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Menorrhagia

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If you are having an unusually heavy period does that mean you have menorrhagia?

No not really. No, not unless the bleeding is so severe that you soak through and have to change your sanitary pad. Menorrhagia basically means abnormally heavy or prolonged bleeding. There also might be cramping and you are unable to carry out your daily activities.

You have Menorrhagia If:

- There is a need to use double sanitary protection at night to prevent bed staining.
- Bleeding lasts longer than a week.
- You are passing blood clots.
- Experiencing tiredness, fatigue and shortness of breath due to anemia caused by the excessive blood loss.
- Bleeding in between periods, having irregular vaginal bleeding or having to bleed after menopause.

Possible causes behind the bleeding:

  • Hormone imbalance:

This causes excessive buildup of the lining of the uterus (endometrium), which is      shed by way of heavy menstrual bleeding.

  • Dysfunction of the ovaries:

If your ovaries don't release an egg (ovulate) during a menstrual cycle (an-ovulation).

  • Uterine fibroids:

These noncancerous tumors of the uterus appear during your childbearing years. This can cause heavy bleeding.

  • Polyps:

Small, benign growths on the lining of the uterus (uterine polyps) maybe one of the causes. Polyps of the uterus most commonly occur in women of reproductive age as the result of high hormone levels.

  • Adenomyosis:

This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and painful menses. Adenomyosis is most likely to develop if you're a middle-aged woman who has had children.

  • Intrauterine device (IUD):

Menorrhagia is a well-known side effect of using a nonhormonal intrauterine device for birth control. Removing the IUD resolves the problem.

  • A miscarriage can cause a single, heavy, late period. If the bleeding occurs at the usual time of menstruation, however, miscarriage is unlikely to be the cause.
  • An ectopic pregnancy — implantation of a fertilised egg within the fallopian tube instead of the uterus — also may cause menorrhagia.
  • Uterine cancer, ovarian cancer and cervical cancer are rare but possible causes of excessive menstrual bleeding.
  • Inherited bleeding disorders:

Some blood coagulation disorders — such as von Willebrand's disease, a condition in which an important blood-clotting factor is deficient or impaired — can cause abnormal menstrual bleeding.

  • Medications:

Certain drugs, including anti-inflammatory medications and anticoagulants, can contribute to heavy or prolonged menstrual bleeding.

  • Other medical conditions:

A number of other medical conditions, including pelvic inflammatory disease (PID), thyroid problems, endometriosis, and liver or kidney disease, may be associated with menorrhagia.

If you are having heavy menstrual bleeding, it is important to see your doctor to determine the cause. Your doctor will take a detailed medical, menstrual and sexual history.

Your doctor will carry out a physical exam and may recommend one or more tests or procedures such as:

Blood tests for iron deficiency (anaemia) and other conditions, such as thyroid disorders or blood-clotting abnormalities.

Pap test:

In this test, cells from your cervix are collected and tested for infection, inflammation or changes that may be cancerous or may lead to cancer.

Endometrial biopsy:

Your doctor may take a sample of tissue from the inside of your uterus to be examined by a pathologist.

Ultrasound scan:

This imaging method uses sound waves to produce images of your uterus, ovaries and pelvis.

Further testing may include:

Sonohysterogram:

During this test, a fluid is injected through a tube into your uterus by way of your vagina and cervix and an ultrasound we carried out.

Hysteroscopy:

This exam involves inserting a tiny camera through your vagina and cervix into your uterus, which allows your doctor to see the inside of your uterus.

Doctors can be certain of a diagnosis of menorrhagia only after ruling out other menstrual disorders, medical conditions or medications as possible causes or aggravations of this condition.

Preferred Medication:

1. Iron Supplements:

Iron supplements may be prescribed to prevent or treat anaemia.

2. Nonsteroidal anti-inflammatory drugs:

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen help reduce menstrual blood loss and relieve painful menstrual cramps.

3. Tranexamic acid:

Tranexamic acid helps reduce menstrual blood loss and needs to be taken only at the time of the bleeding.

4. Oral contraceptives:

Oral contraceptives can help regulate menstrual cycles and reduce episodes of excessive or prolonged menstrual bleeding.

5. Oral progesterone:

When taken for 10 or more days of each menstrual cycle, the hormone progesterone can help correct hormone imbalance and reduce menorrhagia.

6. Surgical Treatment:

You may need surgical treatment for menorrhagia if drug therapy is unsuccessful. Treatment options include:

7. Dilation and curettage (D&C):

In this procedure, your doctor opens (dilates) your cervix and then scrapes or suctions tissue from the lining of your uterus to reduce menstrual bleeding.

8. Uterine artery embolization:

A catheter is passed through the large artery in the thigh (femoral artery) to the uterine arteries, which is injected with micro-spheres made of plastic. This causes shrinkage of the fibroids by blocking their blood supply.

9. Focused ultrasound ablation:

This procedure uses ultrasound waves to destroy the fibroid tissue. There are no incisions required for this procedure.

10. Myomectomy:

This procedure involves surgical removal of uterine fibroids using open abdominal surgery, through several small incisions (laparoscopically), or through the vagina and cervix (hysteroscopic ally).

11. Endometrial ablation:

The lining of the uterus is permanently destroyed by using a variety of techniques.

12. Endometrial resection:

An electrosurgical wire loop is used to remove the lining of the uterus. Both endometrial ablation and endometrial resection benefit women who have very heavy menstrual bleeding. Pregnancy isn't recommended after this procedure.

13. Hysterectomy:

A surgery to remove your uterus and cervix — is a permanent procedure that causes sterility and ends menstrual periods. It is performed under anesthesia and requires hospitalization.

When menorrhagia is a sign of another condition, such as thyroid disease, treating that condition usually results in lighter periods.

To know more, ask a gynecologist online, visit DOC N ME.


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