Menorrhagia or Heavy Menstrual Bleeding

What is heavy menstrual bleeding?

Heavy menstrual bleeding (menorrhagia) means that the bleeding is regular but you bleed more powerful and possibly. for longer than normal. It can be hard to know if you bleed more powerful than you have to. However, it is within the normal if you bleed for 7 days. Most bleed most in the beginning of menstruation. If you bleed with chunks larger than a walnut, make up and change the volume at night or often bleed through your clothing, menstruation be so troublesome that there is reason to seek medical attention.

How frequently are strong menstrual bleeding?

It is a frequent problem, occurring in 15-20% of menstruating women. In the course of a year it is estimated that 5% of all women aged 30-49 years seeking medical due to heavy bleeding.

What causes menorrhagia?

Menstruation are becoming stronger with age. In some they are heavy bleeding so annoying that affect quality of life. The blood loss can lead to anemia and fatigue.

Heavy periods are not signs of cancer. Often there is no obvious explanation for the strong bleeding. If you have had heavy bleeding ever since her first period, one can have a reduced clotting in the blood, for example. the hereditary condition of von Willebrand’s disease . In that case, you often other signs of increased bleeding. One gets such. easy bruising. With age increases the risk of developing fibroids (myomas, fibroids) in the womb. They are harmless, but if they sit close to the uterine lining, they can cause heavy periods. By fibroids in the uterus  can also have a feeling of heaviness in the abdomen and frequent urination. There can also get polyps in the lining of the uterus. 99% of these are benign, but they can also cause bleeding, particularly with exertion.

The doctor can detect more myomas by gynecological examination. Smaller fibroids which sits inside the uterine cavity and polyps in the lining, can not be felt by an ordinary gynecological examination.

Using copper coil causes increased bleeding volume, especially in connection with the first menstruation after insertion. IUS other hand, allows reduced bleeding amount and is a good treatment of heavy bleeding.

Heavy bleeding can also be caused by metabolic disorders ( hyperthyroidism , hypothyroidism ). A few drugs, particularly blood thinning medications and acetyl salicylic acid may also cause heavy bleeding.

What are the symptoms of menorrhagia?

Heavy menstrual bleeding.

What symptoms should you pay particular attention to?

If the bleeding is so powerful that your hemoglobin is low and you experience dizziness or fainting.

How is it diagnosed?

The doctor will perform both a general and a gynecological examination and measuring the hemoglobin percentage. On suspicion of metabolic disease or increased bleeding, you will also have taken other blood tests.

Ultrasound examination is relevant if the doctor suspects the disease in the uterus, such as fibroids. On suspicion of polyps or fibroids inside the uterus, a keyhole examination of the uterus become current.

What treatment is there?

It is usually not necessary to treat mild cases of menorrhagia. Whether to treat or not depends on how bothered you are and whether you develop anemia (anemia).

• The most effective treatment is hormone spiral . The spiral contains the hormone progestin, which causes the lining of the uterus does not grow. Therefore, menstruation less potent. The hormone IUD is also very safe contraception and reduces menstrual pain. Hormone Spiral is like the first choice in women who have no immediate desire pregnancy
• Progestogens as mini-pills  , or p-rod  can reduce the bleeding amount . Instead of the heavy bleeding may develop irregular spotting. Gestagentabletter must be taken every day to work
• The pill  is used in younger women and make bleeding less, of shorter duration and reduces any menstrual pain
• Arthritis Pills (NSAIDs) reduces blood loss and must be taken three times daily for the first three days of menstruation. They reduce blood loss by 20-50% and also has a good effect on menstrual pain
• Tranexamic acid  is a blood clotting substance, which prevents heavy bleeding of many. This agent used in tablet form, while the bleeding is ongoing – often the first 3 days of menstruation. They will in many effectively reduce the amount of bleeding
• If the body’s iron content is low, you develop anemia. In these cases, treatment with iron supplements

In women with an ordinary (not hormone) and heavy bleeding spiral, the spiral should be removed or replaced by an IUS.

In most cases the problem can be solved or ameliorated by medical treatment or advice. If the medical treatment is not sufficient and the genes are expressed, may be a last resort to remove the endometrium (endometrial ablation) at a smaller engagement through the cervix. This can often be performed under local anesthesia and ambulatory. The last option is to remove the entire uterus by surgery.

How is long-term prospects?

There are several good treatment options.

How do I avoid or aggravate menorrhagia?

You can not even do anything to prevent menorrhagia.