Menorrhagia – prolonged or profuse menstruation may occur twice or thrice in the same month (polymenorrhagia).
It is a term to describe heavy and / or prolonged periods. The menstrual cycle remains unaltered but duration and quantity of menstrual loss is increased.
One of the most common female disorders aged 30–49 years and about one-third seek treatment for it.
Some women have such irregular menstrual bleeding between periods, or earlier or later in their cycles than expected.
Average blood loss during menstruation is about 2–3 tablespoons, equating to 30–45 millilitres, over 4–5 days and occurs every 21 to 35 days.
Abnormal uterine bleeding is when one bleeds outside of the normal monthly periods i.e. more than 7 days or between monthly periods, prolonged or sometimes extremely heavy period, that make it harder to do their usual activities.
A female with menorrhagia may experience bleeding lasts longer than 7 days or heavy bleeding that causes them to soak through one or more tampons or pads every hour for several hours.
Signs and symptoms of menorrhagia may include:
- Severe menstrual and abdominal pain, bloating or cramps (dysmenorrhea), throughout at other times of the cycle.
- Soaking through one or more sanitary pads or tampons every hour for several hours in a row.
- Needing double sanitary protection to control your menstrual flow.
- Getting up at night to change sanitary pads or tampons.
- Bleeding for more than a week.
- Passing blood clots larger than a quarter.
- Symptoms of iron deficiency anaemia, such as pale skin, weakness, tiredness, fatigue or shortness of breath as the result of blood loss.
- Periods that occur less than 28 days apart or menstrual cycle is shorter than 21 days, or more than 35 days apart.
- Women of menopausal age experience heavy bleeding known as flooding.
- Bleeding after sexual embrace.
- Mood swings
- Tenderness, pain and dryness of the vagina.
- Time between periods changes each month
Underlying causes of menorrhagia may include:
50% of women with menorrhagia, no underlying cause is found – called dysfunctional uterine bleeding.
Common Causes and Risk factors:
- Heavy uterine bleeding in adolescent girls is typically due to anovulation cycles – when ovaries don’t ovulate (release an egg), especially prone to the first year after their first menstrual period (menarche).
- Women who started with their menstruation at a young age may be at higher risk of menorrhagia.
- Women in their teens, 20s, and 30s – quite common for teenagers who have just started getting their periods. This can cause “spotting” between your periods.
- It has been observed that taller women may have a higher risk of menorrhagia.
- After delivery, the risk may also increase.
- Menorrhagia in older reproductive-age women or around menopause is typically due to uterine pathology, including fibroids, polyps and adenomyosis, when they don’t ovulate.
- HRT’s – Hormone replacement therapy is a common cause of uterine bleeding after menopause.
- Emotional or physical stress – psychological problems which are making patient think she is bleeding heavily.
- Weak constitutions
- Vaginal and cervical lesions (benign or cancerous), endometriosis, endometrial adhesions
- Hormonal imbalance causing Irregular ovulation: common during puberty and perimenopause. It can sometimes occur due to weight loss, stress or certain medical conditions, including polycystic ovary syndrome (PCOS), obesity, insulin resistance etc.
- Dysfunction of the ovaries. If your ovaries don’t release an egg during a menstrual cycle, your body doesn’t produce the hormone progesterone, as it would during a normal menstrual cycle.
- PID’s – Pelvic inflammatory disease – inflammation or infection of the reproductive organs – uterus or cervix etc., often results from untreated sexually transmitted diseases – STD’s
- Weaker muscles in the uterus when they are not doing their job as they should.
- Use of Intrauterine birth control device (IUD)
- Pregnancy-related complications such as miscarriage, abortion or an ectopic pregnancy.
- Cancer e.g., Uterine, cervical, and ovarian cancers etc.
- Congenital or Inherited disorders like platelet function disorders or Von Willebrand’s disease a condition in which an important blood-clotting factor is deficient or impaired.
- Use of Certain anti-inflammatory, anticoagulant, hormonal regulating or chemotherapy drugs.
- Bleeding disorders (blood clotting disorders)
- Pituitary disorders
- Thickening of the uterine wall or lining
- Excessive weight gain or loss
Systemic diseases and disorders, such as:
- Coagulation disorders
- Hypertension
- Thyroid disorders
- Thrombocytopenia purpura
- Retroversion of uterus
- Diabetes mellitus
- Liver or kidney disease.
Further complications if left untreated:
- Infertility – difficulty conception
- Iron deficiency anaemia
- Alopecia – hair thinning
- Cancer of endometrium
- Hypotension, shock, and even death.
Natural remedies that might help
- Eat plenty fresh fruit and vegetables
- Nuts, soy, and flaxseed contain phytoestrogens and essential fatty acids which may reduce blood flow.
- Brewer’s yeast, wheat germ, apricots, raisins, beans and cooked spinach are all excellent sources of iron.
- Limit dairy products and animal fat
- Reduce or eliminate sugar
- Limit or avoid alcohol and caffeine intake
- Avoid processed food
- Avoid artificial sweeteners and preservatives
- Hydrate – Drinking 4 to 6 extra cups of water each day can help to maintain your blood volume. Drink an electrolyte solution or add more salt to your diet to balance out the extra fluid you’re drinking.
- Eat vitamin C-rich foods help your body absorb iron, which can help prevent anaemia. Include more:
- Citrus fruits like oranges and grapefruits.
- Red and green peppers
- Kiwis
- Strawberries
- Brussels sprouts
- Broccoli
- Tomato juice
Add more iron-rich foods
- Eat foods high in iron like:
- Lean Beef
- Oysters
- Chicken And Turkey
- Beans
- Tofu
- Spinach
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