A Simple Guide to Menorrhagia
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What is Menorrhagia?
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Menorrhagia is defined as excessively heavy or prolonged bleeding through the vagina either during menstrual period or any time between menses or after menopause in women.
It is a symptom not an illness.
What is the cause of Menorrhagia?
------------------------------
The cause of Menorrhagia is abnormal uterine bleeding.
The most common causes are
1.hormonal imbalances.
During a normal menstrual cycle, there is a balance between estrogen and progesterone, two female hormones in the body. These regulate the buildup of the endometrium which is the lining of blood and tissuein the wall of the uterus and which is shed each month during menstruation.
Menorrhagia can occur because of an imbalance between estrogen and progesterone.
As a result of this imbalance, the endometrium keeps building up. When it is eventually shed, there is heavy bleeding.
Hormone imbalances are often present in adolescents and in women approaching menopause. This type of menorrhagia also known as Dysfunctional Uterine Bleeding is fairly common in these groups.
2.fibroids and benign tumour of the uterus
Another frequent cause of menorrhagia is uterine fibroids (benign tumours of the lining of the womb).
Together, hormone imbalances and fibroids account for about 80% of menorrhagia cases.
Other causes include
3.cancer of the uterus(endometrial cancer) or cervix
4.inflammation or infection of the vagina, cervix, or pelvic organs
5.polyps which are small growths on the cervical or uterine wall
6.thyroid diseases
7.liver, kidney diseases
8.blood bleeding diseases,
9.the use of blood-thinning drugs
10.stress affects the hormonal imbalance
11.injury or disease of the vaginal opening as a result of intercourse, infection, polyp, genital warts, ulcer, or varicose veins.
12.vaginal injury from insertion of foreign objects, from malignancy, or from infection
13.dry vaginal walls from lack of estrogen after menopause
14.abortion spontaneous or induced
15.stopping and starting birth control pills or estrogens
16.low thyroid function
17.IUD or intrauterine device use for contraception can cause occasional spotting
18.abnormal pregnancy eg.ectopic pregnancy
19.drugs such as oral contraceptives and anticoagulants
20.cervical conization or cauterization procedures
Bleeding may be more serious in women over 50 (post-menopausal) or younger than 12 (prepubertal).
The risk of cancer increases with
1.age.
2.obesity,
3.taking estrogen (without progestin),
4.young women who have not established a regular ovulation cycle,
5.approaching menopause.
What are the Signs of Menorrhagia?
-------------------------------------------
The most common sign is excessive bleeding per vagina.
Make sure that bleeding is coming from the vagina and not from the rectum or in the urine.
Some women may experience paleness and fatigue (anaemia)due to loss of blood.
Women with menses which consistently last more than seven days or whose periods are less than 21 days apart (unless that's normal for the woman) may be required to have a medical examination.
For a married woman or non-virgins,
1.a pelvic exam (examination of the internal reproductive organs),
2.a Pap smear test.
3.blood tests for hormonal changes and bleeding tendencies
4. urine and stool tests for conditions of the gastrointestinal and urinary systems.
5.investigations to determine ovulation
6.pregnancy test may be done if you are sexually active.
7.tests for any sexually transmitted diseases.
8.colposcopy- examination of the inside ot the uterus with a small amount of tissue taken from the endometrium may be taken for testing for canceror hormonal disorders.
Cancer should be ruled out in older women (aged 35-40) or in younger women with longer duration of exposure to unopposed estrogen.
For a non-married woman or virgin, the same examination may be done except care is taken to avoid damaging the hymen.
What is the Treatment of Menorrhagia?
----------------------------------------------
Any underlying medical condition (eg infection,bleeding disease)causing menorrhagia should be treated first.
If a hormone imbalance is responsible for Menorrhagia, hormonal treatment or replacement may be started.
Polyps are generally removed.
Anti-bleeding drugs such as daflon, dicyclone, etc can be given but may not necessarily work.
If the bleeding do not stop in spite all these measures, hysterectomy sometimes may be your only option.
Recently there is a procedure makes use of lasers or microwave technology to remove the lining of the womb (which is the part that bleeds) while leaving the rest of the womb intact.
Fibroids may require myomectomy or hysterectomy.
Hysterectomy and radiation are the usual treatment for endometrial cancer.
Bed rest may be recommended if bleeding is heavy.
The number of pads or tampons used should be recorded (so that the doctor can determine the amount of bleeding). Change tampons regularly, at least twice a day.
To help in relieving menstrual cramps, nonsteroidal anti-inflammatory drugs e.g. mefenemic acid and ibuprofen are prescribed.
The menstrual cycle is not the same for every woman. Menstrual flow occurs about every 28 days, lasts about 5 days, and produces an average of 30 - 40 mls (six to eight teaspoons) total blood loss. The menses may be regular, irregular, light, heavy, painful, pain-free, long, or short, and still be normal. Any variation in the menstrual cycle is medically less important than bleeding, pain, or discharge between menses.
The best prevention of Menorrhagia is having annual pelvic examinations with a cervical smear test (Pap smear).
-----------------
What is Menorrhagia?
-----------------
Menorrhagia is defined as excessively heavy or prolonged bleeding through the vagina either during menstrual period or any time between menses or after menopause in women.
It is a symptom not an illness.
What is the cause of Menorrhagia?
------------------------------
The cause of Menorrhagia is abnormal uterine bleeding.
The most common causes are
1.hormonal imbalances.
During a normal menstrual cycle, there is a balance between estrogen and progesterone, two female hormones in the body. These regulate the buildup of the endometrium which is the lining of blood and tissuein the wall of the uterus and which is shed each month during menstruation.
Menorrhagia can occur because of an imbalance between estrogen and progesterone.
As a result of this imbalance, the endometrium keeps building up. When it is eventually shed, there is heavy bleeding.
Hormone imbalances are often present in adolescents and in women approaching menopause. This type of menorrhagia also known as Dysfunctional Uterine Bleeding is fairly common in these groups.
2.fibroids and benign tumour of the uterus
Another frequent cause of menorrhagia is uterine fibroids (benign tumours of the lining of the womb).
Together, hormone imbalances and fibroids account for about 80% of menorrhagia cases.
Other causes include
3.cancer of the uterus(endometrial cancer) or cervix
4.inflammation or infection of the vagina, cervix, or pelvic organs
5.polyps which are small growths on the cervical or uterine wall
6.thyroid diseases
7.liver, kidney diseases
8.blood bleeding diseases,
9.the use of blood-thinning drugs
10.stress affects the hormonal imbalance
11.injury or disease of the vaginal opening as a result of intercourse, infection, polyp, genital warts, ulcer, or varicose veins.
12.vaginal injury from insertion of foreign objects, from malignancy, or from infection
13.dry vaginal walls from lack of estrogen after menopause
14.abortion spontaneous or induced
15.stopping and starting birth control pills or estrogens
16.low thyroid function
17.IUD or intrauterine device use for contraception can cause occasional spotting
18.abnormal pregnancy eg.ectopic pregnancy
19.drugs such as oral contraceptives and anticoagulants
20.cervical conization or cauterization procedures
Bleeding may be more serious in women over 50 (post-menopausal) or younger than 12 (prepubertal).
The risk of cancer increases with
1.age.
2.obesity,
3.taking estrogen (without progestin),
4.young women who have not established a regular ovulation cycle,
5.approaching menopause.
What are the Signs of Menorrhagia?
-------------------------------------------
The most common sign is excessive bleeding per vagina.
Make sure that bleeding is coming from the vagina and not from the rectum or in the urine.
Some women may experience paleness and fatigue (anaemia)due to loss of blood.
Women with menses which consistently last more than seven days or whose periods are less than 21 days apart (unless that's normal for the woman) may be required to have a medical examination.
For a married woman or non-virgins,
1.a pelvic exam (examination of the internal reproductive organs),
2.a Pap smear test.
3.blood tests for hormonal changes and bleeding tendencies
4. urine and stool tests for conditions of the gastrointestinal and urinary systems.
5.investigations to determine ovulation
6.pregnancy test may be done if you are sexually active.
7.tests for any sexually transmitted diseases.
8.colposcopy- examination of the inside ot the uterus with a small amount of tissue taken from the endometrium may be taken for testing for canceror hormonal disorders.
Cancer should be ruled out in older women (aged 35-40) or in younger women with longer duration of exposure to unopposed estrogen.
For a non-married woman or virgin, the same examination may be done except care is taken to avoid damaging the hymen.
What is the Treatment of Menorrhagia?
----------------------------------------------
Any underlying medical condition (eg infection,bleeding disease)causing menorrhagia should be treated first.
If a hormone imbalance is responsible for Menorrhagia, hormonal treatment or replacement may be started.
Polyps are generally removed.
Anti-bleeding drugs such as daflon, dicyclone, etc can be given but may not necessarily work.
If the bleeding do not stop in spite all these measures, hysterectomy sometimes may be your only option.
Recently there is a procedure makes use of lasers or microwave technology to remove the lining of the womb (which is the part that bleeds) while leaving the rest of the womb intact.
Fibroids may require myomectomy or hysterectomy.
Hysterectomy and radiation are the usual treatment for endometrial cancer.
Bed rest may be recommended if bleeding is heavy.
The number of pads or tampons used should be recorded (so that the doctor can determine the amount of bleeding). Change tampons regularly, at least twice a day.
To help in relieving menstrual cramps, nonsteroidal anti-inflammatory drugs e.g. mefenemic acid and ibuprofen are prescribed.
The menstrual cycle is not the same for every woman. Menstrual flow occurs about every 28 days, lasts about 5 days, and produces an average of 30 - 40 mls (six to eight teaspoons) total blood loss. The menses may be regular, irregular, light, heavy, painful, pain-free, long, or short, and still be normal. Any variation in the menstrual cycle is medically less important than bleeding, pain, or discharge between menses.
The best prevention of Menorrhagia is having annual pelvic examinations with a cervical smear test (Pap smear).
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