Menorrhagia is one of the most common forms of
It is the most common type of abnormal uterine bleeding characterized
by heavy and prolonged menstrual bleeding. In some cases, bleeding may
be so severe and relentless that daily activities become interrupted.
Any woman of childbearing age can develop menorrhagia. However, some
women are likely to experience heavier menstrual bleeding than
others. Risk factors include:
- being a young adolescent or pre-menopausal woman
- being overweight
- using certain medications, such as blood thinners
- having a hereditary bleeding disorder
In some cases, the cause of heavy menstrual bleeding is unknown, but a
number of conditions may cause menorrhagia. Common causes include:
- Hormonal imbalance- In a normal menstrual cycle, a balance
between the hormones estrogen and progesterone regulates the buildup of
the lining of the uterus (endometrium), which is shed during
menstruation. If a hormonal imbalance occurs, the endometrium develops
in excess and eventually sheds by way of heavy menstrual bleeding.
- Dysfunction of the ovaries- Lack of ovulation (anovulation)
may cause hormonal imbalance and result in menorrhagia.
- Uterine fibroids- These noncancerous (benign) tumors of the
uterus appear during your childbearing years. Uterine fibroids may
cause heavier than normal or prolonged menstrual bleeding.
- Polyps- Small, benign growths on the lining of the uterine
wall (uterine polyps) may cause heavy or prolonged menstrual bleeding.
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 pain. Adenomyosis is most likely to develop if you're a
middle-aged woman who has had many children.
- Intrauterine device (IUD)- Menorrhagia is a well-known side
effect of using a nonhormonal intrauterine device for birth control.
When an IUD is the cause of excessive menstrual bleeding, you may need
to remove it.
- Pregnancy complications- A single, heavy, late period may
be due to a miscarriage. If bleeding occurs at the usual time of
menstruation, however, miscarriage is unlikely to be the cause. An
ectopic pregnancy - implantation of a fertilized egg within the
fallopian tube instead of the uterus - also may cause menorrhagia.
- Cancer- Rarely, uterine cancer, ovarian cancer and cervical
cancer can cause 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 (to prevent blood clots), can contribute
to heavy or prolonged menstrual bleeding. Improper use of hormone
medications also can cause menorrhagia.
- Other medical conditions- A number of other medical
conditions, including pelvic inflammatory disease (PID), thyroid
problems, endometriosis, and liver or kidney disease, may cause
In general, bleeding is considered excessive when a woman soaks through
enough sanitary products (sanitary napkins or tampons) to require
changing every hour. In addition, bleeding is considered prolonged when
a woman experiences a menstrual period that lasts longer than seven
days in duration. The following are the most common (other) symptoms of
menorrhagia. However, each individual may experience symptoms
differently. Symptoms may include:
- spotting or bleeding between menstrual periods
- spotting or bleeding during pregnancy
The symptoms of menorrhagia may
resemble other menstrual conditions or medical problems. Always consult
physician for a diagnosis.
Excessive or prolonged menstrual bleeding can lead to other medical
- Iron deficiency anemia. In this common type of anemia,
there is decrease in hemoglobin. Low hemoglobin may be the result of
insufficient iron. Menorrhagia may deplete iron levels enough to
increase the risk of iron deficiency anemia. Signs and symptoms include
pallor, weakness and fatigue.
Although diet plays a role in iron
deficiency anemia, the problem is complicated by heavy menstrual
periods. Most cases of anemia are mild, but even mild anemia can cause
weakness and fatigue. Moderate to severe anemia can also cause
shortness of breath, rapid heart rate, lightheadedness and headaches.
- Severe pain. Heavy menstrual bleeding often is accompanied
by menstrual cramps (dysmenorrhea). Sometimes the cramps associated
with menorrhagia are severe enough to require prescription medication
or a surgical procedure.
or vaginal trauma
inflammatory disease (PID):
Diagnosis begins with a gynecologist evaluating a patient's medical
history and a complete physical examination including a pelvic
examination. A diagnosis of menorrhagia can only be certain when the
physician rules out other menstrual disorders, medical conditions, or
medications that may be causing or aggravating the condition. Other
diagnostic procedures for menorrhagia may include the following:
1. Blood tests
2. Pap test - test that involves microscopic examination of cells
collected from the cervix; used to detect changes that may be cancerous
or may lead to cancer, and to show non-cancerous conditions, such as an
infection or inflammation.
3. Ultrasound (Also called sonography.) - a diagnostic imaging
technique which uses high-frequency sound waves and a computer to
create images of blood vessels, tissues, and organs. Ultrasounds are
used to view internal organs as they function, and to assess blood flow
through various vessels.
4. Biopsy (endometrial) - a procedure in which tissue samples are
removed (with a needle or during surgery) from the body for examination
under a microscope; to determine if cancer or other abnormal cells are
5. Hysteroscopy - a visual examination of the canal of the cervix and
the interior of the uterus using a viewing instrument (hysteroscope)
inserted through the vagina.
6. Dilation and curettage (D & C) - a common gynecological
surgery which consists of widening the cervical canal with a dilator
and scraping the uterine cavity with a curette.
Specific treatment for menorrhagia will be determined by physician
- age, overall health, and medical history
- extent of the condition
- cause of the condition
- tolerance for specific medications, procedures, or
- expectations for the course of the condition
Treatment for menorrhagia may include:
- Iron supplementation (if the condition is coupled with
anemia, a blood disorder caused by a deficiency of red blood cells or
- Prostaglandin inhibitors such as nonsteroidal
anti-inflammatory medications (NSAIDs), such as aspirin or ibuprofen
(to help reduce cramping and the amount of blood expelled)
- Oral contraceptives (ovulation inhibitors)
- Progesterone (hormone treatment)
- Endometrial ablation - a procedure to destroy the lining of
the uterus (endometrium).
- Endometrial resection - a procedure to remove the lining of
the uterus (endometrium).
- Hysterectomy - surgical removal of the uterus.
Role of Homoeopathy-
Homeopathic remedies often bring relief. Menstrual problems that are
chronic or severe are best addressed with the guidance of an
experienced practitioner: a constitutional remedy can help to bring
balance to a person's system on many levels, not just a particulsr symptom.
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