Understanding Heavy Periods (Menorrhagia) – Symptoms, Causes &Treatment
Menorrhagia is a condition in which the uterus only empties completely during the days of the menstrual period. Menorrhagia varies among individuals, but it’s what causes enough bleeding to interfere with everyday living — from having to change sanitary protection every hour for multiple hours to missing work or experiencing fatigue from blood loss.
While many women think they have a “heavy period” that is just part of their cycle, it may be a symptom of a wider issue that they should consider. To be diagnosed early can have life-changing consequences when it comes to accessing the right care and avoiding complications. We will use this blog to discuss some of what we know about menorrhagia, including its symptoms and potential causes, as well as treatment options.
What is Menorrhagia?
Menorrhagia: Menstrual bleeding that lasts more than seven days or requires you to change your sanitary protection more often than every one to two hours. Now with a normal menstrual cycle they may lose approx. 30-40 ml or less of blood per period but those with menorrhagia lose more than 80 ml.
This is more common than people realise, but it often goes undiagnosed as people think heavy bleeding is normal. For others, heavier flow may not be a problem but when it is constant or debilitating, it is not unreasonable to seek proper medical attention. ‘The key to seeking help is knowing what is normal “heavy” and what is menorrhagia.’
Menorrhagia Symptoms
Symptoms of Menorrhagia can be mild to severe and may include:
- Having to switch pads or tampons every 1-2 hours.
- Passing big blood clots, which are usually bigger than a 10p coin.
- Bleeding that saturates clothing or bedding overnight.
- Having to double up with tampons and pads.
- Menstrual period lasting over 7 days.
- Symptoms of anaemia, such as tiredness, dizziness, or shortness of breath.
Such symptoms can have a big impact on day-to-day living, making it hard to keep up with normal work, social and family schedules. If you’re scheduling your life around your periods, it might be worth talking with a healthcare provider.
Causes of Menorrhagia
There are different potential causes for menorrhagia, and it is important to discover the underlying cause to optimise treatment. Among the most typical causes are:
- Uterine fibroids – Benign tumours that can lead to distortion of the uterus and heavy menstrual flow.
- Endometriosis — This is when tissue that normally lines the inside of your uterus starts to grow outside of it, commonly causing painful and heavy periods.
- Adenomyosis – The condition when endometrial tissue grows into the walls of the uterus, thickening them and causing heavier periods.
- Polycystic ovary syndrome (PCOS) – A hormonal condition which can cause periods to be erratic and heavy.
- Pelvic inflammatory disease (PID) – Infection of organs in the reproductive system that can cause abnormal bleeding.
- Blood clotting disorders – Like von Willebrand disease; a condition that makes it difficult for blood to clot correctly.
- Thyroid disease – In particular hypothyroidism can interfere with menstrual cycles.
- Endometrial hyperplasia or cancer – If cells grow in the lining of the uterus there may be long and heavy periods, though this is unlikely.
- Drugs – Such as hormonal IUDs or blood thinners.
Although each of these have a different aetiology, the common denominator is the increased menstrual flow that could come from an altered hormone status, uterine configuration or haemostasis.
Is Menorrhagia Dangerous?
Menorrhagia, despite being non-lethal for the most part, can lead to very dangerous health complications if not treated. Long-term heavy bleeding may cause an iron deficiency and anaemia with symptoms including tiredness, being lethargic and susceptibility to infection.
More seriously, prolonged menorrhagia can be a symptom of underlying health problems, such as fibroids, thyroid problems and, in very rare cases, cancer. If your periods start changing drastically or your symptoms increasingly interfere with your day-to-day life, it’s a good idea to see a healthcare professional to rule out anything more serious and start managing it properly.
Diagnosis of Menorrhagia
Menorrhagia is diagnosed through a history and physical exam, and in many cases tests are performed. The process may include:
- Comprehensive medical history – such as prior menstrual cycles, lifestyle influence, and family health issues.
- Blood work – Blood tests may be performed to rule out anaemia, thyroid problems, or clotting disorders.
- Ultrasound scan – Enables to find structural issues such as fibroids or polyps.
- Endometrial biopsy – A test in which a sample of the lining of the uterus is removed and examined to detect cancer or abnormal cells.
- Hysteroscopy – A test that uses a tiny telescope to look inside the womb.
Proper diagnosis is important to identify the cause and to exclude more serious conditions before treatment is begun.
Menorrhagia Treatment Options
There are various treatment options to choose from with menorrhagia depending on the cause, age, and reproductive plans of the patient.
Medication-based treatments:
- Hormonal IUS (Mirena coil) – Progesterone is released into the uterus and bleeding is dramatically reduced.
- Tranexamic acid – A non-hormonal medication that can decrease the loss of blood.
- NSAID (like ibuprofen or mefenamic acid) – Relieve cramps and bleeding.
- Oral contraceptives – Control the menstrual and reduce the flow.
Surgical options:
- Endometrial ablation: Kills the endometrium to put an end to or lessen bleeding.
- Myomectomy – A procedure that eliminates fibroids and leaves the uterus in place.
- Hysterectomy – The surgical removal of the uterus in total; normally is a last line of defence when less invasive forms of treatment prove to be ineffective.
Lifestyle changes including iron-rich diet and iron supplements can help to offset anaemia due to blood loss.
Conclusion
Menorrhagia is a common yet frequently neglected problem affecting a woman’s physical and emotional health. Learning about its symptoms, causes, and treatments can help women get the help they need and take back their health.
If you have symptoms of heavy or long periods, don’t hesitate to discuss this with a specialist who can help you find the right solution for you.
Contact Chase Lodge Hospital today for expert advice and compassionate care tailored to your needs.
