Menorrhagia: Everything About Heavy Menstrual Bleeding

Menorrhagia is a medical condition characterized by abnormally heavy or prolonged menstrual bleeding. It is a common gynecological issue that can significantly impact a woman’s quality of life. Although heavy menstrual bleeding is a common concern, most women don’t experience blood loss severe enough for it to be considered menorrhagia. With menorrhagia, you aren’t able to perform your usual activities when you have your period because you have so much blood loss and cramping.

How to track it?

Finding out If a woman has heavy menstrual bleeding is not easy because a lot may think it’s just “Heavy bleeding” in a normal way. A usual menstrual cycle lasts for about 4-5 days and the amount of blood loss is less (2-3 table spoons). However, A woman who has Menorrhagia bleeds for more than 7 days and twice as much.

These common signs and symptoms can help you understand whether what you suffer from is Menorrhagia.

• Filling up one or more sanitary pads or tampons every hour for several consecutive hours
• Need to use double sanitary protection to control your menstrual flow
• Bleeding for longer than a week
• Restricting daily activities due to heavy menstrual flow
• Needing to wake up to change sanitary protection during the night
• constant lower abdominal and pelvic pain
• the passage of blood clots that are the size of a quarter or larger
• Abdominal pain 
• Losing more than 80 milliliters of blood during your period instead of what is typical, 35-40 milliliters
• Anemia symptoms, like feeling exhausted, fatigue, tired or short of breath

Causes

1. Hormonal imbalances: Hormonal imbalances, such as those caused by conditions like polycystic ovary syndrome (PCOS) or hormonal disorders, can lead to menorrhagia.

2. Uterine fibroids: Uterine fibroids are noncancerous growths that can develop in the uterus. Large fibroids or those located in certain areas of the uterus can cause heavy or prolonged menstrual bleeding.

3. Adenomyosis: Adenomyosis is a condition in which the tissue that lines the uterus (endometrium) grows into the muscular walls of the uterus. It can cause heavy or prolonged menstrual bleeding, as well as pain.

4. Endometrial polyps: Endometrial polyps are growths that occur in the lining of the uterus. They can cause heavy or irregular bleeding.
5. Pelvic inflammatory disease (PID): PID is an infection of the female reproductive organs, typically caused by sexually transmitted infections. It can lead to menorrhagia along with other symptoms like pelvic pain and fever.

6. Blood clotting disorders: Certain blood clotting disorders, such as von Willebrand disease or platelet function disorders, can contribute to heavy menstrual bleeding.

7. Medications or medical treatments: Certain medications like anticoagulants or hormone therapies can cause menorrhagia as a side effect. In some cases, intrauterine devices (IUDs) used for contraception can also cause heavy bleeding.

8. Other underlying conditions: Menorrhagia can be associated with other underlying conditions like thyroid disorders, liver or kidney disease, or certain types of cancers.

Diagnosis

If a person is suffering from any of these symptoms listed above or must change their pad due to heavy bleeding, it is advised to go meet a doctor and explain your menstrual cycles in detail for an accurate diagnosis and appropriate treatment. The doctor may ask a few questions about your medical history.

The questions may be similar to:

• How old were you when you got your first period?
• How regular are your periods?
• How many days does your period last usually?
• Do you have any cramps or feel any uneasiness during that time of the month?
• Would you say you have heavy bleeding during periods?

Make sure you have answers to all the possible questions that can be asked during Health care professional consultation to ensure proper treatment.

Treatment Options

The treatment options for menorrhagia vary depending on the underlying cause and individual circumstances. Here are some common treatment approaches:

1. Medications:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs like ibuprofen can help reduce menstrual flow and relieve pain.
• Hormonal contraceptives: Birth control pills, hormonal patches, vaginal rings, or hormonal intrauterine devices can regulate hormonal imbalances and reduce bleeding.
• Progestin therapy: Progestin-only medications, such as oral progestins or progestin-releasing intrauterine devices, can help control excessive bleeding.
• Gonadotropin-releasing hormone (GnRH) agonists: These medications temporarily induce a menopause-like state and can reduce menstrual bleeding. They are typically used for short-term treatment due to potential side effects and are often combined with low-dose estrogen and progestin to reduce bone loss.

2. Non-hormonal medications:

• Tranexamic acid: This medication helps reduce bleeding by preventing blood clots from breaking down.
• Iron supplements: Iron supplementation may be recommended if menorrhagia leads to iron deficiency anemia.

3. Surgical or minimally invasive procedures:

• Endometrial ablation: In this procedure, the lining of the uterus is destroyed or removed to reduce menstrual bleeding. It can be performed using various techniques, such as laser, heat, or freezing.
• Uterine artery embolization (UAE): This minimally invasive procedure involves blocking the blood supply to the uterus, reducing menstrual bleeding.
• Hysterectomy: In severe cases when other treatments have been ineffective or if the patient does not desire future fertility, surgical removal of the uterus may be considered.

4. Levonorgestrel-releasing intrauterine system (LNG-IUS): 

The LNG-IUS, also known as a hormonal IUD, is a small device inserted into the uterus that releases a progestin hormone called levonorgestrel. It can help reduce menstrual bleeding and is effective for up to five years. LNG-IUS is a long-term treatment option and can be particularly beneficial for women who also desire contraception.

5. Iron supplementation: 

Menorrhagia can lead to iron deficiency anemia due to excessive blood loss. Iron supplementation may be recommended to address anemia and replenish iron stores. It is often used in combination with other treatment approaches.

6. Herbal remedies: 

Certain herbs are believed to help reduce menstrual bleeding and regulate hormonal balance. Examples include shepherd’s purse, yarrow, and cinnamon. However, scientific evidence supporting their effectiveness is limited, and it’s important to consult with a healthcare provider before using herbal remedies, as they may have interactions or side effects.

7. Dilation and curettage (D&C): 

In some cases, a D&C procedure may be performed to remove excess tissue from the uterine lining, which can help reduce menstrual bleeding. D&C may be considered when other treatments have been ineffective or when there is a need for further evaluation of the uterine lining.

8. Platelet-rich plasma (PRP) therapy: 

PRP therapy involves injecting a concentrated solution of platelets into the uterine lining to promote healing and reduce excessive bleeding. This is a relatively new treatment option, and its effectiveness and safety are still being studied.

Lifestyle Changes for Menorrhagia: Self-Care Practices

In addition to medical treatments, there are some lifestyle changes, natural remedies, and self-care practices that may help manage menorrhagia. While these approaches may not address the underlying cause of menorrhagia, they can potentially provide some relief. Here are some suggestions:

1. Maintain a healthy diet: Eating a balanced diet that includes foods rich in iron, such as leafy green vegetables, lean meats, and fortified cereals, can help prevent iron deficiency anemia caused by heavy menstrual bleeding.

2. Manage stress: Chronic stress can worsen hormonal imbalances and exacerbate menstrual symptoms. Engage in stress-reducing activities like yoga, meditation, deep breathing exercises, or hobbies that help you relax and unwind.

3. Apply heat: Applying a heating pad or taking warm baths can help alleviate menstrual cramps and promote relaxation.

4. Exercise regularly: Regular exercise can help regulate hormonal balance, reduce stress, and improve overall well-being. Aim for moderate-intensity aerobic activities, such as brisk walking, swimming, or cycling. Consult with a healthcare provider before starting a new exercise regimen.

5. Adequate rest and sleep: Getting enough restful sleep and prioritizing rest during menstruation can support overall hormonal balance and reduce fatigue.

6. Hydration: Drink plenty of water to stay hydrated, which can help maintain overall health and support menstrual function.

7. Herbal remedies: Some herbal remedies, such as ginger or cinnamon, are believed to have anti-inflammatory properties and may help reduce menstrual bleeding or alleviate symptoms. However, scientific evidence is limited, and it’s important to consult with a healthcare provider before using herbal remedies, especially if you have any underlying health conditions or are taking medications.

8. Keep a menstrual diary: Keeping track of your menstrual cycles, including the duration and severity of bleeding, can help identify patterns and provide useful information for discussions with your healthcare provider.

9. Stress management: Chronic stress can worsen menstrual symptoms. Consider incorporating stress management techniques such as mindfulness meditation, deep breathing exercises, or engaging in activities you enjoy to help reduce stress levels.

10. Limit caffeine and alcohol: Caffeine and alcohol can potentially worsen menstrual symptoms, including heavy bleeding. Consider reducing or eliminating the consumption of these substances to see if it makes a difference in your symptoms.

11. Quit smoking: Smoking has been associated with an increased risk of menstrual disorders, including heavy bleeding. Quitting smoking can have numerous health benefits, including potentially improving menstrual health.

12. Maintain a healthy weight: Being overweight or underweight can disrupt hormonal balance and contribute to menstrual irregularities. Aim to maintain a healthy weight through a balanced diet and regular exercise.

13. Dietary modifications: Some individuals find that making dietary changes can help alleviate menstrual symptoms. It may be helpful to reduce the consumption of processed foods, refined sugars, and saturated fats. Instead, focus on a diet rich in whole grains, fruits, vegetables, and lean proteins.

14. Regular sleep patterns: Establishing regular sleep patterns and ensuring adequate sleep can support hormonal balance and overall well-being. Aim for 7-9 hours of quality sleep per night.

15. Gentle exercise during menstruation: Engaging in gentle exercises such as walking, stretching, or yoga during menstruation may help alleviate symptoms and promote blood flow. Listen to your body and choose activities that feel comfortable for you.

16. Manage iron deficiency: Menorrhagia can lead to iron deficiency anemia due to excessive blood loss. If you have iron deficiency, consider incorporating iron-rich foods into your diet or taking iron supplements as advised by your healthcare provider.

Effects of Menorrhagia on fertility and pregnancy

• Difficulty in conceiving: Menorrhagia can sometimes be associated with underlying conditions such as polycystic ovary syndrome (PCOS), endometriosis, or uterine fibroids, which may impact fertility. If you are experiencing difficulties conceiving, it’s important to consult with a fertility specialist who can evaluate your specific situation and provide appropriate guidance and treatment options.

• Impact on menstrual cycle regularity: Menorrhagia can cause irregular menstrual cycles, making it more challenging to predict ovulation and time intercourse for conception. Tracking your menstrual cycles, including the duration and intensity of bleeding, can provide valuable information to help optimize fertility efforts.

• Pregnancy complications: In some cases, menorrhagia may persist during pregnancy, leading to concerns about its impact on maternal and fetal health. It is crucial to discuss your medical history, including any history of menorrhagia, with your healthcare provider during pregnancy. They can monitor your condition and provide appropriate care to ensure a healthy pregnancy.

It’s essential to consult with a healthcare provider or gynecologist to determine the most appropriate treatment option based on individual circumstances, medical history, and desired outcomes. The healthcare provider will consider factors such as the underlying cause of menorrhagia, severity of symptoms, age, reproductive plans, and overall health before recommending a specific treatment approach.

*Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Please consult a healthcare professional for a thorough evaluation of your symptoms and appropriate treatment.