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 Heavy menstruation, or menorrhagia, refers to the occurrence of abnormally heavy bleeding during regular menstrual periods over several consecutive menstrual cycles.
The amount of blood discharged during a woman's period can vary considerably from woman to woman, and it is difficult to quantify objectively what heavy blood loss is. You will be able to tell if your periods are heavier than normal – you may find yourself using more sanitary pads or tampons than usual, or find that your clothes and bedding are stained. If your periods are causing such disruptions to your everyday life, it may be an indication of excessive blood loss.
Causes
Some causes of heavy periods include:
• Hormonal imbalance
• Change in contraception method. Changes in birth control pills or oestrogens, or use of the IUD
• Dysfunction of the ovaries. Lack of ovulation (anovulation) may cause hormonal imbalance and result in menorrhagia.
• Infection of the womb
• Abnormal growths in the uterus, such as polyps and fibroids
• Adenomyosis, a condition in which the walls of the womb are abnormally thick as a result of glands from the endometrium becoming embedded in the uterine muscle
• Conditions that produce high oestrogen levels, such as certain ovarian cysts, may stimulate the lining of the womb and cause bleeding
• Medications such as anti-inflammatory medications and anticoagulants, or the improper use of hormone medications, can cause menorrhagia.
• Pregnancy complications. A single, heavy, late period not during the usual time of menstruation may be due to a miscarriage. An ectopic pregnancy – when a fertilised egg is implanted within the fallopian tube instead of the uterus – also may cause menorrhagia.
• Genetic blood-clotting disorders such as von Willebrand's disease, a condition in which an important blood-clotting factor is deficient or impaired, can cause abnormal menstrual bleeding.
• Other medical conditions such as pelvic inflammatory disease, thyroid problems, endometriosis, and liver or kidney disease may cause menorrhagia.
• Cancer of the reproductive organs, including the uterus, cervix or uterus, in rare cases
What you can do:
It is advisable to see your doctor if your periods last longer than usual or if you experience excessive bleeding. A significant complication of menorrhagia is iron deficiency anaemia, signs and symptoms of which include pallor, weakness and fatigue. You will be prescribed iron supplements if you’re found to be anaemic, and may also be put on oral contraceptives or progesterone, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, which can reduce heavy bleeding and menstrual cramps. If any fibroids or polyps are found, removing them will resolve the bleeding problem.
In extreme cases where the bleeding is debilitating and medication proves ineffective, your doctor may recommend inserting an intrauterine device (IUD) that releases the hormone progestin. Hysterectomy, or surgery to remove the uterus, is more seldom prescribed, as the procedure will result in sterility and the permanent cessation of periods. This surgery should only be done after a full discussion with your doctor and after careful consideration.
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