Menorrhagia or excess menstrual bleeding is among the most widely reported problems by women. According to a statistic by U.S. Centers for Disease Control and Prevention, more than 10 million women are affected by it each year. In other words, one out of every five women suffers from menorrhagia. Many women just bear this problem, which keeps them from enjoying their life to the fullest. There are several proven permanent solutions to menorrhagia; it's easy to get treatment before it turns into a bigger problem. It helps to be aware of certain signs and symptoms to know whether your condition warrants medical attention.
How do you know you are bleeding more than normal?
Typically, menstrual bleeding that lasts for more than seven days is classified as menorrhagia. However, there are cases where women bleed heavily even through the flow does not last beyond seven days. If you are compelled to change pads or tampons every two hours, you might be suffering from menorrhagia. Another sign of menorrhagia could be passage of clots. If you are passing clots the size of a quarter or larger, then it is a sure symptom that you have this problem.
The repercussions of untreated menorrhagia
The primary concern with excess bleeding is always anemia, which leaves you weak and tired. Anemia in itself causes many problems, including:
- Weak bones: Blood promotes bone generation. When you have anemia, this process is impaired, leading to weak bones. You might end up with problems like osteoporosis (porous bones) or osteoarthritis in the later stages of your life.
- Depression: The tiredness and lethargy that result from anemia can cause depression. Also the thought that you have to plan your life around the heavy-flow days can be both impeding and depressing for many women.
- Shortness of breath: Observe yourself. You might find yourself winded after climbing just one flight of stairs. It may be because you have restricted oxygen supply to your lungs because of anemia.
- Hair thinning and loss: Anemia can deplete the iron stores in your body, which can lead to hair thinning and loss. It is believed that 72 percent of women who experience hair loss have anemia.
Since blood is the transport system of our body, carrying essential nutrients to different parts, excessive blood loss through menorrhagia is not something to ignore.
The primary causes of menorrhagia
There are several underlying causes of menorrhagia. Ignoring it might mean unknowingly harboring bigger problems, including:
• Fibroids in your uterus
• Hormonal imbalance between estrogen and progesterone
• Liver disease
• Kidney disease
• Thyroid disease
• Cervical, ovarian or uterine cancer
• Pelvic inflammatory disease
• Bleeding disorder
Menorrhagia could also be a result of blood thinners (like aspirin and warfarin), ectopic pregnancy, miscarriage, or non-hormonal intrauterine device implants.
Diagnosis of menorrhagia
Upon visit to the doctor's office for the first time with menorrhagia, you will be asked questions like your current age, your age during the first menstrual period, the length of each cycle, the duration of flow, the extent of flow and its effect on your normal activities of daily living. You may also be questioned about your family medical history. Be prepared for these questions. You could even note these things down on a piece of paper before you visit the doctor.
Once you have answered these questions, you might be given a pelvic examination. This exam helps the doctor decide what kind of tests should be performed to confirm menorrhagia. These tests could be:
- Blood test: Your blood is checked to ascertain whether you have thyroid problems, clotting disorder or anemia.
- Pap test: Cells from your cervix are collected and analyzed to look for cancerous cells, infection and inflammation.
- Endometrial biopsy: Endometrium is the lining of the uterus. Cells are collected from this area to analyze whether you have uterine cancer or any abnormal cells. This test is mildly painful but does not last long.
- Ultrasound: This test might be suggested to check the integrity of your internal genital organs.
Depending on the results of these tests, further diagnostic treatments might be suggested to get to the root cause of menorrhagia, which are:
- Dilation and curretage: You might be given local or general anesthesia for this procedure. Here, the uterus is scraped to check for the source of bleeding. If the surgeon finds that the endometrial lining is the culprit, he or she may just remove it to reduce the bleeding. This is an outpatient procedure, which means you can go home the same day, after the treatment.
- Sonohysterogram: This test is done to take a closer look at the uterus. Here, an ultrasound scan is performed after injecting a liquid into the uterus. You may feel a mild pressure-like or cramping sensation during the procedure.
- Hysteroscopy: This test is performed to check whether you have fibroids in your uterus with the aid of a viewing device. You will be given general or local anesthesia during this procedure.
Freeing you from menorrhagia
Your doctor would have a lot of information about the cause of menorrhagia at the end of these diagnostic tests, and either medications or surgical therapy will be suggested accordingly. The drug therapy could include pain medications, iron supplements, birth control pills or hormone therapy. If you have a bleeding disorder like Von Willebrand disease, you will be prescribed medications that reduce clotting time.
If your situation warrants or you wish to have a permanent solution to your problems, surgery might be suggested by your physician. Apart from dilation and curettage, which has been discussed above, you may be recommended to have:
- Endometrial ablation and resection: Here all or part of the endometrial lining may be removed. You would still retain the uterus but would not be able to bear children after this. The bleeding could completely stop or drastically reduce.
- Operative hysteroscopy: If abnormal findings are noticed during hysteroscopy, the doctor might choose to correct them at the same time. You may undergo removal of polyps, fibroids or endometrial lining. Any abnormality in the uterus can also be taken care of during this operation. Surgical correction during hysteroscopy will not be performed unless you have given an informed consent before the procedure.
- Hysterectomy: This is considered a major surgery, which would require you to spend a few days in a hospital. This surgery is performed to remove the uterus. You will stop having periods after this and it is a sure way to stop menstruation altogether.
Keep in mind that menorrhagia is not something you must live with. There is nothing to be embarrassed about when you communicate it to a doctor. Your clear communication allows the doctor to give you timely and effective treatment so that you can lead a normal and healthy life.