Long and heavy menstrual bleeding is called menorrhagia in gynecology. A lot of mucous membrane builds up during the monthly cycle and during the menstrual period there is a long and heavy bleeding. The opposite of menorrhagia is oligomenorrhoea (short and weak menstrual bleeding).
What is menorrhagia?
The monthly cycle of a woman of childbearing age is usually twenty-eight days. Four to seven days of this, the woman has her monthly menstrual period, during which the tissue built up over the month for pregnancy is shed. See AbbreviationFinder for abbreviations related to Menorrhagia.
If this pregnancy does not take place, this superfluous tissue is removed again under complicated hormonal processes. This process repeats itself from the first menstrual period in early puberty to the last before menopause, the so-called menopause. Most women have little discomfort with their menstrual period, but some experience heavy, painful bleeding.
This can be due to various reasons such as benign and malignant changes in the uterus or endometriosis. But menorrhagia also occurs as a result of hormonal disorders and a changed condition of the uterus after multiple births or abortions.
If cysts, abscesses or tumors have formed on and in the uterus, this can lead to increased menstrual bleeding. But even early stages of cancer can cause these symptoms. Endometriosis is a special case among menstrual disorders.
Due to hormonal imbalances, uterine tissue builds up throughout the woman’s body. This serious and chronic condition needs to be monitored and treated by a gynecologist. Hormonal imbalances can lead to increased menstrual bleeding, creating an imbalance between progesterone and estrogen. Women who have already given birth to several children tend to have increased and prolonged menstruation.
The uterus is usually enlarged and builds up too much tissue during the menstrual cycle. The same symptoms often occur in women who have suffered one or more miscarriages. In addition, infections with viruses, fungi, bacteria and protozoa can lead to menstrual disorders.
Symptoms, Ailments & Signs
Menorrhagia is characterized by long and heavy menstrual bleeding, resulting in a blood loss of more than 80 milliliters. Normally, this averages 60 milliliters. The greater loss of blood in menorrhagia is caused by a longer prolongation of the bleeding phase, ranging from 7 to 14 days. The bleeding is often heavier at the same time.
With a combination of prolonged bleeding and heavy bleeding, the woman can lose up to 150 milliliters of blood during this phase. While it is not a life-threatening condition, the constant loss of blood can severely limit quality of life. Symptoms are usually chronic tiredness, exhaustion and exhaustion.
It can also lead to circulatory problems, with blood pressure often being too low. The loss of blood also leads to anemia because the body’s own blood cannot be reproduced so quickly. Since iron is an inherent part of hemoglobin, blood loss also causes iron loss at the same time. This also inhibits further blood formation.
As a result of anemia, there is also an increase in susceptibility to infections. In some cases with severe blood loss, the passage of thick blood clots is also observed. In addition to tiredness and listlessness, menorrhagia often becomes a burden in everyday life, at work and above all in sex life for many women. This can also lead to depression and psychological problems.
As with all disease diagnoses, the doctor-patient conversation, i.e. the anamnesis, is also the top priority for menorrhagia. In the further course, the doctor can then use the following examination methods, depending on the suspicion and indications:
- tactile examination
- pregnancy test
- Examination of the cervix and vagina
- Cancer examination using smear and colposcopy
- Magnetic resonance imaging ( MRI ) or computed tomography ( CT )
- blood test
- Examination of the hormonal balance
Complications of menorrhagia can result from excessive blood loss. In the case of both very heavy and very long menstrual bleeding, women can lose so much blood that, on the one hand, circulatory problems can result. Since these are not based on any fundamental disease value, minor circulatory problems do not require separate medical treatment.
Iron deficiency can be more serious. Severe blood loss causes iron levels to drop rapidly. The limit here is an iron value of about 12. If this falls below this, symptoms such as paleness, tiredness, difficulty concentrating and general weakness can occur. An iron deficiency also promotes the occurrence of infections, since the immune system is restricted in its performance in the event of a permanent iron deficiency.
Iron has important functions in blood formation and should therefore be substituted accordingly. Since an oversupply of the body with iron can be just as critical as a deficiency, an iron deficiency should also be diagnosed before taking the appropriate preparations. In the context of menorrhagia, the gynecological check-up should be used. In rare cases, menorrhagia is the result of a tumor in the tissues of the uterus, which then leads to complications such as infertility or spread to other organs.
When should you go to the doctor?
Menorrhagia is not only uncomfortable, but also a reason to see a doctor. Even if it occurs for the first time, a doctor should clarify why the menstrual period lasted so long. The causes are often treatable, but if ignored, menorrhagia will recur and have a significant long-term impact on the patient’s health. The doctor will first ask how often menorrhagia has already occurred, whether other symptoms and complaints have occurred in the meantime and whether anything has changed in the discharge itself.
Depending on the suspicion, blood or tissue samples are then taken to find out whether it is a tissue change or a hormonal disorder. In connection with a newly taken hormonal contraceptive, it can already help to stop this in consultation with the gynecologist and try an alternative instead. There is nothing wrong with seeing a doctor if menorrhagia occurs while the bleeding is still in full swing. This is not a problem for an examination and in the doctor’s office there are enough possibilities for the patients to clean themselves after the examination.
Treatment & Therapy
Different causes of menorrhagia require different treatments. First, the doctor will try to stop the excessive bleeding by using medication. If cysts or cancer are suspected, tissue samples are taken afterwards or possibly during the bleeding and examined in a laboratory.
Depending on the result, cysts are removed or surgery to remove cancerous growths is required. This can also lead to chemotherapy or radiation. At the slightest suspicion of cancer, the gynecologist will act very quickly, since metastases can form through scattered tissue.
If the menorrhagia is caused by hormonal disorders, the doctor will try to treat them with hormone preparations or homeopathic medicines. In addition, taking the so-called contraceptive pill, which reduces menstrual bleeding to a minimum, can also be considered here.
In women who have given birth several times or who have had miscarriages, a uterine curettage should be considered. Excess tissue is removed to allow the mucosa to completely rebuild. However, this method is only used in rare cases, since scars form in the uterus, which can further aggravate the menorrhagia.
In the case of infectious diseases of the genitals, the gynecologist will treat the underlying condition with oral and local medication, whereby the sexual partner usually has to be treated as well.
Outlook & Forecast
In the case of menorrhagia, further health development is largely linked to the cause of the long and heavy menstrual period. The prognosis can be good or very unfavorable. If the course of the disease is favorable, the cause can be found in the area of emotional complaints. If there is a high level of sensitivity and the presence of various stressors, the symptoms will often be alleviated if there is an improvement in lifestyle, a change in thinking and psychotherapeutic help.
Spontaneous healing cannot necessarily be assumed for this disorder. It can occur when the bleeding is linked to experiencing a temporary exceptional situation. However, an unfavorable course of the disease can also lead to premature death. Disturbance of menstrual bleeding can indicate the presence of cancer. If no medical care is initiated or if cancer treatment is only initiated at an advanced stage of the disease, patients are threatened with a shortened average lifespan.
In the case of other tissue changes such as cysts or abscesses, freedom from symptoms is usually achieved if they are completely removed in a surgical procedure. In the course of life, irregularities in menstrual bleeding can occur again up to the onset of menopause. The prognosis remains unchanged if the symptoms return.
There are prophylactic measures to prevent some forms of menorrhagia. Responsible use of contraception can save women from having an abortion. Breastfeeding the baby after birth has a direct impact on the normal size of the uterus. Infections of the urogenital tract are very often caused by changing sexual partners and poor hygiene. Infection with the HP virus can be prevented by vaccination or condoms. Regular preventive examinations of the vagina, uterus and ovaries save many women from cancer or it is detected early and treated in good time.
Long and heavy menstrual bleeding can be associated with above-average blood loss. The acute consequences can be severe circulatory problems. Those affected then complain of nausea, dizziness, tachycardia and severe drowsiness. This can lead to complications in everyday situations such as driving a car or make it difficult to concentrate on your job. If you lose blood often and for a long time, you may also develop an iron deficiency.
Therefore, succession focuses on making up for blood loss. Affected women should regularly have the corresponding blood values clarified by their gynaecologist. Special preparations can compensate for iron deficiency and thus prevent long-term consequences. Mennorhagia can also lead to psychological complications.
Long and heavy bleeding sometimes severely restricts the everyday life of those affected and does not allow unrestricted social situations. Social withdrawal and even depression can result as psychological complications. It can be useful to discuss this extensively with the doctor treating you. From these points of view, too, it is important to have mennorhagia clarified by a doctor and treated in a targeted manner.
You can do that yourself
In addition to physical causes, psychological stress can also trigger menorrhagia. A healthy lifestyle with a balanced diet and regular exercise in the fresh air, learning relaxation techniques to reduce stress and getting enough sleep have a positive effect on the menstrual cycle and improve mental and physical well-being.
Herbal medicine knows numerous medicinal herbs that are mostly used as a tea preparation against heavy and long menstrual bleeding: These include lady ‘s mantle, shepherd’s purse, chaste tree and raspberry leaves. Cinnamon, cayenne pepper, and coriander seeds can be used as a spice or infusion to help stop heavy bleeding. Menorrhagia should ensure adequate intake of magnesium, iron and vitamins B, C and Emust be taken into account, as these micronutrients influence the production and function of hormones and blood cells. Fresh fruit and vegetables, legumes, whole grain products and nuts are rich in vitamins and minerals – food supplements should only be used in exceptional cases.
Cold compresses help reduce blood flow and pain: They can be applied to the lower abdomen for about 15 minutes up to four times a day. If the cold application on the stomach is uncomfortable, footbaths with cold water or cooling calf wraps are an alternative. Over-the-counter anti-inflammatory painkillers can also reduce blood flow. If self-treatment has no effect, a gynecologist should be consulted.