The condition menorrhagia causes heavy or prolonged menstrual bleeding that can affect quality of life and cause complications such as anemia, infection, or infertility. The treatment options for menorrhagia vary depending on the cause, the severity of the symptoms, and the person's preferences. It can be caused by hormonal imbalances, uterine problems, or bleeding disorders.
Causes of Menorrhagia
Different factors can cause menorrhagia, including:
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Hormonal imbalance: Estrogen and progesterone play an important role in regulating the menstrual cycle and uterine lining thickness. If these hormones are out of balance, the uterine lining may become too thick and shed excessively during menstruation. Polycystic ovary syndrome (PCOS), thyroid problems, obesity, and insulin resistance can all cause hormonal imbalance.
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Various problems with the uterus can lead to abnormal bleeding, including fibroids, polyps, adenomyosis, and cancer. A fibroids are benign tumors that grow in the uterine wall, whereas polyps are small growths that protrude from the uterine lining. An adenomyosis occurs when the uterine lining becomes the uterine muscle. Cancer is a malignant growth that can affect the uterus or the cervix.
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Blood clotting disorders: Certain inherited or acquired disorders can affect the blood's ability to clot, causing excessive bleeding. These disorders include von Willebrand disease, hemophilia, and platelet dysfunction.
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There are certain medications that can interfere with the normal menstrual cycle and cause heavy bleeding, such as anticoagulants, anti-inflammatory drugs, and hormonal contraceptives.
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Menorrhagia can also be caused by pregnancy complications, intrauterine devices (IUDs), infections, liver disease, or kidney disease.
Symptoms of Menorrhagia
Symptoms of menorrhagia include heavy or prolonged menstrual bleeding. This includes:
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More than seven days of bleeding
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Using one or more pads or tampons every hour
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Blood clots larger than a quarter in size
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Changing pads or tampons during the night or using double protection
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As a result of blood loss, you may feel tired, weak, or short of breath
Menorrhagia may also be accompanied by the following symptoms:
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Cramping or back pain in the lower abdomen or lower back
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Vomiting, nausea, or headaches
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Depression, mood swings, or irritability
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Having difficulty performing daily activities or socializing
Diagnosis of Menorrhagia
It is important to have a medical history, an understanding of your menstrual cycle, and symptoms in order to diagnose menorrhagia. Additionally, the doctor will perform a pelvic exam to look for signs of infection, inflammation, or abnormalities in your uterus or cervix, as well as a physical examination. To confirm the diagnosis and determine the cause of menorrhagia, the doctor may also order some tests, including:
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Tests for anemia, hormone levels, thyroid function, or clotting factors.
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A Pap test is used to determine whether the cervix is infected, inflamed, or cancerous by collecting cells from the cervix.
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To create images of the uterus, the ovaries, and the pelvic organs and detect fibroids, polyps, or other abnormalities.
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An endometrial biopsy involves removing a small sample of the uterine lining and examining it under a microscope for any abnormalities.
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An hysteroscopy involves inserting a thin, lighted instrument through the vagina and the cervix to view the uterus and its lining.
Treatment of Menorrhagia
Treatment options for menorrhagia depend on the cause, severity, and individual preferences.
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There are some medications that can help reduce the bleeding and pain, such as:
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Nonsteroidal anti-inflammatory drugs (NSAIDs): To relieve inflammation and cramps and decrease the blood flow.
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Tranexamic acid: To prevent the breakdown of blood clots and reduce the bleeding.
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Oral contraceptives: To regulate the hormone levels and the menstrual cycle and thin the uterine lining.
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Progesterone: To balance the estrogen and progesterone levels and stabilize the uterine lining.
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Iron supplements: To treat or prevent anemia caused by blood loss.
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Procedures: Some procedures can help treat the underlying cause of menorrhagia or remove the uterine lining, such as:
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Endometrial ablation: To destroy the uterine lining with heat, cold, or electricity and reduce or stop the bleeding.
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Endometrial resection: To cut out the uterine lining with a surgical instrument and reduce or stop the bleeding.
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Uterine artery embolization: To block the blood supply to the fibroids and shrink them.
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Myomectomy: To surgically remove the fibroids and preserve the uterus.
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Hysterectomy: To surgically remove the uterus and the cervix and stop the bleeding permanently.
Prevention of Menorrhagia
Menorrhagia cannot be completely prevented, but some steps can be taken to reduce the risk or the severity of the condition, such as:
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Maintaining a healthy weight and a balanced diet
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Managing stress and practicing relaxation techniques
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Exercising regularly and moderately
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Avoiding smoking and excessive alcohol consumption
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Following the doctor’s instructions and the treatment plan
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Seeking medical help if the symptoms worsen or persist
