Menorrhagia: Everything You Should Know About Heavy Menstrual Bleeding

Heavy menstrual bleeding refers to a condition when your period lasts longer than a week and involves heavier blood flow than what’s considered typical during menstruation.

In some cases, the excessive bleeding during the period can be so profound that women may have to change their pads or tampons back-to-back for several hours with passing quarter-sized blood clots. 

Needless to say, such heavy menstrual bleeding can greatly interfere with everyday activities. That said, if you are in the area and looking for treatment options, we can be your go-to gynecologist in Boca Raton, Florida, to help you with questions about monthly cycles.

How Common is Heavy Menstrual Bleeding? 

Excessive bleeding during your periods is actually relatively common, affecting around 27% to 54% of women. Generally speaking, the condition is more uncomfortable than severe, but it can lead to serious consequences if you lose too much blood and start producing symptoms of anemia or iron deficiency. Without treatment, this condition can even be life-threatening.

On the other hand, menorrhagia may be a symptom of more severe conditions like cancer. As these malignancies require immediate medical assistance, all women who are experiencing heavy menstrual bleeding should reach out to their healthcare provider to rule out any severe medical problems.

Signs You’re Losing Too Much Blood During Your Period

The signs of the condition may be the following:

• Periods that last longer than a week
• Pain in the abdominal area
• Blood that appears brown, pink, red, and sometimes rust-like
• Passing large, quarter-sized, or even bigger blood clots
• Bleeding through at least one or more pads or tampons each hour for more than two hours
• Instead of losing around 35-40 milliliters of blood during your period, you tend to lose way more (more than 80 millimeters)
• Shortness of breath, fatigue (anemia-related symptoms)

When anemia is present along with menorrhagia, patients may also develop a condition called pica, which produces symptoms like pale skin, hair loss, and the urge to eat non-foods like hair, paper, etc.

How To Tell Whether You’re Suffering From Heavy Menstrual Bleeding?

The condition tends to interfere with the patient’s life heavily. The problem is that most women who suffer from the problem assume that losing this much blood is typical. As a matter of fact, periods should never interfere with your everyday life or restrict your activities. 

Whenever menstrual bleeding occurs, women should still be able to:

• Wear only one menstrual product (no need to wear two pads, for example)
• Use a standard tampon or pad for three-four hours
• Go about your everyday life without having to carry extra pads, tampons, or changing clothes
• Not missing work or going out in public because of menstrual bleeding

Simply put, whenever your periods cause disruptions in your life, it’s best to schedule an appointment with your doctor.

Menorrhagia Causes

Several things may lead to heavy menstrual bleeding, and the most common conditions are the following: 

• Hormonal imbalances: Conditions like thyroid-related issues, PCOS, anovulation, and even being overweight may lead to estrogen and progesterone imbalances which may trigger more profound bleeding during your periods.
• Non-malignant uterine growths: Polyps, adenomyosis, and fibroids may also cause menorrhagia.
• Malignant uterine growths: cancers of the reproductive system like uterine and cervical cancer may also cause heavy menstrual bleeding.
• Infections: STIs like gonorrhea and chlamydia may also trigger the condition.
• Complications during pregnancy: sometimes, menorrhagia may signal pregnancy complications like miscarriage or ectopic pregnancy.
• Other conditions: kidney disease, Von Willebrand disease, leukemia, and liver disease, may also cause heavy bleeding.
• Medication: Blood thinners, HRT, tamoxifen, and IUDs may also lead to bleeding problems.

Menorrhagia Diagnosis

To diagnose whether you’re dealing with heavy menstrual bleeding or not, your doctor will review your medical history and ask about your periods.

More specifically, they may ask: 

• About the age, you started having your periods
• The number of days they usually last
• The number of days you’re dealing with heavy flows
• Whether you have family members who also suffer from the condition
• About the medications you are taking at the moment
• Past pregnancies and current contraception methods

Furthermore, your doctor might perform various tests to diagnose the issue, such as:

• Songysterogram to check the inside of the uterus
• Hysteroscopy to check for fibroids, polyps, or other abnormal tissue formations.
• Blood tests
• Pap smear
• Transvaginal ultrasound
• MRI or magnetic resonance imaging
• Endometrial biopsy

Treatment for Heavy Menstrual Bleeding

For the most part, the treatment for the condition will depend on what’s causing the profound bleeding and how severe it is. Your overall health, age, and medical history are also important factors, along with your response to a specific medication.

Also, your preferences may play a determining factor in the treatment process. You might want to reduce the bleeding or want to stop having periods altogether. Additionally, planned pregnancy may also affect the menorrhagia treatment.

Medications for Heavy Menstrual Bleeding

• Iron supplements to help with anemia
• Nonsteroidal anti-inflammatory compounds to reduce bleeding and cramps
• Birth control options to make your periods regular
• Hormone therapy to help with hormone imbalances
• Ganodotrpoin-realising hormone agonists to reduce bleeding temporarily
• Desmopressin to address Willebrand disease-associated bleeding
• Antifibrinolytic drugs to prevent clot-breakdown

Procedures

After noticing several signs you’re losing too much blood during your period, a hysteroscopy is the most common method to diagnose and treat menorrhagia. 

However, several other procedures can address the problem:

• UAE or uterine artery embolization
• Endometrial ablation
• Myomectomy
• Hysterectomy

Depending on your health, the severity of the condition, and other factors, the treatment may only begin with taking medication and then move to surgical options. It’s best to consult with your doctor to work out which options are the best for you, especially if you are planning to get pregnant (then, your doctor probably won’t recommend a hysterectomy).

Prevention

Unfortunately, you can’t prevent heavy menstrual bleeding but getting medical help as soon as possible can go a long way in managing your periods and getting you back on track with your everyday life. The longer you wait to get help, the more the bleeding will make daily activities during your period more difficult. Furthermore, you may develop anemia which will leave you weak and tired.

Don’t Hesitate To Get Help

If you notice any of the symptoms above and your monthly bleeding gets abnormal, you should talk to your healthcare provider and talk about your concerns. While usually not life-threatening, these heavy bleedings can significantly affect your quality of life and even mental well-being. 

As such, you should track your periods to identify any irregularities. These notes can also come in handy if you choose to get help from your provider.

As we’ve said before, such heavy periods are common, but that doesn’t mean that you should ignore them. They can be highly uncomfortable, and there are several treatment options that you can choose from.

If you have any concerns or questions regarding diagnostics or treatments, feel free to reach out to us and schedule an appointment. We’re here to help.