What is menorrhagia. How does it affect women’s health. What are the common causes of heavy menstrual bleeding. How is menorrhagia diagnosed. What tests are used to identify menorrhagia. How can women track their menstrual cycles for better diagnosis. What are the treatment options for heavy menstrual bleeding.

Understanding Menorrhagia: Definition and Impact

Menorrhagia, also known as heavy menstrual bleeding, is a condition that affects many women worldwide. It is characterized by menstrual bleeding that lasts more than 7 days or is excessively heavy. But what exactly constitutes “heavy” bleeding?

Heavy menstrual bleeding is typically defined as needing to change your tampon or pad after less than 2 hours or passing blood clots the size of a quarter or larger. This condition can significantly impact a woman’s quality of life and may lead to other health complications if left untreated.

The Health Implications of Menorrhagia

Untreated heavy or prolonged bleeding can have serious consequences on a woman’s health and well-being. What are the potential risks associated with menorrhagia?

• Anemia: The excessive blood loss can lead to iron-deficiency anemia, causing fatigue and weakness.
• Lifestyle disruption: Heavy bleeding can interfere with daily activities and social engagements.
• Emotional stress: The unpredictability and intensity of bleeding can cause anxiety and affect mental health.
• Potential for unnecessary procedures: If not properly diagnosed, some women might undergo unnecessary treatments like dilation and curettage (D&C) or hysterectomy.

Exploring the Causes of Heavy Menstrual Bleeding

The causes of menorrhagia can be diverse and complex. Understanding these underlying factors is crucial for proper diagnosis and treatment. What are the main categories of causes for heavy menstrual bleeding?

Uterine-Related Causes

Several uterine conditions can lead to menorrhagia. These include:

• Uterine fibroids or polyps: These non-cancerous growths in the uterus can cause excessive bleeding.
• Cancer of the uterus or cervix: Although less common, these cancers can present with heavy bleeding.
• Certain types of birth control: For example, an intrauterine device (IUD) may cause heavier periods in some women.
• Pregnancy-related issues: Miscarriage or ectopic pregnancy can result in abnormal bleeding patterns.

Hormone-Related Problems

Hormonal imbalances play a significant role in menstrual health. How do hormones affect menstrual bleeding?

Fluctuations in estrogen and progesterone levels can lead to changes in the uterine lining, potentially causing heavier or prolonged bleeding. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt the delicate hormonal balance necessary for regular menstrual cycles.

Other Medical Conditions

Several other health issues can contribute to menorrhagia:

• Bleeding disorders: Conditions like von Willebrand disease (VWD) or platelet function disorder can affect blood clotting.
• Systemic diseases: Liver, kidney, or thyroid diseases can impact menstrual patterns.
• Pelvic inflammatory disease: This infection can cause irregular bleeding.
• Certain medications: Drugs like aspirin can increase bleeding tendency.

It’s important to note that in about half of all cases, doctors are unable to identify a specific cause for heavy menstrual bleeding. This underscores the complexity of the condition and the need for comprehensive evaluation.

Recognizing the Signs of Menorrhagia

Identifying menorrhagia can be challenging, as perceptions of “heavy bleeding” may vary among individuals. However, certain signs can indicate that your menstrual bleeding is heavier than normal. What are the key indicators of menorrhagia?

• Soaking through one or more pads or tampons every hour for several consecutive hours
• Needing to double up on pads to control menstrual flow
• Changing pads or tampons during the night
• Experiencing menstrual periods lasting more than 7 days
• Passing blood clots larger than a quarter
• Feeling restricted in daily activities due to heavy flow
• Experiencing constant pain in the lower abdomen during periods
• Feeling tired, lacking energy, or being short of breath

If you experience any of these symptoms, it’s crucial to consult with a healthcare provider for proper evaluation and diagnosis.

Diagnosing Menorrhagia: A Comprehensive Approach

Diagnosing menorrhagia requires a thorough assessment of a woman’s menstrual history and overall health. How do healthcare providers approach the diagnosis of heavy menstrual bleeding?

Medical History and Menstrual Cycle Assessment

Your doctor will likely ask detailed questions about your menstrual cycles and medical history. These may include:

• The age at which you got your first period
• The length of your menstrual cycle
• The duration of your periods
• The number of days you consider your period to be heavy
• How your periods affect your quality of life
• Family history of heavy menstrual bleeding

Menstrual Tracking

To aid in diagnosis, you may be asked to track your menstrual cycles. How can you effectively track your periods?

Consider keeping a menstrual diary where you record the dates of your periods and assess the heaviness of your flow. This can be done by counting the number of pads or tampons used. Some healthcare providers use specific charts to track menstrual patterns, which you can replicate at home.

Physical Examination

A pelvic exam is typically part of the diagnostic process. This allows the doctor to check for any visible abnormalities or signs of infection.

Diagnostic Tests for Menorrhagia

To confirm a diagnosis of menorrhagia and identify any underlying causes, your doctor may recommend several tests. What are the common diagnostic tests used for heavy menstrual bleeding?

Blood Tests

Blood tests can provide valuable information about your overall health and potential causes of heavy bleeding. What can blood tests reveal?

• Anemia: A complete blood count can detect if you’re anemic due to blood loss.
• Thyroid function: Thyroid disorders can affect menstrual patterns.
• Clotting disorders: Tests can identify problems with blood clotting that may contribute to heavy bleeding.

Pap Test

A Pap smear involves collecting cells from the cervix to check for infections, inflammation, or cellular changes that could indicate cancer or pre-cancerous conditions.

Endometrial Biopsy

In this procedure, tissue samples are taken from the lining of the uterus (endometrium) to check for abnormalities or cancer.

Imaging Tests

Various imaging techniques may be used to visualize the uterus and surrounding structures. What are the common imaging tests for menorrhagia?

• Ultrasound: This non-invasive test uses sound waves to create images of the uterus and ovaries.
• Sonohysterography: A specialized ultrasound where fluid is injected into the uterus to provide clearer images of the uterine cavity.
• Hysteroscopy: A thin, lighted tube is inserted through the cervix to examine the inside of the uterus.

Treatment Options for Menorrhagia

Once diagnosed, there are several treatment options available for menorrhagia. The choice of treatment depends on the underlying cause, the severity of symptoms, and the patient’s preferences. What are the main approaches to treating heavy menstrual bleeding?

Medications

Various medications can be used to manage menorrhagia:

• Hormonal treatments: Birth control pills, hormonal IUDs, or other hormonal medications can help regulate menstrual flow.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These can help reduce blood loss and alleviate menstrual cramps.
• Tranexamic acid: This medication helps blood clot more effectively, reducing menstrual blood loss.
• Iron supplements: For women with iron-deficiency anemia due to heavy bleeding.

Surgical Interventions

In some cases, surgery may be recommended. What are the surgical options for menorrhagia?

• Endometrial ablation: This procedure destroys the uterine lining, reducing or stopping menstrual flow.
• Uterine artery embolization: This minimally invasive procedure can shrink fibroids, reducing bleeding.
• Myomectomy: Surgical removal of fibroids while preserving the uterus.
• Hysterectomy: Removal of the uterus, considered a last resort when other treatments fail.

Living with Menorrhagia: Coping Strategies and Lifestyle Adjustments

While seeking medical treatment is crucial, there are several ways women can manage the day-to-day challenges of living with menorrhagia. What strategies can help women cope with heavy menstrual bleeding?

Menstrual Products

Choosing the right menstrual products can make a significant difference in managing heavy flow:

• High-absorbency pads or tampons: These can provide better protection during heavy days.
• Menstrual cups: Some women find these reusable devices effective for managing heavy flow.
• Period panties: These absorbent undergarments can provide an extra layer of protection.

Dietary Considerations

Certain dietary changes may help manage symptoms associated with menorrhagia:

• Iron-rich foods: To combat potential anemia, include foods like lean meats, leafy greens, and legumes in your diet.
• Hydration: Staying well-hydrated can help replace fluids lost during heavy periods.
• Vitamin C: This nutrient can enhance iron absorption from plant-based sources.

Stress Management

Stress can exacerbate menstrual symptoms. What are some effective stress-reduction techniques?

• Yoga and meditation: These practices can help reduce stress and alleviate menstrual discomfort.
• Regular exercise: Physical activity can help regulate hormones and reduce stress.
• Adequate sleep: Prioritizing good sleep hygiene can improve overall well-being and help manage stress.

The Importance of Seeking Professional Help

While menorrhagia is a common condition, it’s not something women should simply endure. Seeking professional medical help is crucial for several reasons. Why is it important to consult a healthcare provider about heavy menstrual bleeding?

• Accurate diagnosis: A healthcare provider can determine whether your bleeding is indeed abnormal and identify any underlying causes.
• Prevent complications: Early intervention can prevent complications like severe anemia or unnecessary surgical procedures.
• Improve quality of life: Effective treatment can significantly improve your day-to-day life and overall well-being.
• Rule out serious conditions: In some cases, heavy bleeding can be a sign of more serious conditions that require prompt attention.

Remember, every woman’s experience with menstruation is unique, and what’s normal for one person may not be for another. If you’re concerned about your menstrual bleeding, don’t hesitate to speak with a healthcare provider.

Advancing Research and Understanding of Menorrhagia

The field of women’s health, including the study of menstrual disorders like menorrhagia, is continuously evolving. What are some of the current areas of research and development in understanding and treating heavy menstrual bleeding?

Genetic Factors

Researchers are exploring the genetic components that may contribute to menorrhagia. Understanding these genetic factors could lead to more personalized treatment approaches in the future.

Novel Treatment Approaches

Scientists are investigating new therapies for managing heavy menstrual bleeding. What are some promising areas of research?

• Advanced hormonal treatments: Researchers are working on developing more targeted hormonal therapies with fewer side effects.
• Innovative medical devices: New devices for managing heavy flow or treating underlying causes like fibroids are in development.
• Regenerative medicine: Some studies are exploring the potential of stem cell therapies in treating uterine disorders that cause heavy bleeding.

Improved Diagnostic Tools

Advancements in medical technology are leading to more accurate and less invasive diagnostic methods. These could include:

• Advanced imaging techniques: More precise imaging could lead to earlier detection of uterine abnormalities.
• Biomarker identification: Researchers are working to identify biological markers that could indicate the presence of conditions causing heavy bleeding.

As research progresses, our understanding of menorrhagia continues to grow, potentially leading to more effective treatments and improved quality of life for women affected by this condition.

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.

Causes, When to Seek Help, Treatment, and More

If you experience periods that last longer than seven days, see your doctor. It may be a sign of a serious underlying health condition that needs to be addressed.

Generally, a period lasts between three to seven days. A menstrual period that lasts longer than seven days is considered a long period.

Your doctor may refer to a period that lasts longer than a week as menorrhagia. You may also be diagnosed with menorrhagia if you experience unusually heavy bleeding that lasts less than a week. Five percent of women have menorrhagia.

A long period may be a sign of a serious underlying health condition, such as:

• hormone irregularities
• uterine abnormalities
• cancer

It’s important to see your doctor if you experience a long or heavy period so they can identify the underlying cause or rule out more serious possible causes.

Menorrhagia can cause discomfort during your period as well as disrupt your regular routine. You may find that the bleeding affects your activities or your sleep. You may also experience iron deficiency anemia if you regularly experience long menstrual periods, especially if they’re heavy.

Read on to learn more about long periods, including possible causes and what you can do to manage this symptom.

Long periods can be caused by a wide range of underlying conditions.

Hormone and ovulation changes

Changes to your hormones or ovulation may cause a long period. You may notice hormonal changes when you first get your period during puberty or in perimenopause. You may also experience a hormonal imbalance from different health conditions, such as thyroid disorders or polycystic ovary syndrome.

If your hormones aren’t at a normal level or if your body doesn’t ovulate during your menstrual cycle, the uterine lining can become very thick. When your body finally sheds the lining, you may experience a period that’s longer than normal.

Medications

You may experience long periods because of medications you take. These can include:

• contraceptives, such as intrauterine devices and extended birth control pills
• aspirin and other blood thinners
• anti-inflammatories

Pregnancy

While not actually a period, extended vaginal bleeding may be a sign of an unsafe or nonviable pregnancy, such as an ectopic pregnancy or a miscarriage.

You may also have extended bleeding in pregnancy if you have a condition like placenta previa.

If you’ve had a pregnancy test come back positive and you’re experiencing vaginal bleeding, see your healthcare provider.

Uterine fibroids or polyps

Uterine fibroids and polyps can lead to extended, and sometimes heavy, bleeding.

Fibroids occur when muscle tissue begins to grown in the wall of the uterus.

Polyps are also the result of irregular tissue growth in the uterus and cause small tumors to grow.

Generally, neither fibroids or polyps are cancerous.

Adenomyosis

Adenomyosis is another type of tissue buildup. The condition occurs when your endometrium, or uterine lining, embeds itself into the muscles of your uterus. This can lead to a long or heavy period.

Thyroid condition

You may have a long period if your thyroid is underperforming. This condition is known as hypothyroidism.

Bleeding condition

You may have a condition that affects your body’s ability to clot blood, causing your long periods. Two of these conditions are hemophilia and von Willebrand’s disease.

A long period may be the only sign of one of these conditions, or you may have other symptoms.

Obesity

Excess weight may cause long periods. That’s because fatty tissue can cause your body to produce more estrogen. This excess estrogen can lead to a change in your period.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) occurs when bacteria infect your reproductive organs. In addition to changes to your menstrual cycle, PID can also lead to abnormal vaginal discharge among other symptoms.

Cancer

A prolonged period may the sign of cancer in your uterus or cervix. For some women, this may be one of the earliest symptoms of either of these cancers.

Don’t ignore a long period. It’s important to see your doctor to discuss why you might be experiencing this symptom. Delaying your diagnosis and treatment could lead to a worsening of the underlying condition responsible for the extended bleeding.

You may want to seek immediate care with a long period if you spike a fever or are losing an abnormally heavy amount of blood or large blood clots. A sign that you’re losing a lot of blood is if you need to change a pad or tampon one to two times per hour for several hours. You may also begin to feel lightheaded if you’re losing a lot of blood.

There are many causes for a long period, so your doctor will likely begin your appointment by asking you some questions. These may include:

• when your period started
• how many pads and tampons you’ve used in the last day
• your sexual activity
• other symptoms you’re experiencing
• your medical and relevant family histories

They may also do a physical exam that includes a pelvic exam and measuring your vital signs.

Your doctor may also recommend any of the following tests to help them make a diagnosis:

• blood tests to check hormone levels and also to look for signs of an iron deficiency
• pap smear
• biopsy
• abdominal or transvaginal ultrasound
• hysteroscopy
• dilation and curettage

Treatment methods for a long period can vary. Your doctor will treat the underlying cause. They may also recommend a treatment to reduce your current bleeding, regulate your period, or relieve any discomfort.

Hormonal birth control may regulate your period and shorten it in the future. This medication can be administered as:

• a pill
• an intrauterine device
• a shot
• a vaginal ring

Your doctor also may advise you to take medication that reduces pain or discomfort you experience from the prolonged period. These medications may include over-the-counter nonsteroidal anti-inflammatories, such as Advil or Motrin.

In some cases, your doctor may recommend a surgical procedure to alleviate long periods.

Dilation and curettage can thin the layer of your uterus and reduce how much you bleed during your period.

If you’re no longer considering having children, you may undergo endometrial ablation, resection, or a hysterectomy. These procedures can relieve the long periods, but they may also eliminate the possibility of getting pregnant.

Delaying a diagnosis could result in a more invasive procedure or intensive treatment for the underlying cause.

Additionally, if your long period causes heavier blood loss, you could be at risk of developing anemia. This may contribute to feelings of tiredness and weakness.

Your doctor can use results from a blood test to diagnose anemia. If your iron levels are low, your doctor may recommend boosting your diet with iron-rich foods and a possible iron supplement to get your levels back to normal.

Long periods may also be painful and interfere with your well-being and quality of life. You may miss days of school or work, or withdraw from activities you enjoy because of your long period.

There are many reasons you may have a period that’s longer than normal. Long periods can get in the way of your normal life, and they may also be a sign of an underlying condition that requires treatment.

See your doctor to find out the cause of your long period so you can begin to treat it. Delaying treatment may cause complications and lead to more invasive treatments in the future.

Long periods | diagnosis and treatment of cycle disorders

Prolonged periods | diagnosis and treatment of cycle disorders

HOW DOES MENORRHAGIA MANIFEST?

When menstruation lasts longer and more than 90-100 ml of blood is secreted (even if they do not cause discomfort or pain), it is necessary to seek advice from a gynecologist.

How often you change your tampon or pad during your period can be an indicator of how much blood is lost. If you need to replace your hygiene product every 2 hours or more often, this is a reason for an unscheduled gynecological examination.

Long periods are usually a symptom of existing gynecological problems. It can be endometriosis, submucosal uterine leiomyoma, polyps, endometrial hyperplasia. They can also be associated with a disorder of the blood coagulation process (for example, with thrombocytopenia) or endocrine disorders – dysfunction of the thyroid gland, adrenal glands.

Our advantages

Our medical center has modern diagnostic and treatment equipment. Laboratory studies are carried out on the basis of our own diagnostic laboratory.

Treatment is carried out only in accordance with international recommendations and WHO standards, diagnostic and treatment standards of the Ministry of Health of Ukraine, taking into account the world experience of leading experts.

From the first day of work, we adhere to an individual approach to the problem of each client, as we are convinced that this is the key to effective treatment and minimal risk of complications.

Reception and treatment is carried out by highly qualified specialists. We pay special attention to the selection of personnel, as well as create all the conditions for their professional growth and improvement.

They recommend us to their relatives, which means they trust us. More than 50% of patients come to us on the recommendation of their relatives, relatives or friends.

Terms and results may vary, depending on the patient’s body

STAGES OF TREATMENT OF LONG MENSTRUCTION

Consultation and examination by a gynecologist. Collection of anamnesis.

Tests:

• clinical blood test;
• thyroid function tests (if necessary)

Ultrasound diagnostics of the pelvic organs (performed at different periods of the menstrual cycle on days 7 and 21).

Follow-up consultation based on test results and prescription of treatment.

The essence of the treatment will depend on the results of the examinations carried out and is more directed to the treatment of the disease that caused heavy menstruation.

The price of treatment for menorrhagia (heavy menstruation) in Kyiv at the Health of the Family clinic depends on the number and types of examinations performed. The cost of a consultation with a gynecologist starts from 750 UAH. In addition, the services of our medical center can be found in the price list.

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Menstruation during menopause – how do menstruation go during menopause? How long can menstruation go with menopause?

Contents

• HOW DO MENSTRUCTION OCCUR?
• FEATURES OF MENSTRUAL BLEEDING DURING CLIMAX
• UTERINE BLEEDING WITH CLIMAX
• NORMALIZATION OF THE MENSTRUAL CYCLE WITH CLIMAX

HOW DOES MENSTRUCTION OCCUR?

The female menstrual cycle is controlled by hormones ² responsible for reproductive function. The cycle begins with the fact that follicles ripen in the ovary – the structural components inside which the egg is located. A few days after the start of the cycle, estrogen production increases, which becomes a signal for the thickening of the endometrial layer – the mucous tissue that lines the uterine cavity. This layer is needed for the attachment of the embryo.

Several follicles continue to develop until one dominant follicle emerges from them. The rest of the follicles after the isolation of the dominant follicle cease to develop.

At this time, the concentration of luteinizing hormone begins to rise. It is needed to rupture the follicle and release the egg into the fallopian tubes. In the empty follicle, a corpus luteum is formed – a gland that produces progesterone. Under the influence of progesterone, the endometrium becomes even thicker, glands develop in it, which secrete nutrients for the future embryo.

If the egg is not fertilized, then the endometrium is destroyed and begins to be rejected. It comes out of the uterus along with blood and mucus. This is the menstrual flow. They mark the end of one cycle and the beginning of another.

Menstrual cycles repeat as long as there are eggs in the ovaries. They are formed during fetal development, the supply of eggs decreases with age. Therefore, menstruation before menopause can become irregular.

PECULIARITIES OF MENSTRUAL BLEEDING IN CLIMAX

Menstruation, albeit irregular, is possible during the perimenopausal period. This is the stage of reproductive aging, when the function of the ovaries has already begun to fade, but a complete “shutdown” has not yet occurred.

Premenopause lasts for several years. Often it is accompanied by climacteric syndrome. This is a complex of symptoms associated with changes in hormonal status during menopause. Women may experience different symptoms. One of them may appear, or two or more may disturb:

• Excessive sweating, hot flashes, chills.
• Jumps in blood pressure, tachycardia.
• Increased fatigue, chronic fatigue, cognitive decline.
• Mood swings, irritability, excessive emotionality.
• Deterioration in the quality of sleep, problems with falling asleep.

Symptoms are due to a change in the hormonal status of a woman. Female hormones are involved not only in reproductive processes, but also in the work of the nervous system, in metabolic processes. Changing the concentration of hormones affects the entire body.

The menstrual cycle also changes. For example, if a woman had long periods with heavy discharge, in premenopause they may become short and not so plentiful. The situation can also be reversed: women who have had scanty and short discharges may experience an increase in the duration and abundance of menstruation.

The regularity of the cycle also changes. It may become noticeably longer or menstruation may come 2 times a month. It is important to remember that regardless of regularity, there are norms for how many days menstruation can go. Allocations within 5-7 days are considered normal. If the process continues longer, you need to see a doctor.

After the complete extinction of the ovaries, menopause occurs. There are no periods during menopause. Any discharge during this period is a reason to visit the clinic.

Scanty periods with menopause

Menstruation before menopause may become less abundant, the interval between them may increase. These changes in the cycle are observed in most premenopausal women. But you need to carefully monitor the nature of the discharge. If menstruation is observed twice a month or more, and at the same time, the discharge is unusual – they have blood clots, brown mucus, then this may be a sign of problems with the endocrine system, metabolic disorders or cervical erosion.

Slight spotting may appear when taking hormone replacement therapy during menopause.

Also, the causes of spotting discharge can be:

• Damage to mucous membranes during sexual intercourse. Due to the decrease in estrogen levels, women produce less vaginal secretions that provide lubrication. And the mucous membranes themselves become thin, lose their elasticity. Therefore, the risk of microtrauma with the release of a small amount of blood increases.
• Inflammatory processes in the genitals. During menopause, the female genitourinary system becomes vulnerable to infections and inflammations, cervicitis and vaginitis often develop.

Only a doctor can determine for sure whether female discharge is normal or not. For any deviations from the usual menstruation, you need to sign up for a consultation.

Protracted menstruation with menopause

It happens that with menopause the interval between menstruation is lengthened, and then menstruation goes on for a long time. This is due to the lack of ovulation against the background of the fading of the ovaries. First there is a delay, and then menstruation comes, which can last more than 7 days and be plentiful.

Prolonged periods may be a sign of:

• High pressure.
• Blood clotting disorders.
• Myomas, polyps.

If the discharge does not end for more than 7 days, you should consult a doctor. Even if prolonged menstruation is not associated with any disease, then blood loss can provoke anemia. It is important not to lose control over the situation and get expert advice in time.

UTERINE BLEEDING IN CLIMAX

Irregularity of the menstrual cycle during menopause is a normal phenomenon. But against the background of ongoing changes, you can miss the onset of the disease or an emergency. We recommend that you undergo an examination at the first signs of menopause and visit your gynecologist regularly.

The reason for an extraordinary visit to the doctor should be:

• pain in the abdomen and lower back;
• blood clots in secretions;
• temperature increase;
• painful urination;
• nausea, vomiting;
• change in blood pressure.

Menopause is a dangerous period for the occurrence of pathologies, among which benign (fibroids, polyps, cysts) and malignant neoplasms are not the last. It is they and such a disease as endometrial hyperplasia ³ that can cause monthly bleeding similar to menstruation.

Women approaching menopausal age should visit a doctor at the slightest disruption of the menstrual cycle. An examination by a gynecologist, ultrasound and laboratory blood tests will help determine the true nature of the changes and, if necessary, start treatment in a timely manner.

It is important to remember that menstruation with menopause will sooner or later stop completely. If menstruation is absent for a year, the onset of menopause is diagnosed. The next stage is called postmenopause, during which the function of the ovaries completely fades away. Menstruation during menopause becomes a physiologically impossible phenomenon. Any discharge of blood from the vagina during this period is pathological and requires immediate medical attention.

NORMALIZATION OF THE MENSTRUAL CYCLE WITH CLIMAX

The restoration of menstruation during menopause worries many women. And this is understandable. With the loss of reproductive function, the body begins to age rapidly. Normalization of hormone levels can slow down this process.

Regulation of menstruation may also be required in case of untimely (up to 45 years) onset of menopausal changes, when a woman is not yet ready to give up the opportunity to have children. Early menopause often has genetic causes. The provoking factors are:

• excessive dieting;
• smoking;
• acceleration;
• immune diseases;
• operations on the pelvic organs;
• endocrine pathologies.

Do not forget that it is possible to restore the menstrual cycle only before the onset of menopause. Menstruation during menopause is impossible due to irreversible changes in the ovaries. The probability of restoration of menstruation with menopause is higher, the earlier a woman consults a doctor.