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Menorrhagia

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Introduction

Menorrhagia is a condition in which you experience excessive menstrual bleeding during your periods. The bleeding may be prolonged and accompanied by cramping and lower abdomen pain.

Heavy bleeding during periods may be a common thing for most women. However, that does not mean that you have menorrhagia. What makes it different from normal excess bleeding is that with menorrhagia, the cramps are intense, and you have to change your sanitary almost every hour.

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What are the Causes of Menorrhagia?

Several underlying health conditions may cause menorrhagia. Some of them are:

  • Hormone Imbalance: Hormonal imbalance can make the lining that forms in your uterus very thick. It is the lining that you shed during your period. When the lining becomes thick, the bleeding gets heavier. Another cause for hormonal imbalance is when your ovaries don’t ovulate (anovulation) or release an egg during periods.
  • ● Anovulation stops the production of progesterone in your body, causing hormonal imbalance and heavy menstrual bleeding. Some conditions may also cause hormonal imbalance. They are:
  1. Polycystic Ovary Syndrome (PCOS)
  2. Obesity
  3. Insulin resistance
  4. Thyroid conditions
  • Adenomyosis: This is a condition in which the inner lining of the uterus grows into the wall of the uterus, causing cramps, bloating, and excessive menstrual bleeding.
  • Polyps: Polyps are tissue growths in the inner lining of the uterus. Although they are benign, they may cause heavy bleeding and pain.
  • Cancer: Cancerous growth in the uterus, ovaries, or cervix can cause menorrhagia. The risk factors are high if you have crossed menopause.
  • Fibroids: Uterine fibroids are tissue growth or tumour that are non-cancerous. However, they can cause menorrhagia and extended menstrual bleeding.
  • Issues related to pregnancy: Two pregnancy-related complications can cause menorrhagia.
    1. Ectopic pregnancy: A fertilized egg is supposed to implant itself inside the uterus. In rare cases, it implants outside the uterus and is called an ectopic pregnancy.
    2. Miscarriage: A miscarriage is the death of a foetus or embryo in the womb.
  • Bleeding disorders: Having a family history of bleeding disorder can make you prone to menorrhagia.
  • Drugs: Some anti-inflammatory and hormonal medications, including anticoagulants, can also lead to menorrhagia.
  • Health problems: Some seemingly unrelated health problems are also associated with menorrhagia. They include:
    1. Thyroid problems
    2. Kidney ailments
    3. Liver problems
    4. Pelvic inflammatory disease (PID)
    5. Endometriosis

What are the Symptoms of Menorrhagia?

Some signs and symptoms of menorrhagia that you may experience are:

  • ● Need to change sanitary pads every hour throughout the day because of soaking
  • ● Need for double sanitary pad because of heavy menstrual flow
  • ● Need to change sanitary pad even at night
  • ● Menstrual bleeding that lasts for more than a week
  • ● Large blood clots in menstrual bleeding
  • ● Fatigue and shortness of breath
  • ● Abdominal pain

What are the Complications Associated With Menorrhagia?

Excessive bleeding may lead to other health complications, including:

  • ● Weakness
  • ● Blood loss anaemia because of excessive bleeding
  • ● Iron deficiency
  • ● Fatigue
  • ● Intense pain requiring medical attention

How is Menorrhagia Diagnosed?

Your doctor will ask you about your menstrual cycle and medical history and then recommend the following tests:

  • Pap test: This test is done to rule out any infection or inflammation in your cervix.
  • Ultrasound: This test is done to create images of your ovaries, pelvis, and uterus.
  • Blood test: A blood test is done to ascertain if you have anemia, thyroid disorders, or blood clotting disorder.
  • Endometrial biopsy: A sample of your uterus tissue is taken for biopsy.

After these initial tests, your doctor will evaluate the results and might recommend some more tests that include:

  • Hysteroscopy
  • Sonohysterography

How is Menorrhagia Treated?

Your doctor may recommend either a medication or a surgical procedure to treat your Menorrhagia.

Medications may include:

  • Birth control pills: Oral contraceptives or birth control pills are effective in regulating and controlling menstrual flow.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs help reduce menstrual pain and excessive bleeding.
  • Intrauterine devices (IUDs): IUDs are used to control excessive bleeding. They work by making the uterine line thin.
  • Tranexamic acid: This medication is useful in reducing excess blood flow.

Your doctor may recommend surgical procedures if the medications fail to treat Menorrhagia. Some procedures are:

  • Focused ultrasound surgery: It is a procedure to shrink fibroids that may be causing excessive menstrual bleeding. This procedure does not require an incision.
  • Uterine artery embolization: This procedure is also used to shrink the fibroids. However, it requires an incision on your thigh artery. A catheter is passed through the large artery on your thigh all the way to your artery on your uterine to inject a medicine that reduces blood flow to the fibroid.
  • Dilation and curettage (D&C): In this procedure, your doctor opens your cervix and removes the tissue from your uterus to decrease the bleeding.
  • Myomectomy: In this procedure, the uterine fibroids are surgically removed.
  • Hysterectomy: Your cervix and uterus are permanently removed. This procedure requires hospitalization.

What are the Risks Associated with Menorrhagia treatments?

Risk factors are the chances of developing a condition or a disease. With menorrhagia, your age and medical history may play a role.
Adolescent girls might get menorrhagia because of anovulation, i.e., lack of ovulation. Menorrhagia is common in adolescents in the year following their first menstrual period.
In older women, having conditions such as fibroids, adenomyosis, and polyps may increase menorrhagia’s chances.

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FAQ's

Does Menorrhagia Go Away on Its Own?

Menorrhagia may have many causes and does not go away on its own. Medical attention is recommended if the bleeding continues for over seven days.

What Happens if Menorrhagia Goes Untreated?

Untreated Menorrhagia can lead to complications like blood loss, anaemia, and intense pain. You can also experience fatigue, weakness, and shortness of breath.

Are Menorrhagia and Metrorrhagia the Same?

No, they are not the same. Metrorrhagia is a condition in which you have vaginal bleeding at irregular intervals, mostly between your expected monthly period cycle. In Menorrhagia, you have severe bleeding during your periods.

Can Menorrhagia Cause Death?

No, Menorrhagia is not a fatal condition and does not cause death. It may make you weak and weary during your period.

Can Menorrhagia Cause Anaemia?

Yes, Menorrhagia or excessive menstrual bleeding can cause anaemia.

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