Heavy menstrual bleeding

Heavy Menstrual Bleeding (HMB), also known as Menorrhagia, is a medical condition characterized by abnormally heavy or prolonged menstrual bleeding. With HMB, menstrual bleeding lasts more than 7 days and/or is so heavy that it requires frequent changing of sanitary protection. This condition can significantly impact an individual's physical, emotional, and social life.

Causes

Heavy menstrual bleeding can result from a variety of causes, including but not limited to:

• Uterine fibroids: Noncancerous growths in the uterus can lead to heavier or prolonged menstrual bleeding.
• Polycystic ovary syndrome (PCOS): A hormonal disorder causing enlarged ovaries with small cysts on the outer edges.
• Endometriosis: A condition in which tissue similar to the lining inside the uterus is found outside the uterus, causing heavy periods.
• Adenomyosis: When the tissue that normally lines the uterus grows into the muscular wall of the uterus.
• Bleeding disorders: Conditions such as von Willebrand disease can cause heavy menstrual bleeding.
• Pelvic inflammatory disease (PID): An infection of the reproductive organs can result in heavy bleeding.
• Thyroid problems: Both hypothyroidism and hyperthyroidism can cause heavy menstrual bleeding.
• IUD (Intrauterine device): A non-hormonal IUD can increase menstrual flow.

Symptoms

Symptoms of heavy menstrual bleeding include:

• Soaking through one or more sanitary pads or tampons every hour for several consecutive hours
• Needing to use double sanitary protection to control menstrual flow
• Needing to wake up to change sanitary protection during the night
• Bleeding for more than a week
• Passing large blood clots (larger than a quarter)
• Restricting daily activities due to heavy menstrual flow
• Symptoms of anemia, such as tiredness, fatigue, or shortness of breath

Diagnosis

Diagnosis of heavy menstrual bleeding may involve:

• Medical history evaluation and physical examination
• Blood tests to check for anemia, thyroid problems, and blood-clotting disorders
• Pap test to check for changes in cervical cells
• Endometrial biopsy to take a sample of the lining of the uterus
• Ultrasound to obtain images of the uterus, ovaries, and pelvis

Treatment

Treatment for heavy menstrual bleeding may include:

• Non-steroidal anti-inflammatory drugs (NSAIDs): To help reduce menstrual blood loss
• Tranexamic acid: To reduce menstrual blood loss
• Oral contraceptives: To help regulate menstrual cycles and reduce bleeding
• Hormonal IUD (Intrauterine device): To reduce menstrual bleeding
• Iron supplements: To treat anemia caused by heavy menstrual bleeding
• Surgery: Procedures such as endometrial ablation, uterine artery embolization, or hysterectomy may be considered in severe cases

Prevention

While it may not be possible to prevent heavy menstrual bleeding, regular check-ups with a healthcare provider can help manage symptoms and underlying conditions. Maintaining a healthy lifestyle and managing stress levels can also be beneficial.

See Also

• Menstrual cycle
• Anemia
• Gynecology