Warning signs of excessive menstrual bleeding
Heavy menstrual bleeding, medically known as Menorrhagia, is a condition where a woman experiences excessive menstrual blood loss that interferes with normal activities[1]. This condition is characterized by bleeding that exceeds 80 mL per cycle.
Common Causes
The most frequent cause of Menorrhagia is hormonal imbalances, particularly in adolescents and women near menopause. Hormonal imbalances can lead to excessive thickening of the uterine lining, resulting in heavier bleeding.
- Estrogen dominance occurs when estrogen levels are high in comparison to progesterone, causing the uterine lining to thicken excessively[2]. Factors contributing to estrogen dominance include obesity, perimenopause, PCOS, and environmental estrogens.
- Anovulatory cycles are periods where ovulation does not occur, leading to inadequate progesterone and unopposed estrogen stimulation, resulting in irregular and heavy periods[2].
- Thyroid dysfunction can also cause heavy bleeding by disrupting reproductive hormones. Both hypothyroidism and hyperthyroidism can be culprits, with 20-30% of women with heavy bleeding having thyroid issues[2].
Another possible cause of Menorrhagia is endometriosis, a condition that affects the overall quality of life[5].
Common Symptoms
Symptoms of Menorrhagia include excessive bleeding during periods, often soaking through sanitary products rapidly. Periods may also last more than 7 days, leading to fatigue and potential anemia from blood loss. Menstrual cramps due to uterine contractions may be stronger in some women. Other possible menstrual symptoms include headaches, diarrhea or constipation, which are hormonally influenced but not specific to Menorrhagia[3].
Heavy bleeding may require medical evaluation if it causes significant disruption or anemia[4]. Signs of too much blood loss during a period may include shortness of breath, low energy, and weakness, which may be indicative of anemia. If blood often soaks through tampons or pads in less than 2 hours, or a person often passes large clots, they should speak with a doctor.
Treatment
If heavy periods are due to a pregnancy-related condition, treatment may involve monitoring, medication, surgery, or a hysterectomy. If heavy periods are unrelated to pregnancy, treatment focuses on identifying and managing the underlying cause, and reducing symptoms. This may involve IUD removal, hormonal contraceptives, hormone replacement therapy, medications for thyroid or liver disorders, medications for bleeding disorders, antibiotics for PID, surgically removing fibroids or polyps, eating more iron-rich foods, or taking a supplement.
In some cases, other surgeries, including uterine artery ablation and hysterectomy, may stop heavy periods if other options do not work. It is important to discuss the risks and benefits of these treatments with a doctor.
If heavy periods are severe, doctors may reduce bleeding by fitting an IV line, giving a blood transfusion, applying pressure inside the uterus, emptying the bladder with a Foley catheter, or performing dilation and curettage. If a person starts losing a lot of blood from the vagina, or has symptoms such as pale or clammy skin, rapid heart rate, nausea, dizziness, blurry vision, fainting, swelling around the vagina, or in the space between the vagina and anus (perineum), they should call 911.
In conclusion, Menorrhagia is a common condition that can be caused by hormonal imbalances, thyroid disorders, and conditions like endometriosis. It is characterized by excessive, prolonged bleeding often accompanied by painful cramps and fatigue. If you are experiencing heavy periods, it is important to speak with a healthcare professional for proper evaluation and treatment.
- Hormonal imbalances, particularly in adolescents and women near menopause, are a common cause of Menorrhagia, a condition characterized by excessive menstrual blood loss.
- Estrogen dominance, caused by high estrogen levels relative to progesterone, can lead to excessive thickening of the uterine lining and result in heavy bleeding.
- Factors contributing to estrogen dominance include obesity, perimenopause, PCOS, and environmental estrogens.
- Anovulatory cycles, periods where ovulation does not occur, lead to inadequate progesterone and unopposed estrogen stimulation, causing irregular and heavy periods.
- Thyroid dysfunction can also cause heavy bleeding by disrupting reproductive hormones, with 20-30% of women with heavy bleeding having thyroid issues.
- Endometriosis, a condition affecting the overall quality of life, is another possible cause of Menorrhagia.
- Symptoms of Menorrhagia include excessive bleeding during periods, periods lasting more than 7 days, and potential anemia from blood loss.
- Menorrhagia may require medical evaluation if it causes significant disruption or anemia.
- If heavy periods are due to a pregnancy-related condition, treatment options may include monitoring, medication, surgery, or a hysterectomy.
- If heavy periods are unrelated to pregnancy, treatment focuses on identifying and managing the underlying cause, and reducing symptoms through methods such as IUD removal, hormonal contraceptives, medications for thyroid or liver disorders, and surgically removing fibroids or polyps.
- In severe cases, doctors may reduce bleeding by fitting an IV line, giving a blood transfusion, applying pressure inside the uterus, or performing dilation and curettage.
- If a person starts losing a lot of blood from the vagina, or has symptoms such as pale or clammy skin, rapid heart rate, nausea, dizziness, blurry vision, fainting, swelling around the vagina, or in the space between the vagina and anus (perineum), they should call 911.
