| |
Normal healthy women have a menstrual cycle of between 21-35 days, with menstrual bleeding lasting 5-7 days on average. Heavy menstruation, or menorrhagia, refers to abnormally heavy bleeding experienced during a menstrual period, with menstrual cycles remaining regular in duration. It is important to distinguish this symptom from prolonged menstrual bleeding, where menstrual cycles may become irregular, which can be a sign of something more serious.
When is menstruation heavy?
Heavy menstruation can be a very subjective symptom. Many women who complain of heavy periods do not actually suffer from excessive bleeding. Conversely, there are also many women who perceive their period flow to be normal despite losing an abnormally high volume of blood.
Possible causes
In many cases, no actual cause can be found for heavy menstruation. Young teenage girls who have just started to menstruate, as well as women just before their menopause, may commonly experience heavy periods.
In some women, heavy periods can be caused by the presence of conditions such as
uterine fibroids (especially if they protrude into the cavity of the womb), or adenomyosis in which the walls of the womb are abnormally thick. In rare cases, heavy periods can occur in women with blood clotting problems, or in women who are taking medications to prevent blood clotting (such as warfarin). Heavy periods can also be associated with hormonal disorders such as thyroid disorders or dysfunction of the ovaries.
Irregular and heavy menstrual bleeding needs to be investigated thoroughly as bleeding in between periods or after menopause can be a sign of cancer of the womb lining. Early pregnancy problems can sometimes cause unexpected or heavy vaginal bleeding. A urine pregnancy test may be useful in cases where pregnancy is suspected.
How to treat or minimise the problem
There is very little a woman can do on her own to treat or minimise the bleeding experienced during menstrual periods. As iron, a major component of blood, can be lost in large quantities during heavy periods, taking a diet rich in iron (such as eating red meat) or iron supplements may help to prevent anaemia, which can result from excessive blood loss. Tablets can be prescribed by a doctor to reduce the amount of bleeding experienced. These are frequently taken only during the period itself and can be combined with painkillers if the woman complains of painful periods as well. Painkillers not only help to reduce pain, but may also contribute to lowering the amount of bleeding experienced. Hormonal tablets or injections can also be prescribed at regular intervals to reduce heavy menstrual bleeding.
In a woman desiring contraception, contraceptive pills can be prescribed, which apart from providing an efficient method of birth control, can also effectively reduce menstrual bleeding and menstrual pain. Another form of contraception that can help to reduce heavy periods is the levonorgestrel intrauterine system (LNG-IUS or Mirena®), which is a special kind of intrauterine device placed inside the womb for contraception. Medication in the LNG-IUS is released daily into the lining of the womb, which not only helps to prevent pregnancy, but can also reduce, by up to 90 per cent, the amount of menstrual bleeding.
In women who do not desire further pregnancies, and in whom all the above methods fail to reduce heavy menstruation, surgery may be an option. This can range from simple procedures such as endometrial ablation (in which the womb lining is destroyed by an energy source such as heat or microwaves) to a hysterectomy (in which the womb is surgically removed). These are invasive procedures with the potential for risks and complications and should be discussed in detail with a doctor before a decision is made to proceed with them.
Ref: Z00 |
|