstruation:

• You should be able to use a regular pad or tampon for three to four hours without changing it.
• You should be able to use just one pad or tampon. You shouldn't have to put two together.
• You should be able to use an overnight pad when you sleep at night.
• You don't need to carry extra pads and clothes when you leave the house.
• You should be able to go to work, go out, and live your life normally without any obstacles.

If your period is disrupting your life, it's the best time to see a doctor.

Why is there so much bleeding? What are the causes?

Menorrhagia can have many causes. It can be caused by hormonal problems, certain medical conditions, or certain medications you take.

Hormone imbalances

Your monthly menstrual cycle is controlled by hormones produced by your body, such as estrogen and progesterone. These hormones also determine how much blood you bleed during your period. If there is a condition that causes these hormones to become unbalanced, you may experience excessive bleeding. For example:

• Anovulation: Failure to release an egg from the ovaries.
• Thyroid disease.
• Polycystic ovary syndrome (PCOS).

Additionally, being overweight can also affect hormone production and cause excessive bleeding. Talk to your doctor about your ideal body weight to see if it is contributing to this condition.

Noncancerous growths in your uterus

Some benign tumors that form in the uterus and conditions in which uterine cells grow abnormally can also cause excessive bleeding.

• Polyps: These are small growths that form in the lining of the uterus (endometrium) or cervix.
• Fibroids: These are non-cancerous growths that develop in the muscles of the uterus. Many women have them, but they may not have any symptoms.
• Adenomyosis: This is when the tissue from the inner lining of the uterus grows into the muscle layer of the uterus.

Infections

Some infections, including sexually transmitted infections (STIs), can also cause heavy bleeding.

• Trichomoniasis
• Gonorrhea
• Chlamydia
• Chronic endometritis - a long-term infection of the inner lining of the uterus.

Pregnancy complications

Heavy bleeding can also be a warning sign of some complications that may occur during pregnancy.

• Miscarriage.
• Ectopic pregnancy: An embryo implants outside the uterus.
• Problems related to scars after cesarean section (C-section niche).

Other medical conditions

Menorrhagia is a symptom of a number of other disorders, including bleeding disorders. Some common medical conditions that can cause excessive bleeding include:

• Von Willebrand disease - a blood clotting problem.
• Liver disease.
• Kidney disease.
• Pelvic inflammatory disease (PID).
• Leukemia or platelet disorders.

Cancerous growths in your uterus

Menorrhagia can also be caused by a precancerous condition called endometrial hyperplasia. Also, other cancers that affect your reproductive system can cause heavy bleeding.

• Uterine cancer.
• Cervical cancer.

Some medications

Some medications can also cause heavy menstrual bleeding.

• Blood thinners and aspirin.
• Hormone replacement therapy.
• Tamoxifen (a drug used for breast cancer).
• Intrauterine devices (IUDs).
• Birth control implants.
• Birth control pills and injections (e.g., NuvaRing®, Depo-Provera®, Implanon®).

Not removing your birth control device on time can also cause abnormal uterine bleeding. It's important to know exactly when to remove your IUD or implant.

Who is at higher risk of developing menorrhagia?

Anyone can get menorrhagia. However, it is more common in those approaching menopause . If you have any hormonal imbalances or are obese (body mass index (BMI) of 30 or higher), you are at higher risk of having heavy periods.

What are the possible complications of heavy menstrual bleeding?

Excessive bleeding can be dangerous, especially if you lose enough blood to show symptoms of anemia. Anemia can be life-threatening if left untreated.

Also, some conditions, such as cancer, that cause heavy periods may require medical attention at an early stage. Talk to your doctor about any risks associated with your menstrual bleeding.

How do doctors diagnose menorrhagia?

To determine if you have menorrhagia, your doctor will ask you a few questions about your medical history and menstrual cycle, as well as perform a physical exam and pelvic exam.

The doctor may ask things like:

• At what age did you get your first period?
• How many days does menstruation last?
• On how many of those days do you bleed heavily?
• Does anyone in your family have a history of heavy periods?
• What is your pregnancy history and current birth control methods?
• What medications (including over-the-counter (OTC) medications) are you currently taking?

Be prepared to talk about your lifestyle as well. The doctor will want to know if you use two pads at once, miss work because of your period, or have any restrictions in your daily life.

What tests are performed?

A pelvic ultrasound is the most common way doctors diagnose menorrhagia. Other tests may be done depending on your age and the severity of your symptoms.

• Blood test: Check for anemia, blood clotting problems, and thyroid disease.
• Transvaginal ultrasound: View the condition of the organs and tissues in the pelvic cavity.
• Magnetic resonance imaging (MRI): If ultrasound does not provide enough information, it is used to look for abnormal structures in the uterus.
• Pap smear: Examines the cells of the cervix for cancerous changes.
• Cervical culture: To check for infection.
• Endometrial biopsy: Checks for cancer cells or other abnormalities in the uterine tissue.

Other methods that can help determine the cause of bleeding:

• Sonohysterogram (saline-infusion sonography): To check for problems with the lining of the uterus. This involves filling the uterus with saline and looking inside.
• Hysteroscopy: To check for polyps, fibroids, or other abnormal tissue in the uterus. This procedure can examine the vagina, cervix, and uterus. It can also remove things that are causing bleeding, such as fibroids and polyps.

What are the best treatments for Menorrhagia?

Treatment depends on the cause of the bleeding, the severity of the bleeding, your health, age, and medical history.

Sometimes, menorrhagia gets better without treatment. This can be due to minor hormonal changes or conditions such as weight gain (menorrhagia usually subsides once you reach a healthy weight).

Talk to your doctor about your health problems and what you expect from treatment. He or she can then recommend the best course of action.

Medications

Doctors usually prescribe medications before surgery.

• Iron supplements: Restore your iron levels.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Things like ibuprofen or aspirin can help reduce pain and reduce bleeding.
• Birth control: Pills, vaginal rings, patches, and IUDs can help regulate menstruation and reduce bleeding.
• Hormone replacement therapy (HRT): This can help balance the body's estrogen and progesterone levels and reduce menstrual bleeding. Although this is recommended for heavy bleeding during perimenopause, it has risks, so talk to your doctor about it.
• Gonadotropin-releasing hormone (GnRH) agonists and antagonists: These can temporarily stop or reduce bleeding.
• Desmopressin nasal spray (Stimate®): Helps stop bleeding associated with von Willebrand disease by helping blood clot.
• Antifibrinolytic medicines: Things like tranexamic acid break down blood clots and prevent excessive bleeding.

Surgeries and other procedures

If medications don't relieve symptoms, your doctor may recommend surgery. It depends on the cause of the bleeding.

• Hysteroscopy: This can diagnose and treat heavy periods. The doctor uses a thin, lighted tube to look inside the uterus. Then, surgical instruments are used to remove anything that is causing the bleeding, such as polyps.
• Dilation and curettage (D&C): A procedure in which the outermost layer of the uterus is removed. This tissue can be sent to a lab to determine the cause of the bleeding.
• Myomectomy: A surgery to remove fibroids from the uterus.
• Uterine artery embolization (UAE): A procedure that restricts the blood supply to fibroids and tumors.
• Endometrial ablation: A procedure that destroys all or part of the lining of the uterus.
• Hysterectomy: A surgery to remove the uterus. After this, you will not have periods or become pregnant.

Your doctor will recommend the best treatment for the cause of your bleeding. Treatment may start with medications, then progress to minor procedures and surgery. Talk to your doctor to choose what's best for you.

What happens if menorrhagia is not treated?

Excessive bleeding can lead to anemia , which can be serious. If you think you have menorrhagia, it is important to see a doctor and get treatment.

Can the condition (Menorrhagia) get better?

Yes, sometimes menorrhagia can go away without treatment. But it's best to talk to your doctor about whether this is the case for you. Menorrhagia can be temporary and get better without medical intervention. However, many times, there is an underlying condition that is causing your heavy periods. You may not get relief from your heavy periods until that condition is treated.

Can heavy menstrual bleeding be prevented?

Not all causes of heavy periods can be prevented, but talking to a doctor for a diagnosis and treatment can help you manage your bleeding without disrupting your quality of life.

What do you have to say about living with this condition? (Prognosis)

If left untreated, heavy periods can disrupt your life. In addition, heavy periods can cause anemia, which can make you feel tired and weak. If left untreated, other health problems can also arise. With the right treatment and medical support, you can control heavy periods without compromising your well-being.

When should you see a doctor if you suspect excessive bleeding?

If you have symptoms of heavy periods, anemia, or if your periods are affecting your quality of life, you should see a doctor. Keeping track of your periods on a calendar or in an app can help you determine if your periods are heavier than normal and last for a number of days. Show these notes to your doctor.

Make an appointment with your doctor as soon as you notice that you have to use two pads at a time, or that you are missing out on things you enjoy during your period.

Do you need to go to an Emergency Treatment Unit (ETU) ?

Heavy periods are usually not life-threatening. However, if you bleed too much, it can be dangerous. If you're bleeding for two to three hours straight, or if you're soaking more than two pads or tampons per hour, it's a sign that you need to see a doctor or seek emergency treatment.

Although heavy periods are common, you don't have to endure the discomfort they cause. If controlling your bleeding is interfering with your mental and physical well-being, talk to your doctor. He or she can help you find a treatment that will bring you relief and allow you to live the life you want, even during your periods.

Final Take-Home Message

• Heavy menstrual bleeding (menorrhagia) can be a serious condition, so don't be ashamed or afraid, but seek medical advice.
• If you have symptoms that are different from your normal period and are causing discomfort (e.g., changing pads every hour, heavy bleeding, or periods that last more than 7 days), don't ignore it.
• Anemia is a major complication of this condition, so watch out for things like weakness, fatigue, and difficulty breathing.
• This condition can be well controlled by finding the cause and receiving proper treatment.
• You are not alone, there are many people who face similar problems. So don't hesitate to ask for help. Your health is the most important thing!

` Menorrhagia, heavy menstrual bleeding, menstruation, women's health, uterus, hormones, anemia