Menstrual bleeding can vary from person to person, not just in terms of flow, duration, and regularity, but also in terms of symptoms. For some people, the length of menstrual bleeding typically lasts between 2-7 days, while for others, it can be shorter or longer. Some people may experience lighter flow, while others may have heavier flow requiring more frequent changes of sanitary products.
In an interaction with the OnlyMyHealth team, Dr Asha Dalal, Director, Obstetrics & Gynaecology, Well Women Center, Sir H N Reliance Hospital, explains the condition called menorrhagia, which refers to heavy menstrual bleeding due to an underlying cause.
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Understanding Menorrhagia: When Does It Become Concerning
Menorrhagia is characterised by bleeding that is excessive and may interfere with daily activities. The US Centers for Disease Control and Prevention (CDC) defines menorrhagia as menstrual bleeding that lasts more than 7 days, explaining further, "If you need to change your tampon or pad after less than 2 hours or you pass clots the size of a quarter or larger, that is heavy bleeding." According to Dr Dalal, Bleeding is considered heavy when:
- It affects your daily activities
- You are soaking one or more sanitary pad or tampon hourly for a few hours
- You pass large clots
- Your bleeding lasts for more than a week
- It leads to a fall in your haemoglobin
You may also:
- Have constant pain in the lower part of the stomach during your periods
- Feel tired, lack energy, or be short of breath
Menorrhagia, which refers to abnormally heavy or prolonged menstrual bleeding, is not considered normal and can lead to anaemia, fatigue, and other related symptoms. “Even if bleeding is normal you need to visit your doctor if there is a change in your pattern of bleeding. Where your periods are prolonged or you are having inter menstrual bleeding,” said Dr Dalal.
Common Causes Of Menorrhagia
Menorrhagia can have various causes. These include:
Hormonal imbalances
Hormonal imbalances, particularly an imbalance between oestrogen and progesterone, can lead to excessive or prolonged menstrual bleeding.
Uterine fibroids
These noncancerous growths in the uterus can cause menorrhagia by affecting the normal contraction and shedding of the uterine lining.
Adenomyosis
This condition occurs when the tissue lining the uterus grows into the muscular wall of the uterus, leading to heavy or prolonged menstrual bleeding.
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Polyps
Uterine or cervical polyps are abnormal growths on the lining of the uterus or cervix. They can cause menorrhagia by increasing the surface area of the uterus and affecting the normal shedding process.
Endometrial hyperplasia
This condition involves the excessive growth of the uterine lining, leading to heavy or prolonged menstrual bleeding.
Certain medications and medical conditions
Certain medications, such as anticoagulants, and medical conditions like bleeding disorders and thyroid disorders, can contribute to menorrhagia.
Conclusion
If you are experiencing heavy or prolonged menstrual bleeding, it is recommended to consult with a healthcare professional for a proper evaluation and diagnosis. They can determine the underlying cause and provide appropriate treatment options.