Prolonged Menstrual Bleeding: What you need to know?

Prolonged menstrual bleeding, also known as menorrhagia, is a condition where a woman experiences excessively heavy or extended menstrual periods. Understanding the causes, symptoms, and available treatment options is crucial for managing this condition effectively. Here’s what you need to know about prolonged menstrual bleeding:

Causes of Prolonged Menstrual Bleeding

Prolonged menstrual bleeding can be caused by a variety of factors, including:

1. Hormonal Imbalances: Imbalances in estrogen and progesterone levels can cause the endometrium (the lining of the uterus) to develop excessively, leading to heavier menstrual bleeding when it sheds.

2. Uterine Fibroids or Polyps: These non-cancerous growths on the uterine wall can lead to heavier or longer menstrual periods.

3. Adenomyosis: This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavier menstrual bleeding and pain.

4. Medications: Certain medications, including anti-inflammatory drugs and anticoagulants, can increase menstrual bleeding.

5. Medical Conditions: Pelvic inflammatory disease (PID), thyroid problems, endometriosis, and other health issues can cause prolonged menstrual bleeding.

6. Intrauterine Device (IUD): An IUD used for birth control can sometimes increase menstrual bleeding and cramping.

Symptoms of Prolonged Menstrual Bleeding

The main symptom of prolonged menstrual bleeding is a menstrual flow that lasts longer than seven days or is extremely heavy. Other symptoms can include:

• Needing to change sanitary products every one to two hours

• Passing large blood clots

• Anemia symptoms such as fatigue, shortness of breath, and pale skin

• Severe menstrual cramps

• Disruption of daily activities due to heavy flow

Diagnosis

To diagnose menorrhagia, a healthcare provider may perform:

• Physical exams and discuss your medical history and symptoms.

• Blood tests to check for anemia, thyroid disorders, and blood-clotting abnormalities.

• Ultrasound to detect abnormalities in the uterus or ovaries.

• Endometrial biopsy to examine the lining of the uterus if there's concern about more serious conditions.

• Hysteroscopy: A small camera examines the inside of the uterus.

Treatment Options

Treatment depends on the underlying cause, your health, and whether you plan to have children in the future:

1. Medications: Hormonal therapies such as birth control pills can help regulate cycle length and reduce bleeding. Non-hormonal medications like tranexamic acid can reduce menstrual bleeding.

2. Non-invasive Procedures:

   • IUDs: An intrauterine device releasing progesterone can reduce bleeding.

3. Surgical Options:

   • Dilation and curettage (D&C): Scrapping the top layer of the uterus lining can reduce bleeding.

   • Endometrial ablation: Destroys the lining of the uterus to reduce or stop bleeding.

   • Uterine artery embolization: Used to treat fibroids by shrinking them.

   • Hysterectomy: Removal of the uterus; a permanent solution that is typically a last resort.

Managing Prolonged Menstrual Bleeding

In addition to medical treatment, managing symptoms at home with iron supplements (to combat anemia), using heat therapy for pain, maintaining a balanced diet, and staying hydrated are beneficial.