Heavy Periods

The medical term for menstrual periods with abnormally heavy or prolonged bleeding is known as Menorrhagia. It is the most common type of abnormal bleeding from the uterus.

Normally the menstrual cycle is 21–35 days in duration, with bleeding lasting an average of 5 days. Menorrhagia is menstrual bleeding which lasts more than 7 days and interferes with a woman’s physical, emotional, social, and material quality of life, and it can occur alone or in combination with other symptoms.

The signs and symptoms of menorrhagia may include:

• Soaking through one or more sanitary pads or tampons every hour for several consecutive hours
• Needing to use double sanitary protection to control your menstrual flow
• Needing to wake up to change sanitary protection during the night
• Bleeding for longer than a week
• Passing blood clots with menstrual flow for more than one day
• Restricting daily activities due to heavy menstrual flow
• Symptoms of anemia, such as tiredness, fatigue or shortness of breath

In some cases, the cause of heavy menstrual bleeding is unknown, but common causes include:

• Hormone imbalance. The two main hormones that control the menstrual cycle (i.e estrogen and progesterone) regulate the buildup of the lining of the uterus which is shed during menstruation. If a hormone imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding.
• Dysfunction of the ovaries. If the ovaries don’t release an egg (ovulate) during a menstrual cycle (anovulation), the body doesn’t produce the hormone progesterone, as it normally would, leading to hormone imbalance and may result in menorrhagia.
• Uterine fibroids. These noncancerous (benign) tumors of the uterus may cause heavier than normal or prolonged menstrual bleeding. Infact menorrhagia is usually the most common symptom in women who have fibroids.
• These are small, benign growths on the lining of the uterus (uterine polyps) which may cause heavy or prolonged menstrual bleeding. They commonly occur in women of reproductive age as the result of high hormone levels.
• This condition occurs when tissue which normally lines the womb is found in other locations such as the uterine muscle, often causing heavy bleeding and painful menstruation.
• Intrauterine device (IUD). Menorrhagia is a common side effect of using a nonhormonal intrauterine device for birth control.
• Pregnancy complications. A single, heavy, late period may be due to a miscarriage. If bleeding occurs at the usual time of menstruation, however, miscarriage is unlikely to be the cause. An ectopic pregnancy — implantation of a fertilized egg within the fallopian tube instead of the uterus — also may cause menorrhagia.
• Rarely, uterine cancer, ovarian cancer and cervical cancer can cause excessive menstrual bleeding.
• Inherited bleeding disorders. Some blood coagulation disorders — such as von Willebrand’s disease, a condition in which an important blood-clotting factor is deficient or impaired — can cause abnormal menstrual bleeding.
• Certain drugs, including anti-inflammatory medications and anticoagulants, can contribute to heavy or prolonged menstrual bleeding.
• Other medical conditions. A number of other medical conditions, including pelvic inflammatory disease (PID), thyroid problems, endometriosis, and liver or kidney disease, may be associated with menorrhagia.

The most common complication which occurs as a result of excessive menstrual bleeding is Iron deficiency anemia. The blood is low in hemoglobin which enables red blood cells to carry oxygen to tissues. When this function is compromised there is poor oxygen delivery to tissues in the body and this may manifest as pale skin, weakness and fatigue and in very severe cases, shortness of breath, increased heart rate and dizziness.

It is important to seek medical help if any of these symptoms is noticed.

In the next installment we shall discuss how a diagnosis of menorrhagia is made and the treatment options available.