Every month, heavy bleeding affects thousands of Indian women. This results in significant weakness and anemia as well as a great deal of discomfort, incontinence, lost workdays, and exclusion from religious activities. Menorrhagia is a medical condition where menstrual periods are abnormally heavy or protracted, and last for more than 7 days. Although heavy monthly bleeding is not uncommon, it is important to seek a doctor if menorrhagia starts to interfere with personal life and emotional health.
Know the causes
Although there are several factors that can cause menorrhagia which includes fibroids, polyps, a tumour, or even a preexisting disorder. Some of other causes include:
Hormonal imbalances: Dr. Priyanka Suhag, Consultant - Obstetrics & Gynaecology at the CK Birla Hospital (R), Delhi says, “Fluctuations in hormonal levels, particularly estrogen and progesterone, can disrupt the normal menstrual pattern and lead to heavy bleeding.”
Uterine fibroids: Non-cancerous growths in the uterus can cause heavy and prolonged menstrual bleeding. Fibroids can vary in size and number, and their location within the uterus can influence the severity of the bleeding.
Polyps: Uterine polyps are small, benign growths on the uterine lining. They can cause heavy bleeding, especially during menstruation.
Adenomyosis: “This condition occurs when the uterine lining (endometrium) grows into the muscular wall of the uterus. It can lead to heavy menstrual bleeding, severe cramping, and pelvic pain,” Dr. Suhag.
Blood clotting disorders: Certain medical conditions or medications that affect blood clotting can contribute to heavy menstrual bleeding.
Pelvic inflammatory disease (PID): Infections in the reproductive organs, such as PID, can cause inflammation and lead to heavy menstrual bleeding.
Symptoms that mean excess bleeding
Excessive flow that requires more than one period product at a time
Women with menorrhagia may pass large blood clots during their menstrual cycle.
Heavy bleeding can cause fatigue and weakness due to the loss of iron and other essential nutrients.
In some cases, women with menorrhagia may experience shortness of breath due to the loss of blood.
Prolonged and heavy bleeding can lead to anaemia, which can cause symptoms such as dizziness, headaches, and pale skin.
Women with menorrhagia may experience painful menstrual cramps due to heavy bleeding.
Ways to manage
Although it is completely impossible to evade the risk of menorrhagia, there are several management options available for heavy menstrual cycles. In some cases, certain hormones may be added to regulate the cycle. The choice of treatment depends on the underlying cause, severity of symptoms, and the individual's preferences. Some tips to manage this condition include:
Medications: Dr. Suhag says, “Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce menstrual bleeding and alleviate pain. Hormonal medications, such as combined oral contraceptive pills or progestin-only contraceptives, may be prescribed to regulate the menstrual cycle and reduce bleeding.”
Tranexamic acid: This medication helps to reduce heavy bleeding by promoting blood clotting. It is usually taken during the menstrual period.
Intrauterine devices (IUDs): According to Dr.Suhag, “Hormonal or non-hormonal IUDs can be effective in reducing heavy menstrual bleeding. They work by thinning the uterine lining or releasing hormones that regulate the menstrual cycle.”
Surgical interventions: In cases where medications are not effective or appropriate, surgical options may be considered. These can include endometrial ablation (removal or destruction of the uterine lining), uterine artery embolization (blocking the blood supply to the uterus), or in severe cases, hysterectomy (removal of the uterus).
Iron supplementation: “If heavy menstrual bleeding leads to anemia, iron supplements may be recommended to replenish iron levels and address associated symptoms.,” says Dr. Suhag.
Lifestyle modifications: Maintaining a healthy weight, engaging in regular exercise, and managing stress levels can help manage heavy menstrual cycles. Some women find relief through relaxation techniques, such as yoga or meditation.
