What is menorrhagia. How does it affect women’s daily lives. What are the common causes of heavy menstrual bleeding. How is menorrhagia diagnosed and treated. When should you seek medical attention for heavy periods.

Understanding Menorrhagia: A Common Menstrual Disorder

Menorrhagia, characterized by heavy or prolonged menstrual bleeding, is a prevalent condition affecting many women worldwide. This menstrual disorder can significantly impact a woman’s quality of life, often interfering with daily activities and causing physical discomfort. But what exactly defines menorrhagia, and how does it differ from normal menstrual bleeding?

Menorrhagia occurs when menstrual blood loss is excessive, typically defined as losing more than 80 ml of blood during a single menstrual cycle. In practical terms, this often translates to needing to change sanitary products every 1-2 hours due to heavy saturation or experiencing menstrual periods lasting longer than 7 days.

The Impact of Menorrhagia on Daily Life

Heavy menstrual bleeding can have a significant impact on a woman’s daily life. It may lead to:

• Fatigue and weakness due to potential anemia
• Disruption of work or social activities
• Emotional stress and anxiety
• Decreased quality of life during menstruation

Despite its prevalence, many women may not realize that their heavy bleeding is abnormal or that effective treatments are available. Understanding the condition and its potential causes is crucial for seeking appropriate medical care and improving one’s overall well-being.

Unraveling the Causes of Menorrhagia

Menorrhagia can stem from various underlying factors, ranging from hormonal imbalances to structural issues within the uterus. Identifying the root cause is essential for determining the most effective treatment approach. So, what are the primary culprits behind heavy menstrual bleeding?

Hormonal Imbalances

Hormonal fluctuations play a significant role in menstrual health. Common hormonal causes of menorrhagia include:

• Imbalance between estrogen and progesterone levels
• Thyroid disorders (both hypothyroidism and hyperthyroidism)
• Polycystic ovary syndrome (PCOS)
• Perimenopause and menopause-related hormonal changes

Uterine Abnormalities

Structural issues within the uterus can lead to heavy menstrual bleeding. These may include:

• Uterine fibroids: Non-cancerous growths in the uterus
• Polyps: Small, benign growths on the uterine lining
• Adenomyosis: A condition where the uterine lining grows into the muscular wall of the uterus

Other Medical Conditions

Several other health issues can contribute to menorrhagia:

• Bleeding disorders, such as von Willebrand disease
• Certain medications, including anticoagulants
• Pelvic inflammatory disease (PID)
• Liver or kidney disease
• Certain types of cancer, though this is less common

Understanding these potential causes can help women and their healthcare providers determine the most appropriate diagnostic approach and treatment plan.

Recognizing the Signs and Symptoms of Menorrhagia

Identifying menorrhagia can be challenging, as perceptions of “normal” menstrual flow can vary widely among women. However, certain signs and symptoms can indicate that menstrual bleeding has become excessive or problematic. What should women look out for when assessing their menstrual health?

Key Indicators of Menorrhagia

• Needing to change sanitary products every 1-2 hours due to saturation
• Menstrual periods lasting longer than 7 days
• Passing large blood clots (larger than a quarter)
• Bleeding through clothing or bedding
• Restricting daily activities due to heavy flow
• Experiencing fatigue, shortness of breath, or pale skin (signs of anemia)

It’s important to note that menorrhagia is not just about the quantity of blood loss but also about the impact on a woman’s quality of life. If heavy menstrual bleeding interferes with daily activities or causes significant discomfort, it’s worth discussing with a healthcare provider.

Tracking Menstrual Flow

Keeping a menstrual diary can be helpful in assessing the severity of menstrual bleeding. This may include:

• Recording the number of sanitary products used each day
• Noting the duration of each menstrual period
• Documenting any associated symptoms or discomfort
• Tracking energy levels and impact on daily activities

This information can provide valuable insights for healthcare providers when diagnosing and treating menorrhagia.

Diagnostic Approaches for Menorrhagia

Accurately diagnosing menorrhagia involves a comprehensive evaluation of a woman’s menstrual history, physical examination, and various diagnostic tests. How do healthcare providers approach the diagnosis of heavy menstrual bleeding?

Medical History and Physical Examination

The diagnostic process typically begins with a thorough medical history and physical examination. This may include:

• Discussing menstrual patterns and symptoms
• Reviewing overall health history and any medications
• Performing a pelvic examination to check for any visible abnormalities

Laboratory Tests

Blood tests are often conducted to assess overall health and identify potential underlying causes:

• Complete blood count (CBC) to check for anemia
• Thyroid function tests
• Coagulation studies to rule out bleeding disorders
• Hormone level tests, including estrogen and progesterone

Imaging Studies

Various imaging techniques may be employed to visualize the uterus and surrounding structures:

• Transvaginal ultrasound: Provides detailed images of the uterus, ovaries, and pelvic area
• Sonohysterography: Uses saline solution to enhance ultrasound imaging of the uterine cavity
• Hysteroscopy: Allows direct visualization of the uterine cavity using a thin, lighted scope

Endometrial Biopsy

In some cases, a small sample of the uterine lining may be taken for examination. This can help rule out cancer or identify other abnormalities in the endometrium.

By employing these diagnostic tools, healthcare providers can pinpoint the underlying cause of menorrhagia and develop an appropriate treatment plan tailored to each woman’s specific needs.

Treatment Options for Menorrhagia: Finding Relief

Once menorrhagia is diagnosed, a range of treatment options becomes available. The choice of treatment depends on various factors, including the underlying cause, the severity of symptoms, and the patient’s personal preferences. What are the primary approaches to managing heavy menstrual bleeding?

Medications

Several medications can help reduce menstrual blood flow and alleviate symptoms:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Reduce pain and blood loss
• Tranexamic acid: Helps blood clot more effectively
• Hormonal medications: Including birth control pills, patches, or hormonal IUDs
• Gonadotropin-releasing hormone (GnRH) agonists: Temporarily stop menstruation

Surgical Interventions

In cases where medications are ineffective or not suitable, surgical options may be considered:

• Endometrial ablation: Destroys the uterine lining to reduce or stop menstrual flow
• Uterine artery embolization: Blocks blood flow to fibroids, causing them to shrink
• Myomectomy: Surgical removal of fibroids while preserving the uterus
• Hysterectomy: Complete removal of the uterus (considered a last resort)

Lifestyle and Dietary Changes

Certain lifestyle modifications can complement medical treatments:

• Iron-rich diet to prevent or treat anemia
• Regular exercise to help regulate hormones
• Stress reduction techniques
• Avoiding alcohol and caffeine, which can exacerbate symptoms

The most effective treatment plan often involves a combination of approaches, tailored to the individual’s needs and preferences. Regular follow-ups with healthcare providers are essential to monitor progress and adjust treatments as needed.

Living with Menorrhagia: Coping Strategies and Support

While medical treatments are crucial in managing menorrhagia, developing effective coping strategies can significantly improve quality of life for women dealing with heavy menstrual bleeding. How can women better navigate daily life while managing this condition?

Practical Tips for Managing Heavy Periods

• Use high-absorbency sanitary products or menstrual cups
• Keep extra supplies at work or in your bag
• Wear dark-colored clothing during heavy flow days
• Use waterproof mattress covers to protect bedding
• Plan activities around your menstrual cycle when possible

Emotional Well-being and Self-Care

Dealing with menorrhagia can be emotionally challenging. Consider these self-care strategies:

• Practice relaxation techniques like meditation or yoga
• Engage in gentle exercise to boost mood and energy
• Seek support from friends, family, or support groups
• Consider counseling if menorrhagia is causing significant distress

Nutrition and Supplementation

Proper nutrition can help mitigate the effects of heavy blood loss:

• Consume iron-rich foods like lean meats, leafy greens, and legumes
• Consider iron supplements under medical supervision
• Stay hydrated to replace fluid loss
• Eat foods high in vitamin C to enhance iron absorption

By implementing these strategies and working closely with healthcare providers, women with menorrhagia can effectively manage their symptoms and maintain a high quality of life.

When to Seek Medical Attention for Heavy Menstrual Bleeding

While some variation in menstrual flow is normal, certain signs indicate the need for prompt medical evaluation. Recognizing these red flags can lead to earlier diagnosis and treatment, potentially preventing complications associated with menorrhagia. When should women consult a healthcare provider about their menstrual bleeding?

Warning Signs Requiring Medical Attention

• Soaking through a pad or tampon every hour for several consecutive hours
• Needing to use double sanitary protection to control menstrual flow
• Menstrual periods lasting longer than 7 days
• Passing blood clots larger than a quarter
• Experiencing severe pain or cramping
• Feeling dizzy, light-headed, or experiencing shortness of breath
• Noticing a significant change in your menstrual pattern

Potential Complications of Untreated Menorrhagia

Seeking timely medical care is crucial to prevent potential complications such as:

• Severe anemia, which can lead to fatigue, weakness, and other health issues
• Chronic pain and discomfort
• Reduced quality of life due to disruption of daily activities
• Potential delay in diagnosing underlying conditions like fibroids or endometriosis

Remember, heavy menstrual bleeding is not something women should simply endure. With proper medical care and management, the impact of menorrhagia on daily life can be significantly reduced, allowing women to lead healthier, more comfortable lives.

By understanding the signs, symptoms, and treatment options for menorrhagia, women can take proactive steps towards better menstrual health. Open communication with healthcare providers, coupled with a willingness to explore various treatment options, can lead to effective management of this common yet often overlooked condition. As research in women’s health continues to advance, we can expect even more innovative and personalized approaches to treating menorrhagia in the future.

Menorrhagia | Johns Hopkins Medicine

What is menorrhagia?

Menorrhagia is heavy or prolonged menstrual bleeding. Many women have this type of abnormal uterine bleeding. It can be related to a number of conditions including problems with the uterus, hormone problems, or other conditions. While heavy bleeding can make it tough to take part in normal daily life at times, there are treatments to help.

What causes menorrhagia?

During your menstrual cycle, if an egg is not fertilized, the uterine lining breaks down, and bleeds. The egg and the uterine lining are then shed during your period.

Hormone problems or conditions that affect the uterus can result in heavy bleeding. Other diseases or bleeding disorders can also cause it.

Hormone problems include:

• Imbalance of estrogen and progesterone or other hormones

Problems with the uterus include:

• Fibroids (non cancerous)
• Cancer
• Pregnancy problems (such as a miscarriage or ectopic pregnancy)
• Use of an intrauterine device (IUD)

Other conditions such as thyroid, kidney or liver disease, cancer or bleeding disorders can also cause heavy bleeding.

What are the symptoms of menorrhagia?

If you have to change your pad or tampon every 1 to 2 hours because it is soaked, or bleed longer than 7 days, see your doctor. Spotting or bleeding between periods is also a sign of a problem.

The symptoms of menorrhagia may look like other conditions or medical problems. Always consult your healthcare provider for a diagnosis.

How is menorrhagia diagnosed?

Your healthcare provider will ask you about your medical history and about your periods. You will also have a physical exam including a pelvic exam. You may be asked to keep track of your periods and how many pads or tampons you use for a few months if you haven’t already done so.

• Blood tests. These check for anemia and test how fast your blood clots.
• Pap test. For this test, cells are collected from the cervix and examined. It’s used to check for cancerous changes, infection, or inflammation.
• Ultrasound. Using sound waves and a computer, your healthcare provider can check for fibroids or other problems inside the uterus.
• Biopsy. Examining a tissue sample from the uterine lining can help your healthcare provider find cancer or other abnormal tissue.

Other tests include:

• Hysteroscopy. Using a viewing instrument inserted through the vagina, your healthcare provider can see the cervix and the inside of the uterus.
• Dilation and curettage (D&C).This procedure involves scraping and then examining the uterine cavity.

How is menorrhagia treated?

Your healthcare provider will consider your age and overall health and your personal preferences when finding the best treatment for you.

Treatment for hormone problems may include:

• Prostaglandin inhibitors. These are nonsteroidal anti-inflammatory medicines (NSAIDs), including aspirin or ibuprofen. They help reduce cramping and the amount you bleed.
• Birth control pills. These stop ovulation and result in lighter periods.
• Progesterone. This is a type of hormone treatment.

Treatment for problems with the uterine lining (endometrium) may include:

• Ablation. Healthcare providers use this procedure to destroy the lining of the uterus (endometrium).
• Resection. In this procedure, the lining of the uterus is removed.
• Hysterectomy. This is the surgical removal of the whole uterus.
• Iron supplements. If you have anemia as a result of the heavy loss of blood, you may need iron supplements.

When to seek medical care

See your healthcare provider if:

• You have to change your pad or tampon every 1 to 2 hours because it is soaked
• Bleed longer than 7 days
• Have spotting or bleeding between periods

Key points

• Menorrhagia is heavy or prolonged menstrual bleeding. It is a common problem in women.
• It is caused by hormone problems, problems with the uterus, or other health conditions.
• Menorrhagia is diagnosed with a pelvic exam, ultrasound, pap test, and sometimes a biopsy.
• Treatment includes hormones, or other medicine, or procedures to treat the uterine lining or remove the uterus.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Heavy Menstrual Bleeding | CDC

Menorrhagia is menstrual bleeding that lasts more than 7 days. It can also be bleeding that is very heavy. How do you know if you have heavy bleeding? If you need to change your tampon or pad after less than 2 hours or you pass clots the size of a quarter or larger, that is heavy bleeding. If you have this type of bleeding, you should see a doctor.

Untreated heavy or prolonged bleeding can stop you from living your life to the fullest. It also can cause anemia. Anemia is a common blood problem that can leave you feeling tired or weak. If you have a bleeding problem, it could lead to other health problems. Sometimes treatments, such as dilation and curettage (D&C) or a hysterectomy, might be done when these procedures could have been avoided.

Causes

Possible causes fall into the following three areas:

1. Uterine-related problems
   1. Growths or tumors of the uterus that are not cancer; these can be called uterine fibroids or polyps.
   2. Cancer of the uterus or cervix.
   3. Certain types of birth control—for example, an intrauterine device (IUD).
   4. Problems related to pregnancy, such as a miscarriage or ectopic pregnancy, can cause abnormal bleeding. A miscarriage is when an unborn baby (also called a fetus) dies in the uterus. An ectopic pregnancy is when a baby starts to grow outside the womb (uterus), which is not safe.
2. Hormone-related problems
3. Other illnesses or disorders
   1. Bleeding-related disorders, such as von Willebrand disease (VWD) or platelet function disorder.
   2. Nonbleeding-related disorders such as liver, kidney, or thyroid disease; pelvic inflammatory disease; and cancer.

In addition, certain drugs, such as aspirin, can cause increased bleeding. Doctors have not been able to find the cause in half of all women who have this problem. If you have bleeding such as this, and your gynecologist has not found any problems during your routine visit, you should be tested for a bleeding disorder.

View and print this chart [PDF – 675 KB]

Signs

You might have menorrhagia if you:

• Have a menstrual flow that soaks through one or more pads or tampons every hour for several hours in a row.
• Need to double up on pads to control your menstrual flow.
• Need to change pads or tampons during the night.
• Have menstrual periods lasting more than 7 days.
• Have a menstrual flow with blood clots the size of a quarter or larger.
• Have a heavy menstrual flow that keeps you from doing the things you would do normally.
• Have constant pain in the lower part of the stomach during your periods.
• Are tired, lack energy, or are short of breath.

Diagnosis

Finding out if a woman has heavy menstrual bleeding often is not easy because each person might think of “heavy bleeding” in a different way. Usually, menstrual bleeding lasts about 4 to 5 days and the amount of blood lost is small (2 to 3 tablespoons). However, women who have menorrhagia usually bleed for more than 7 days and lose twice as much blood. If you have bleeding that lasts longer than 7 days per period, or is so heavy that you have to change your pad or tampon nearly every hour, you need to talk with your doctor.

To find out if you have menorrhagia, your doctor will ask you about your medical history and menstrual cycles.

He or she may ask you questions like the following:

• How old were you when you got your first period?
• How long is your menstrual cycle?
• How many days does your period usually last?
• How many days do you consider your period to be heavy?
• How do your periods affect your quality of life?

Your doctor may also ask if any of your family members have had heavy menstrual bleeding. He or she may also have you complete this questionnaire [PDF – 127 KB] to help determine if you need to be tested for a possible bleeding disorder.

You might want to track your periods by writing down the dates of your periods and how heavy you think your flow is (maybe by counting how many pads or tampons you use). Do this before you visit the doctor so that you can give the doctor as much information as possible. Above is a picture of a chart that is used by some doctors to track your period. You can make your own chart based on the one shown. Your doctor also will do a pelvic exam and might tell you about other tests that can be done to help find out if you have menorrhagia.

Click here to view a larger image

Tests

Your doctor might tell you that one or more of the following tests will help find out if you have a bleeding problem:

• Blood test. In this test, your blood will be taken using a needle. It will then be looked at to check for anemia, problems with the thyroid, or problems with the way the blood clots.
• Pap test. For this test, cells from your cervix are removed and then looked at to find out if you have an infection, inflammation, or changes in your cells that might be cancer or might cause cancer.
• Endometrial biopsy. Tissue samples are taken from the inside lining of your uterus or “endometrium” to find out if you have cancer or other abnormal cells. You might feel as if you were having a bad menstrual cramp while this test is being done. But, it does not take long, and the pain usually goes away when the test ends.
• Ultrasound. This is a painless test using sound waves and a computer to show what your blood vessels, tissues, and organs look like. Your doctor then can see how they are working and check your blood flow.

Using the results of these first tests, the doctor might recommend more tests, including,

• Sonohysterogram. This ultrasound scan is done after fluid is injected through a tube into the uterus by way of your vagina and cervix. This lets your doctor look for problems in the lining of your uterus. Mild to moderate cramping or pressure can be felt during this procedure.
• Hysteroscopy. This is a procedure to look at the inside of the uterus using a tiny tool to see if you have fibroids, polyps, or other problems that might be causing bleeding. You might be given drugs to put you to sleep (this is known as “general anesthesia) or drugs simply to numb the area being looked at (this is called “local anesthesia”).
• Dilation and Curettage (D&C). This is a procedure (or test) that can be used to find and treat the cause of bleeding. During a D&C, the inside lining of your uterus is scraped and looked at to see what might be causing the bleeding. A D&C is a simple procedure. Most often it is done in an operating room, but you will not have to stay in the hospital afterwards. You might be given drugs to make you sleep during the procedure, or you might be given something that will numb only the area to be worked on.

Treatment

The type of treatment you get will depend on the cause of your bleeding and how serious it is. Your doctor also will look at things such as your age, general health, and medical history; how well you respond to certain medicines, procedures, or therapies; and your wants and needs. For example, some women do not want to have a period, some want to know when they can usually expect to have their period, and some want just to reduce the amount of bleeding. Some women want to make sure they can still have children in the future. Others want to lessen the pain more than they want to reduce the amount of bleeding. Some treatments are ongoing and others are done one time. You should discuss all of your options with your doctor to decide which is best for you. Following is a list of the more common treatments.

Drug Therapy

• Iron supplements. To get more iron into your blood to help it carry oxygen if you show signs of anemia.
• Ibuprofen (Advil). To help reduce pain, menstrual cramps, and the amount of bleeding. In some women, NSAIDS can increase the risk of bleeding.
• Birth control pills. To help make periods more regular and reduce the amount of bleeding.
• Intrauterine contraception (IUC). To help make periods more regular and reduce the amount of bleeding through drug-releasing devices placed into the uterus.
• Hormone therapy (drugs that contain estrogen and/or progesterone). To reduce the amount of bleeding.
• Desmopressin Nasal Spray (Stimate®). To stop bleeding in people who have certain bleeding disorders, such as von Willebrand disease and mild hemophilia, by releasing a clotting protein or “factor”, stored in the lining of the blood vessels that helps the blood to clot and temporarily increasing the level of these proteins in the blood.
• Antifibrinolytic medicines (tranexamic acid, aminocaproic acid). To reduce the amount of bleeding by stopping a clot from breaking down once it has formed.

Surgical Treatment

• Dilation and Curettage (D&C). A procedure in which the top layer of the uterus lining is removed to reduce menstrual bleeding. This procedure might need to be repeated over time.
• Operative hysteroscopy. A surgical procedure, using a special tool to view the inside of the uterus, that can be used to help remove polyps and fibroids, correct abnormalities of the uterus, and remove the lining of the uterus to manage heavy menstrual flow.
• Endometrial ablation or resection. Two types of surgical procedures using different techniques in which all or part of the lining of the uterus is removed to control menstrual bleeding. While some patients will stop having menstrual periods altogether, others may continue to have periods but the menstrual flow will be lighter than before. Although the procedures do not remove the uterus, they will prevent women from having children in the future.
• Hysterectomy. A major operation requiring hospitalization that involves surgically removing the entire uterus. After having this procedure, a woman can no longer become pregnant and will stop having her period.

Menorrhagia is common among women. But, many women do not know that they can get help for it. Others do not get help because they are too embarrassed to talk with a doctor about their problem. Talking openly with your doctor is very important in making sure you are diagnosed properly and get the right treatment.

Who is Affected

Heavy bleeding (menorrhagia) is one of the most common problems women report to their doctors. It affects more than 10 million American women each year. This means that about one out of every five women has it.

References

1. Fast Facts for Your Health: Menorrhagia. National Women’s Health Resource Center (NWHRC), Washington, D.C. http://www.healthywomen.org.
2. Menstruation: Heavy Bleeding (Menorrhagia). PreventDisease.com. http://preventdisease.com/diseases/menstruation_heavy_bleeding.html.
3. Women with Inherited Bleeding Disorders: Surgical Options for Menorrhagia. Canadian Hemophilia Society. http://www.hemophilia.ca.
4. Menorrhagia (heavy menstrual bleeding). CNN.com. http://www.cnn.com/HEALTH/library/DS/00394.html.
5. Phillip CS, Faiz A, Dowling NF, Beckman M, Owens S, Ayers C, Bachmann G. Development of a screening tool for identifying women with menorrhagia for hemostatic evaluation. American Journal of Obstetrics & Gynecology 2008;198:163.e1–163.e8.
6. Apgar BS, Kaufman AH, George-Nwogu U, Kittendorf A. Treatment of menorrhagia. American Family Physician 2007;75:1813–1819,1820. http://www.aafp.org/afp/20070615/1813.html.
7. Heavy Bleeding and Endometrial Ablation. FertilityAnswers.com. http://www.fertilityanswers.com/endometrial_ablation.htm.
8. Menorrhagia (heavy menstrual bleeding). MayoClinic.com Health Library. http://www.riverside-online. com/health_reference/Womens-Health/DS00394.cfm.
   National Collaborating Centre for Women’s and Children’s Health. National Institute for Health and Clinical Excellence (NICE). Heavy menstrual bleeding. London: Royal College of Obstetricians and Gynaecologists Press; 2007.
9. Higham JM, O’Brien PM, Shaw RW. Assessment of menstrual blood loss using a pictorial chart. British Journal of Obstetrics and Gynaecology. 1990;97:734–739.

Treatment of menstrual disorders and irregular periods

Text created with the participation of gynecologist Natalia Dmitrievna Sadova

Menstrual disorders are not standard changes in a woman’s usual MC. Currently, MC disorders are recognized by doctors around the world as factors that affect the performance and life of women, in connection with the pain and suffering they experience. Therefore, the treatment of menstrual irregularities is of great importance and necessary for the return of comfort to women in their lives. Obstetrician-gynecologists of the clinic “Dynasty” will help each of their patients in the diagnosis and professional treatment of menstrual disorders.

TREATMENT OF MENSTRUAL CYCLE DISTURBANCES AVAILABLE IN THE BRANCHES:

Treatment of menstrual disorders in the Primorsky district

Address: St. Petersburg , Primorsky district, st. Repishcheva, 13

Treatment of menstrual disorders in the Petrogradsky district

Address: St. Petersburg , Petrogradsky district, st. Lenina, 5

Treatment of menstrual disorders in Vsevolozhsk

Address: Vsevolozhsk , Oktyabrsky pr-t, 96

Description of menstrual disorders

Physiological monthly uterine bleeding, during which the unfertilized ovum, together with menstrual blood, endometrial particles and mucous membranes of the cervix, leaves the female body, is called menstruation. Normally, their volume is about 150 ml. The term menstrual cycle combines not only menstruation, but the entire period from the maturation of the egg until the moment of its ovulation and the growth of the endometrium for the subsequent introduction of a fertilized egg into it. In the normal course of the ovarian-menstrual cycle, monthly menstruation occurs with systematic periodicity and duration. Any change from the norm in the MC is considered a disorder, which implies the need for timely treatment of menstrual disorders.

Menstrual disorders manifest themselves in different ways. They vary depending on symptoms and signs, including pain during menstruation, heavy discharge or irregular menstrual bleeding for up to three months, or a reduction in MC for less than 21 days. An irregular cycle of menstruation is associated with a problem in the work of the hypothalamic-pituitary-ovarian axis, therefore, early detection and treatment can minimize the complications of a woman’s reproductive abilities.

Menstrual disorders are classified into the following types:

1. Premenstrual disorders:

• Premenstrual syndrome. It occurs one to two weeks before menstruation and refers to physical and emotional symptoms. Symptoms can vary from mild to very significant and unpleasant manifestations (depression, irritability, headache, increased appetite, etc.).
• Premenstrual dysphoric disorder occurs within a week before menstruation and presents as a severe mood disorder that affects cognitive and physical functions.

2. Violations of the duration of the MC (with a norm of 21-45 days):

• Amenorrhea – non-onset of MC during reproductive age (during pregnancy and lactation) or beyond reproductive age (in childhood and after menopause).
• Irregular menstruation – exceeding the duration of MC 8 days.
• Polymenorrhea – menstrual periods 21 days apart or less.
• Oligomenorrhea – infrequent periods, mild in manifestations, with intervals of more than 35 days.

3. Violations of the MC (at a rate of up to 7 days):

• Abnormal uterine bleeding – changes in the course of bleeding (regularity of the flow, its volume and duration). Bleeding may occur between periods after intercourse and after menopause, during pregnancy is excluded.
• Metrorrhagia is irregular monthly bleeding that does not occur at the expected MC interval. The reasons may be: abnormal blood clotting, failure of hormonal regulation or in the endometrial mucosa of the uterus.
• Hypomenorrhea – abnormally rare menstruation.
• Menorrhagia is an abnormally heavy and prolonged menstrual period.

4. Ovulation disorders:

• Oligoovulation is unstable or infrequent ovulation of less than 8 cycles per year.
• Anovulation is not the onset of ovulation in its usual time period. It manifests itself in the form of irregular periods, inconstancy of intervals of duration or bleeding. May cause missed periods or excessive bleeding.

5. Other menstrual disorders:

• Spasms.
• Dysmenorrhea.
• Painful menstruation (pain may be constant or intermittent, sharp or aching and aching).

Symptoms of disorders

One of the most common MC violations:

• spotting between regular periods;
• decrease in days (rarely prolongation) between subsequent cycles;
• more profusion of menstrual bleeding compared to the norm.

The appearance of any changes may be a symptom of ovarian dysfunction. More attentive to the violation of the MC should be women after 45 years. Ovarian dysfunction may be accompanied by disease of the thyroid and pancreas, kidneys or adrenal glands.

MC Delay

An unplanned absence of menstruation within five days of a woman’s usual schedule is considered a MC delay. The reason for this may be pregnancy, which can be confirmed or refuted using a rapid test, as well as contact a medical center for consultation and further diagnosis.

What causes a change in MC

Doctors consider hormonal changes to be one of the causes of MC changes. Factors that affect the functioning of the hormonal system can be conditionally divided into:

1. Pathological:

• ovarian disease or surgery;
• disorders of the hypothalamic-pituitary system;
• pathological changes in the endometrium;
• existing chronic diseases in the uterus;
• genital infections;
• oncological diseases;
• consequences of abortion;
• diseases of the liver, kidneys;
• coagulopathy.

2. Medications (drugs affecting MC):

• hormonal contraceptives;
• anticoagulants;
• anticonvulsants;
• glucocorticosteroids;
• dilantin and digitalis preparations;
• antidepressants;
• use of an intrauterine device;
• tranquilizers.

3. External (physiological):

• frequent stress;
• malnutrition;
• abrupt climate change;
• lack of sleep.

Violation of the MC is also directly affected by age. So in a teenager, violations of the MC are often observed. The causes of irregular periods in a girl are due to the fact that the MC becomes stable only for several years from the day the first menstruation begins. Therefore, irregular periods should not cause panic in adolescence, it is during this period that the volume of secretions, the duration of MC and menstruation differ. In the case when the MC of the girls has already been established, and the violations have begun to occur again, you need to contact a gynecologist and, if necessary, treat the violation of the menstrual cycle.

Under the supervision of doctors in women after 20 years, MC should be normally stable and systematic. The causes of its violation can be gynecological and systemic diseases, hormonal contraceptives.

After 40 years, the restructuring of the woman’s body to the subsequent menopause begins, the processes of hormonal restructuring are activated. The basis for the violation of the cycle of menstruation during this period can be a decrease in estrogen produced by the ovaries. This can be a reason for meager periods or, on the contrary, abundant ones, as well as a reduction and irregularity of the cycle. Another cause of the violation is the formation of a follicular cyst. The cyst grows in size, but later heavy menstruation follows. This period can last up to 8 weeks, and a woman may mistake this for pregnancy. Also, the MC increases after an abortion, while recovery can take up to two to three months, but if there are concomitant complications, then for a longer period. Frequent reasons for the failure of the menstrual cycle in this age group are cysts, fibroids, endocrine disorders, etc.

At age 50, MC may still be stable despite approaching menopause and this is normal. The intervals between cycles become longer, the body produces a large amount of sex hormones. At this time, you should be more careful about disease prevention, visit a mammologist and gynecologist.

In case of violations of the MC, the occurrence of pregnancy is possible, but it directly depends on the degree of the woman’s disorders. In the early stages of pregnancy, menstrual irregularity often leads to spontaneous interruption.

Diagnostics of MC violations

In the event that any abnormalities occur in the MC, the woman should contact the obstetrician-gynecologist of the clinic for further advice and treatment. The doctor begins the diagnosis with an in-depth anamnesis. It is clarified whether the woman had a pregnancy and how it proceeded, what methods of contraception were used by the patient, the list of diseases she had and the presence of surgical interventions, and the BMI is calculated. The doctor’s next step will be a gynecological examination.

Further diagnostics may include:

• blood test for hormones;
• complete blood count;
• urinalysis;
• gynecological ultrasound;
• vaginal flora swab;
• colposcopy;
• Pap smear (Pap test).

The gynecologist of the clinic, having received the results of the diagnosis, will prescribe the appropriate treatment for the patient’s menstrual disorders. In this case, the doctor may additionally prescribe a consultation of other specialists (therapist, endocrinologist, surgeon).

Treatment of menstrual disorders

The primary task of the doctor is to eliminate the cause of the disease, therefore, the treatment of irregular periods is based on the results obtained during the diagnosis. Having learned the cause of MC disorders, the clinic doctor can use the following methods:

1. Hormone therapy (thyroid replacement therapy, hormone therapy with progesterone and estrogens, oral contraceptives, gonadotropins).

2. Anesthesia and spasm relief (antibiotics, anti-inflammatory drugs, uroseptics, vitamin complexes).

3. Surgical methods. Surgical intervention is performed if neoplasms of the genital organs are found. Removal of the endometrium, accumulated blood clots in case of excessive uterine bleeding is carried out if hormone therapy is not effective.

In the case of physiological causes of MC disorders, the doctor prescribes recommendations to the woman on normalizing the daily regimen, ensuring proper rest, developing a healthy diet, and a system of moderate physical activity is prescribed.

If a woman has problems with MC, she should immediately make an appointment with the doctor of the clinic and receive timely and high-quality treatment.

Reception conducted by gynecologists:

Choose a branchClinic “Dynasty” in St. Petersburg, Krasnogvardeisky districtClinic “Dynasty” in St. Petersburg, Petrogradsky districtClinic “Dynasty” in St. Petersburg, Primorsky districtClinic “Dynasty” in VsevolozhskVisiting service

Pediatric specialists

Consults online

Atajanyan Anna Sarikovna

Obstetrician-gynecologist, gynecologist-endocrinologist, ultrasound specialist

Gavrilyuk Nina Bokhadyrovna

Obstetrician-gynecologist

Ginzhul Galina Mikhailovna

Obstetrician-gynecologist, pediatric gynecologist, oncologist, mammologist, second category

Ekaterina Dudina

Obstetrician-gynecologist

Ivanova Ekaterina Alekseevna

Obstetrician-gynecologist

Krisanenko Julia Georgievna

Obstetrician-gynecologist

Najaryan Marine Tigranovna

Obstetrician-gynecologist

Sadovaya Natalya Dmitrievna

Obstetrician-gynecologist, candidate of medical sciences

Samarina Olga Vladimirovna

Obstetrician-gynecologist, gynecologist-endocrinologist

Tuzhik Anastasia Petrovna

Obstetrician-gynecologist, gynecologist-endocrinologist

Cost of treatment of menstrual irregularities:

Service name	Price in rubles
	St. Petersburg	Vsevolozhsk
Primary appointment with obstetrician-gynecologist 1st stage	2100	1850
Repeated appointment with an obstetrician-gynecologist 1st stage	1900	1650
Primary appointment with an obstetrician-gynecologist, level 2	2500	–
Obstetrician-gynecologist re-appointment 2nd stage	2300	–
MANIPULATION
Insertion of obstetric pessary	1500	1500
Intrauterine device (IUD) insertion	2500	2500
Insertion of the Mirena intrauterine device	4000	4000
Insertion of implantable contraceptive “IMPLANON” (without contraceptive cost)	2500	2100
Video colposcopy	2000	1700
Swab collection (gynecological)	400	400
Instrumental removal of the intrauterine device (IUD)	2500	2100
Intravaginal suppositories (excluding the cost of medicines), 1 procedure	500	500
Vaginal treatment	700	700
Medical abortion	13000	13000
Topical treatment of the vulva	700	700
Obstetric pessary removal	1000	1000
Intrauterine device (IUD) removal	1500	1500
Removal of the Mirena intrauterine device	3000	3000
Implantable contraceptive removal “IMPLANON”	2500	2300
Removal of a foreign body from the vagina	1800	1800
Endometrial streak biopsy (pipel diagnostic)	1500	1200
ULTRASONIC AND FUNCTIONAL DIAGNOSIS
Pelvic ultrasound (single transducer)	1800	1300
Pelvic ultrasound (two transducers)	1900	1500
Folliculometry (1 study)	1400	1400
Folliculometry (4 studies)	3900	3900
PREGNANCY ULTRASOUND
Pregnancy ultrasound	1900	1500
Ultrasound during pregnancy (I, II and III trimesters)	2000	2000
1st trimester ultrasound screening	3000	–
1st trimester ultrasound screening (multiple pregnancy)	3600	–
Ultrasound screening II, III trimester	3250	–
Ultrasound screening II, III trimester (multiple pregnancy)	3900	–
Uteroplacental blood flow Doppler (fetal Doppler)	1200	–
CTG (fetal cardiotocography)	1800	–
CTG (multiple pregnancy)	2300	–
LASER SURGERY
Cervical biopsy + histology	5000	4000
Single cervical cyst	1500	1500
Solitary papillomas and condylomas of the vaginal walls	3000	3000
Generalized condylomatosis, papillomatosis	from 6000	from 6000
Removal of single warts, papillomas of the vulva, cervix (for 1 unit)	600	600
Ectopia (erosion) of the cervix (less than 2 cm)	6000	4000
Ectopia (erosion) of the cervix (more than 2 cm)	9000	9000
Cervical endometriosis (single focus)	1000	1000
RADIOSURGERY
Radioknife cervical biopsy	2500	2000
Treatment of vulvar leukoplakia and kraurosis with the radiosurgical knife	5300	5100
Treatment of cervical pathology with a radiosurgical knife up to 1 cm	5000	3700
Treatment of cervical pathology with a radiosurgical knife up to 2 cm	6500	6000
Removal of cervical polyps with a radiosurgical knife	4000	2500
Fulguration of cysts, endometrial lesions with a radiosurgical knife	3500	2200
Electrocoagulation of warts on the skin in the perineal area with a radioknife (for 1 unit)	800	800
Electrocoagulation of warts, papillomas of the vulva with radioknife	1400	1400
Electrocoagulation of condylomas, vaginal papillomas with radioknife	from 3200	from 3200
OPERATIONS
Intimate contouring	–	26000
Surgical defloration	8000	8000

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what can cause a duration of more than 10 days?

Find out why periods can last more than 10 days and what factors can affect this. Find out the possible causes and what to do if you have long periods.

Menstruation is a natural process in a woman’s life associated with monthly shedding of the inner layer of the uterus. Usually they last from 3 to 7 days, but sometimes they can last longer. If the menstruation lasts more than 10 days, this may indicate the presence of certain problems in the body. It is necessary to pay attention to the possible causes of such prolonged bleeding and consult a doctor for advice and diagnosis.

Hormonal imbalance can be one of the causes of prolonged periods. Too much estrogen or too little progesterone can disrupt normal cycles and cause prolonged bleeding. Also, hormonal changes can be associated with thyroid disorders or polycystic ovaries.

Pelvic inflammatory disease can also cause prolonged periods. For example, inflammation of the uterus or ovaries can cause increased bleeding and prolonged bleeding. This may be due to infectious or non-infectious causes such as endometriosis or polyps in the uterus.

Some medical conditions can also cause prolonged periods. For example, bleeding disorders or the presence of tumors in the uterus or ovaries can lead to prolonged bleeding. It may also be caused by the use of certain medications, such as anticoagulants or hormonal contraceptives.

It is important to remember that prolonged periods can be a sign of serious illness and require the attention of specialists. If you experience prolonged periods or any other unusual symptoms, see your doctor for diagnosis and appropriate treatment.

Prolonged periods: what is it?

Long periods is a condition in which the duration of the menstrual cycle exceeds the usual 5-7 days. If the period lasts more than 10 days, this may be considered a deviation from the norm and requires attention.

This condition can be caused by various factors such as hormonal changes, inflammatory processes in the body, disorders of the reproductive system and other diseases. One of the reasons may be an imbalance of the hormones estrogen and progesterone, which leads to instability of the menstrual cycle.

Also, prolonged periods can be associated with uterine polyps or fibroids, which can cause bleeding and prolonged periods. Inflammatory processes in the body, such as endometritis or inflammation of the appendages, can also be the cause of prolonged periods.

If you have prolonged periods, you need to see a doctor to diagnose and find out the cause of this condition. The doctor will be able to prescribe the necessary treatment and offer recommendations for improving the condition.

Physiological causes of prolonged periods

Long periods lasting more than 10 days may be caused by physiological causes related to the functioning of the female reproductive system. One of the reasons may be hormonal imbalance. For example, an increased release of estrogen can lead to a lengthening of the duration of menstruation.

Another cause may be a malfunction of the endometrium, the inner layer of the uterus. If the endometrium is not completely shed during menstruation, this can lead to prolonged periods. Also, if the endometrium is too thick, it can cause an increase in bleeding time.

Some women may have long periods due to thyroid problems. Hypothyroidism, or an underactive thyroid gland, can lead to menstrual irregularities and longer periods.

Also, prolonged periods may be associated with the presence of polyps or fibroids in the uterine cavity. These formations can cause an increase in the duration and intensity of bleeding during menstruation.

Finally, prolonged periods may be due to the use of certain types of contraception, such as the Mirena coil. The intrauterine device can cause an increase in the duration and intensity of menstruation.

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Hormonal disorders as the cause of prolonged periods 90 008

Long periods lasting more than 10 days can be caused by various factors including hormonal disorders. Hormones play an important role in the regulation of the menstrual cycle, and any deviation from the norm can lead to its violation.

One cause of prolonged periods may be an imbalance of hormones such as estrogen and progesterone. These hormones are responsible for the growth and shedding of the endometrium, the lining of the uterus that is shed during menstruation. If the level of these hormones is disturbed, this can lead to an increase in the thickness of the endometrium and, as a result, to prolonged periods.

Another possible cause of prolonged periods is polycystic ovaries. Polycystic ovaries is a hormonal disorder in which the ovaries produce too many male sex hormones (androgens). This can lead to a violation of the regularity of the menstrual cycle and an increase in the duration of menstruation.

Long periods can also be caused by a malfunction of the thyroid gland. The thyroid gland produces hormones that control the body’s metabolism. If the thyroid gland does not work properly and produces too much or too little hormone, it can affect the menstrual cycle and lead to prolonged periods.

It is important to note that prolonged periods can be a sign of serious illness, so when they occur, you should consult a doctor for diagnosis and appropriate treatment.

Inflammatory processes and prolonged periods

Long periods lasting more than 10 days can be caused by various reasons, one of which is inflammatory processes in the body. Inflammation can occur in various organs and systems, such as the uterus, ovaries, or cervix.

One common cause of prolonged periods is endometritis, an inflammation of the inner lining of the uterus. This condition can result from infections such as chlamydia or gonorrhea, or after medical procedures such as an abortion or caesarean section. Inflammation causes changes in the tissues of the uterus, which can lead to long and heavy periods.

Another possible cause of prolonged periods is an inflammation of the ovaries called oophoritis. This inflammation can be caused by infections such as salpingitis or endometritis and can lead to long and painful periods. With oophoritis, irregular menstrual bleeding may also occur.

Inflammatory processes in the cervix can also cause prolonged periods. The cervix can become inflamed due to infections such as chlamydia or gonorrhea, or due to other causes such as polyps or cancer. Inflammation of the cervix can lead to long and heavy periods, as well as pain during or after intercourse.

The influence of lifestyle on the duration of menstruation

Lifestyle plays an important role in the regularity and duration of menstruation in women. An unbalanced diet, lack of physical activity, stressful situations and bad habits can lead to menstrual irregularities.

Nutrient deficiencies, especially iron and vitamins, can cause abnormal bleeding and prolong periods for more than 10 days. The diet should be balanced, including fresh vegetables and fruits, healthy fats and proteins.

Lack of physical activity can also have a negative effect on the duration of menstruation. Regular exercise helps maintain the normal functioning of the organs of the reproductive system and improves blood circulation in the pelvic region.

Stress is one of the main causes of menstrual irregularities. Constant tension and emotional overstrain can cause a delay in menstruation or prolonged bleeding. It is important to learn how to manage stress and find time to relax.

Wrong habits such as smoking and drinking alcohol can also affect the length of your periods. They negatively affect hormonal balance and can cause irregularities in the menstrual cycle.

In general, a healthy lifestyle that includes proper nutrition, regular physical activity, stress management and avoidance of bad habits helps to normalize the menstrual cycle and reduce the duration of menstruation.

Side effects of drugs and prolonged periods

Long periods lasting more than 10 days can be caused by various factors. One possible cause is the use of certain medications, which can cause changes in the regularity and duration of periods. Some medications, such as anticoagulants and hormonal drugs, can interfere with the hormonal system and cause prolonged periods.

Taking hormonal contraceptives such as the pill or Mirena can also be associated with prolonged periods. These drugs affect the hormonal balance in the body and can cause changes in the menstrual cycle.

In addition, some medicines used to treat other conditions may have side effects related to the menstrual cycle. For example, drugs used to treat epilepsy or endometrial hyperplasia can cause prolonged periods.

If you have prolonged periods, you should consult your doctor. He will be able to determine the cause and prescribe the appropriate treatment. It is important to remember that prolonged periods can be a sign of serious illness, so you need to contact a specialist for professional help.

Influence of psycho-emotional state on the duration of menstruation

Psycho-emotional state of a woman can have a significant impact on the duration of menstruation. Strong emotions, stress, depression and other psychological factors can cause changes in the body’s hormonal balance, which in turn can lead to prolonged periods.

Stress is one of the main causes of prolonged periods. Under the influence of stress, the body produces more adrenaline, which can lead to disruption of the normal cycle of menstruation. This can manifest itself in the form of an increase in the duration of bleeding and profusion of discharge.

Depression can also have a negative effect on the length of your periods. During depression, there may be a malfunction of the hypothalamic-pituitary-ovarian system, which can lead to a change in the duration of menstruation. In addition, with depression, there is often a violation of the general condition of the body, which can also affect menstruation.

It is important to note that the psycho-emotional state can affect the duration of menstruation not only directly, but also through lifestyle changes. For example, when stressed or depressed, a woman can change her diet, eat more unhealthy foods, or, conversely, refuse to eat, which can also affect the duration of menstruation.

In general, the psycho-emotional state is an important factor that can affect the duration of menstruation. In the presence of prolonged periods, it is recommended to consult a doctor for diagnosis and identification of the causes of this condition. The doctor will be able to prescribe appropriate treatment and give recommendations for improving the psycho-emotional state, which will help normalize the duration of menstruation.

When should I see a doctor?

Long periods lasting more than 10 days can be a sign of various diseases and require medical attention. If you have these symptoms, you should consult a gynecologist or other specialist:

• Heavy discharge: polyps, fibromas, or endometriosis.
• Pain and discomfort: If you experience severe pain in the lower abdomen, cramps or other discomfort during your period, this may be a sign of inflammation or the presence of tumors.
• Cycle irregularities: If your cycle becomes irregular or your period becomes too long, this could indicate hormonal problems, thyroid problems, or other problems.

It is important to see a doctor for an accurate diagnosis and appropriate treatment. Don’t put off seeing a specialist, as early treatment can help prevent complications and keep you healthy.

Q&A:

Why does my period last more than 10 days?

Prolonged periods can be caused by various reasons. These can be hormonal disorders, polyps in the uterus, fibroids, inflammatory processes and other diseases. To accurately determine the cause of prolonged periods, you need to contact a gynecologist for an examination.

What hormonal disorders can cause prolonged periods?

Hormonal disorders such as corpus luteum insufficiency, hypothyroidism, hyperprolactinemia, polycystic ovaries and others can cause prolonged periods. If you suspect a hormonal disorder, you should contact an endocrinologist or gynecologist for an appropriate examination.

Can the use of hormonal contraceptives cause long periods?

Yes, the use of hormonal contraceptives, especially at the beginning of their use, can cause a change in the duration of menstruation. In some cases, this may manifest as prolonged periods for more than 10 days. If the duration of menstruation does not improve within several cycles, it is worth consulting with a gynecologist.

What diseases can polyps in the uterus cause?

Polyps in the uterus can be caused by various diseases such as endometriosis, chronic endometritis, endometrial hyperplasia and others. Polyps can cause prolonged periods as well as other symptoms such as bleeding during or after intercourse, pain in the lower abdomen, etc. For the diagnosis and treatment of polyps, you need to contact a gynecologist.

What other symptoms can accompany prolonged periods?

Prolonged periods may be accompanied by other symptoms such as severe lower abdominal pain, heavy discharge, weakness, dizziness, etc. If prolonged periods are accompanied by unpleasant symptoms, you should consult a gynecologist for diagnosis and treatment.

What diagnostic methods can be used to identify the causes of prolonged periods?

Prolonged periods can be caused by various reasons.