Having problems with the menstrual flow is common in women. Period related issues include heavy menstrual bleeding as well, including too much and too often. In the initial years, the flow can feel a little too much. Most of the times it is not, but sometimes it is. Therefore, we should be aware about the difference to know when to call the doctor. When the menstrual cycle begins, it is normal for your periods to be heavy or be irregular. Menses are not associated with ovulation right when they start as the hormones that manage it have not found their space yet. However, a rare heavy menstrual flow is not stressful.
Do you know what is heavy menstrual bleeding? Heavy Menstrual Bleeding (HMB) is clinically called menorrhagia. A woman mostly has loss of menstrual blood which is greater than 60-80 ml per cycle in this condition. Its occurrence increases with age and can be a sign of an underlying health problem that requires medical treatment. Onlymyhealth editorial team spoke to Dr. Amit Kamat, Consultant - Obstetrics and Gynecology, Fortis Hospital, Kalyan, about the symptoms, causes and treatment of heavy menstrual bleeding.
Heavy menstrual bleeding symptoms
There are some serious signs that a woman should watch out for in heavy menstrual bleeding. It is understood that only 1/3rd of women seek treatment for the problem and the other end up ignoring the symptoms. A doctor would diagnose and find the underlying cause after talking to the patient about the signs. Heavy menstrual bleeding can cause the patient to become anemic (Iron deficiency), which would add to their woes. It is also important to check on problems like low blood platelets. The main symptoms of heavy menstrual bleeding are:
- Passing blood clots
- Bleeding more than a week
- Need for double sanitary protection
- Symptoms of anemia and weakness
- A barrier in doing daily activities
What are the causes of heavy menstrual bleeding?
Heavy menstrual bleeding affects about 1-5 women and is a common problem in the 30-50-year-old age group. Around 50 percent of women with heavy menstrual bleeding have no abnormalities in their uterus. It might be linked to hormonal or chemical levels in the Endometrium (the internal lining of the Uterus) or conditions not yet identified. In the other 50 percent, it is related to fibroids, cancer, pregnancy problems such as Ectopic Pregnancy, pelvic Inflammatory disease, polycystic ovary syndrome (PCOS) or use of intrauterine device (IUD).
When to call your doctor?
It is also important to know when you need to call the doctor. Bleeding lasting longer than 7 days or the need to change pads every hour or so is an indication to call the doctor. Spotting can also be a problem and some symptoms might look like other health conditions. The doctor might suggest some tests for full diagnosis which include blood tests for disorders like anemia, thyroid and clotting, ultrasound for checking the uterus, ovaries and pelvis, pap smear to check on cervical infection, inflammation, dysplasia and cancer, endometrial biopsy to check the lining of the uterus and hysteroscopy to evaluate the uterus lining.
Treatment for heavy periods depends on the cause behind the problem. The doctor will talk about your medical history, lineage, general health and other factors before starting the treatment. The following drug therapies or surgical procedures are used to treat menorrhagia:
1. Drug Therapy
- Birth Control Pills can help regularize periods and help reduce the bleeding
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) can treat Dysmenorrhea (painful menstrual cramps) and can help reduce blood loss; sometimes these may increase the risk of bleeding
- Oral contraceptives can regulate menstrual cycles and reduce episode of excessive or prolonged bleeding
- Iron Supplements will help get Iron into the blood and treat Anemia
2. Surgical Interventions
- Dilation and Curettage (D&C) is a surgical procedure for scraping the lining of the uterus
- Uterine Artery Embolization helps treat Fibroids, which causes heavy bleeding, by blocking the arteries that feed them
- Hysteroscopy involves inserting a camera into the Uterus to evaluate the lining, assisting in the removal of Fibroids, Polyps, and the uterine lining
- Myomectomy is a surgical treatment to remove Uterine Fibroids through several small abdominal incisions, an open abdominal incision, or through the vagina
- Hysterectomy is a surgical intervention to remove the uterus
These were symptoms, causes and treatment of heavy menstrual bleeding or menorrhagia by Dr. Amit Kamat. While this condition is quite common, there is still a lack of knowledge among women that they can take medical help to reduce the symptoms and treat the cause. Some are hesitant to talk about it, however, talking to a healthcare expert is very important to make complete diagnosis and start the treatment.
Read more articles on Women's health