What causes heavy menstrual bleeding and painful periods? How can they be diagnosed and treated?. Here are the key facts about menorrhagia and dysmenorrhea.

Understanding Menorrhagia and Dysmenorrhea

Menorrhagia, or heavy menstrual bleeding, and dysmenorrhea, or painful periods, are common gynecological issues that can significantly impact a woman’s quality of life. These conditions have various underlying causes and require comprehensive evaluation and management by experienced healthcare providers.

Causes of Heavy Periods and Painful Menstruation

Several factors can contribute to irregular, heavy, and painful periods, including:

• Adenomyosis: When the endometrial tissue that normally lines the inside of the uterus grows into the uterine muscle wall.
• Bleeding disorders: Inherited conditions like von Willebrand’s disease that affect blood clotting.
• Gynecological cancers: Cervical and uterine cancers can lead to abnormal bleeding.
• Endometriosis: The presence of endometrial-like tissue outside the uterus.
• Medications: Certain anticoagulants, anti-inflammatory drugs, and hormonal medications.
• Polycystic ovary syndrome (PCOS): A hormonal disorder that can cause irregular periods.
• Pregnancy complications: Miscarriage or ectopic pregnancy.
• Premature ovarian failure: When the ovaries stop functioning before age 40.
• Uterine fibroids: Noncancerous tumors in the uterine wall.
• Uterine polyps: Overgrowth of endometrial tissue forming growths inside the uterus.
• Hormonal imbalances: Often related to the perimenopausal period.

Symptoms of Heavy Periods and Painful Menstruation

The signs and symptoms of menorrhagia and dysmenorrhea can include:

• Bleeding for more than seven days
• Soaking through one or more tampons or pads per hour for several hours
• Need to use multiple pads to control menstrual flow
• Changing pads or tampons during the night
• Menstrual flow with blood clots larger than a quarter
• Flooding of clothing and bedsheets with menstrual bleeding
• Symptoms of anemia, such as fatigue and shortness of breath
• Diarrhea
• Headaches
• Lower back pain
• Nausea
• Pain that starts a few days before the period, worsens during the period, and lasts two to three days after
• Throbbing or cramping pain in the lower abdomen

Diagnosis of Heavy Periods and Painful Menstruation

When a patient experiences abnormal menstrual bleeding or severe menstrual pain, their healthcare provider will conduct a thorough evaluation, which may include:

• Physical exam
• Review of medical history, including details of the patient’s menstrual cycle
• Discussion of symptoms
• Blood tests to check for iron deficiency, thyroid disorders, or blood-clotting abnormalities
• Ultrasound to examine the pelvic organs for any abnormalities
• Pap smear to check for cervical changes or infection
• Endometrial biopsy to sample the uterine lining for examination
• MRI scans to further evaluate the uterus and pelvic region

Expert Management of Heavy Periods and Painful Menstruation

UT Southwestern’s gynecologic specialists are nationally recognized for their expertise in women’s health care, including the management of menorrhagia and dysmenorrhea. They work closely with patients to determine the underlying cause and develop a comprehensive treatment plan tailored to the individual’s needs.

Seeking Medical Attention

Patients should seek medical attention if they experience any of the following:

• Their periods stop for more than 60 days
• Their periods become erratic
• Their periods are less than 21 days or more than 35 days apart
• They bleed between periods
• They bleed after sex
• They have any vaginal bleeding after menopause
• They suddenly get a fever and feel sick after using tampons

By seeking prompt medical attention and working closely with experienced gynecologic specialists, women can find effective solutions to manage heavy, irregular, and painful periods, improving their overall quality of life.