Menorrhagia. Causes, effects and treatment

Menorrhagia:

Menorrhagia is a health disorder related to menstrual cycle. When there are periods to a woman there is abnormally heavy and prolonged bleeding. In common cases of menstrual cycle women do not experience blood loss. But when these periods are prolonged or give heavy bleeding it is an alarming situation, because women can lose blood. Menorrhagia is therefore a case of concern, because heavy bleeding and prolonged menses are experienced by patient.

A menorrhagian woman can’t maintain her usual activities when she has her period because she has so much blood loss and cramping. If the situation is dreadful the patient should immediately consult the gynecologist.  Because there are so many effective and successful treatments and medications for Menorrhagia.

Menorrhagia affects 30% of women in reproductive age. In the UK, 20% of all women, and 30% in the USA, but in all over the world the percentage exceeds to 70 %. However 50% cases of heavy and prolonged bleeding is not related to Menorrhagia. Therefore the heavy and prolonged bleed, if, do not suffer the patient in blood loss, it is not Menorrhagia. However heavy menstrual bleeding (HMB) is common, affecting a quarter of the female population. HMB can negatively impact on physical, emotional and social quality of life and reduce work capacity.

Symptoms of Menorrhagia:

Hence the main symptom of Menorrhagia is heavy and prolonged bleeding however the a critical determination of Menorrhagia is as under;

  • In menorrhagia you need to change sanitary pad once in each hour, and consecutively for several hours.
  • If you need to use double sanitary protection to control your menstrual flow, you are suffering disorder of Menorrhagia.
  • If you need to change the sanitary pads also in the night once or twice, you are suffering from Menorrhagia.
  • In menorrhagiac conditions your period exceeds to 8 or more days and heavy bleeding all through the eight days.
  • Passing blood clots larger than a quarter
  • A menorrhagic patient can not perform daily activities due to heavy menstrual flow.
  • Symptoms of anemia such as paleness of face, tiredness, fatigue or shortness of breath.
  • A painful period is the basic symptom of Menorrhagia. However all the painful menses are not because of Menorrhagia, because in some cases slow and continual menses also cause pain.

Causes of Menorrhagia:

Image result for menorrhagia

Following are the conditions which can cause menorrhagia. Any of the following condition may cause the Menorrhagia. However in some cases the causes of menorrhagia are unknown.

  • Hormonal imbalance: Estrogen and Progesterone are the hormones which function over the reproductive organs. In a normal menstrual cycle, a balance between the hormones estrogen and progesterone regulates the buildup of the lining of the uterus (endometrium), which is shed during menstruation. If a hormone imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding. There are many reasons for hormonal imbalance, for example Polycystic Ovary Syndrome, Obesity, Insulin Resistance and Thyroid problems.

 

  • Dysfunction of the ovaries.

A normal ovaries release egg during the course of menstruation. If the ovary is not functioning properly, the ovary does not release egg at the time of menstruation. When egg is not released the hormone progesterone is not produced resulting again an imbalance between the two important hormones i.e progesterone and estrogen. As mentioned in the above heading, a balance between the hormones estrogen and progesterone regulates the buildup of the lining of the uterus (endometrium), which is shed during menstruation. If a hormone imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding.

  • Uterine Fibroids:

Uterine fibroids are benign tumors that originate in the uterus (womb). However, fibroids can cause a number of symptoms depending on their size, location within the uterus, and how close they are to adjacent pelvic organs. These are most commonly abnormal bleeding, pain and pressure.These noncancerous (benign) tumors of the uterus appear during your childbearing years. Uterine fibroids may cause heavier than normal or prolonged menstrual bleeding.

  • Polyps:

 Polyps are abnormal tissue growths that most often look like small, flat bumps or tiny mushroom like stalks. Most polyps are small and less than half an inch wide. Polyps in the colon are the most common, but it’s also possible to develop polyps in places that include: ear canal. cervix.Small, benign growths on the lining of the uterus (uterine polyps) may cause heavy or prolonged menstrual bleeding.

  • Adenomyosis:

Adenomyosis is a condition in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium). Adenomyosis can cause menstrual cramps, lower abdominal pressure, and bloating before menstrual periods and can result in heavy periods.This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and painful periods.

  • Intrauterine device (IUD).

Image result for Intrauterine deviceAn intrauterine device (IUD or coil) [05] is a small, often T-shaped birth control device that is inserted into a woman’s uterus to prevent pregnancy. IUDs are one form of long-acting reversible birth controle. Menorrhagia is a well-known side effect of using a nonhormonal intrauterine device for birth control. Your doctor will help you plan for alternative management options.

 

 

  • Pregnancy complications:

A single, heavy, late period may be due to a miscarriage. Another cause of heavy bleeding during pregnancy includes an unusual location of the placenta, such as a low-lying placenta or placenta previa.

  • Cancer:

Uterine cancer also called cervical cancer can cause excessive menstrual bleeding, especially if you are postmenopausal [03] or have had an abnormal Pap test in the past.

  • Inherited bleeding disorders:

Some bleeding disorders such as Von Willebrand’s disease [04], a condition in which an important blood-clotting factor is deficient or impaired (the condition also called Hemophilia). Due to the un-enough blood clotting factor, blood seeps through the walls of uterus and ovaries. If menorrhagia is the result of this condition then minor bleeding remains throughout the month apart from period.

  • Medications:

Certain medications, including anti-inflammatory medications, hormonal medications such as estrogen and progestins, and anticoagulants such as Warfarin (Coumadin, Jantoven) or Enoxaparin (Lovenox), can contribute to heavy or prolonged menstrual bleeding.

  • Other medical conditions: A number of other medical conditions, including liver or kidney disease, may be associated with menorrhagia.

 

  • Frequency of Sexual Intercourse:

Frequency of Sexual Intercourse is also a an important reason for hormonal imbalance. The hormonal imbalance between estrogen and progesterone cause heavy and prolonged bleeding during period.

Treatment of Menorrhagia:

Specific treatment for menorrhagia is based on a number of factors, including:

  • Your overall health and medical history
  • The cause and severity of the condition
  • Your tolerance for specific medications, procedures or therapies
  • The likelihood that your periods will become less heavy soon
  • Your future childbearing plans
  • Effects of the condition on your lifestyle
  • Your opinion or personal preference

Medications:

Medical therapy for menorrhagia may include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs):

Iibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) are good NSAISs which help reduce menstrual blood loss. NSAIDs have the added benefit of relieving painful menstrual cramps (dysmenorrhea).

  • Tranexamic acid:

Tranexamic acid (Lysteda) helps reduce menstrual blood loss and only needs to be taken at the time of the bleeding.

  • Oral contraceptives:

Aside from providing birth control, oral contraceptives can help regulate menstrual cycles and reduce episodes of excessive or prolonged menstrual bleeding.

  • Oral progesterone:

The hormone progesterone can help correct hormone imbalance and reduce menorrhagia. Taking vitamin supplements of B6, can also help reduce levels of estrogen while boosting progesterone production. Good sources: Russet potatoes, salmon, tuna, bananas, spinach, walnuts, beef, chicken, sweet potato, beans and prunes.

  • Hormonal IUD (Liletta, Mirena):

Mirena is a hormonal intrauterine device (IUD) that’s inserted into the uterus for long-term birth control (contraception). A T-shaped plastic frame that releases a type of progestin, Mirena thickens the cervical mucus to prevent sperm from reaching or fertilizing an egg. This intrauterine device releases a type of progestin called levonorgestrel, which makes the uterine lining thin and decreases menstrual blood flow and cramping.

 

Source of information: mayoclinic and personal knowledge of Author.

 

 

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