Heavy Menstrual Bleeding

Facts About Heavy Menstrual Bleeding

  • Bleeding at regular intervals and normal, but with an increased duration (over 8 days) and / or the amount (more than 80 ml per minute. Menstruation)
  • Symptoms related to the physical, mental and social genes by very heavy bleeding
  • Often found no identifiable cause
  • May be due spiral, hormone disorders, fibroids, increased bleeding, blood thinners. Cancer is found not in regular bleedings
  • Treatment is directed at the cause and to ensure a normal blood percent

What is heavy menstrual bleeding?

  • Termed in the jargon as menorrhagia
  • Bleeding with regular and normal ranges, but with:
    • Increased duration (over 8 days) or
    • Increased blood volume (more than 80 ml per minute. Menstruation)


  • Strong menstrual bleeding is frequent, but there are no precise figures. A US study found that women aged 18-50 years reported abnormal bleeding annually on 53 of 1000. Only part of these will be heavy menstrual regularity

What can lead to menorrhagia

  • Often found no identifiable cause, although you will be thoroughly investigated
  • In young girls
    • Can endocrine disruption the first time after that period is up and running, be a reason. Use of copper coil can also lead to long periods
    • Increased bleeding can occur with the heavy bleeding from the first menstrual
  • In women older than 30 years
    • Fibroids or polyps in the uterus is a frequent cause
  • During menopause
    • May be due to hormonal disturbances – but irregular bleeding is more frequent
    • Fibroids and polyps can also lead to increased and prolonged bleeding – in some cases, bleeding between periods. If the bleeding is completely regular, cancer is not likely

What can be the reason?

Common causes

  • Harmless endocrine disruption
    • Frequent among young girls
    • Also common in women in their 40s
    • Often irregular bleeding
  • Fibroids in the uterus (myoma uteri)
    • Is a frequent cause
    • Increased incidence with increasing age, but muscle knots is usually less after menopause
    • Often no symptoms other than severe bleeding
    • They can be discovered by chance or because they cause severe and frequent menstrual periods, pressure symptoms, difficulty in urination, defecation difficulties
    • Smaller fibroids and polyps, which sits inside the womb, can not feel at a regular gynecological examination
  • spiral
    • Ordinary copper coil generally provides stronger bleeding
    • hormone Spiral , by contrast, less bleeding and in some stops bleeding quite
  • Generally, increased bleeding
    • There are other signs of increased bleeding as bleeding of the skin and nose bleeds
    • Optionally, the use of blood thinners which aspirin or warfarin

No identifiable cause

  • Often menstruation stronger with age, in absence of an obvious cause
  • It is believed that a contributing cause of heavy bleeding is the changing of substances that affect blood coagulation (clotting) and contraction of the small blood vessels locally in the uterine lining

rare causes

  • Uterine cancer (endometrial cancer)
    • May cause bleeding and vaginal discharge in women after menopause or irregular bleeding in women before the changeover. Is rarely seen before the age of 40. Cancer is not a likely diagnosis during heavy, regular bleeding
  • High metabolism (hyperthyroidism)
    • Normal symptoms are palpitations, fatigue, nervousness, irritability, weight loss despite good appetite, sweating, heat intolerance. Provides usually rare menstruation
  • Low metabolism (hypothyroidism)
    • Typical symptoms are lack of initiative, cold intolerance, muscle pain, increased need for sleep, lighter weight gain, constipation, dizziness, loss of hair, unclear voice and in some heavier menstrual bleeding
  • Congenital or acquired defects between the arterial and venous circuits. If bleeding becomes heavier in connection with invasive examination, strengthens the suspicion
  • You can not do anything
  • Any bleeding after menopause, i.e., bleeding coming a year or more after the last menstrual period, should be examined by doctor
  • Sustained strong menstrual bleeding, either troublesome or causes fatigue, should be investigated
  • At such heavy bleeding that it provides acute malaise

What does the doctor?

Medical history

Questions the doctor may ask you:

  • What is menstruation?
    • Have they changed compared to the past?
    • How long do they last, how often do they?
  • Amount?
    • Do you bleed through the bandage?
    • How often switch Volume / tampons?
    • If switching at night?
    • Is there blood clots (clots)?
  • How does bleeding your daily life?
  • Do you use spiral?
  • Do you have other diseases?
  • Do you have pain during menstruation
  • Have you increased tendency to bleed from other places?
    • From the nose?
    • Sheep easy bruising?

medical examination

  • The doctor will usually perform a gynecological examination of the uterus and ovaries. If you have not fully screening program with cell samples every 3 years, can a doctor take a Pap smear
  • On suspicion of other underlying disease may need a more comprehensive study

other studies

  • For heavy bleeding measured hemoglobin level to see if you have developed anemia

Referral to a specialist or hospital

  • You are referred to a specialist if the diagnosis is unclear
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