Heavy menstrual bleeding, or menorrhagia refers to menstrual bleeding that is either prolonged or excessive or sometimes both. Frequently, heavy menstrual bleeding is seen in women who are premenopausal, but it can occur at any age. It is not uncommon for a woman to experience a few heavy menstrual bleeding episodes. Repeated incidences of menorrhagia, however, should be medically evaluated to rule out abnormal gynecological conditions.
Typical causes of heavy menstrual bleeding include uterine fibroids, which are benign uterine tumors. Fibroid tumors may cause excessive or prolonged bleeding and may be accompanied by abdominal cramps and backache. In addition, hormonal imbalances may cause the lining of the uterus to thicken. When this occurs, shedding of the lining may cause heavy menstrual bleeding. Sometimes uterine polyps may cause abnormal menstrual bleeding. These occur most often because of elevated hormone levels.
Frequently, medications can contribute to heavy menstrual bleeding. Medications such as aspirin or anticoagulants can thin the blood, contributing to heavy menstrual blood flow. Heavy bleeding may also signal a complication of pregnancy. Rarely, ectopic pregnancies can cause heavy menstrual bleeding. In addition, certain bleeding disorders that do not allow the blood to clot properly may promote menorrhagia.
It is very important to get a physical examination that includes a pap smear and a pelvic examination to determine the cause of heavy menstrual bleeding. Sometimes excessive blood loss during the menstrual period may be related to uterine, cervical or ovarian cancer. Blood loss can sometimes be so great that the patient may become severely anemic. When severe anemia occurs, the patient may experience extreme fatigue, dizziness and heart palpitations.
Generally, during a physical examination, the physician will inquire about past and present illnesses, medications and family history. In addition, the patient may undergo further testing, such as blood tests and thyroid tests. A diagnosis of hypothyroidism can frequently cause heavy bleeding during menstrual periods. In addition to blood tests, other diagnostic tests may include a pelvic ultrasound and an endometrial biopsy.
Common treatments for heavy, abnormal menstrual periods may include hormones and iron supplementation. A dilation and curettage or D and C, where tissue is removed from the uterus, may reduce heavy bleeding. Sometimes, endometrial ablation may be performed to ablate the lining of the uterus and decrease blood flow. In extreme cases, the physician may recommend a hysterectomy which will cause the patient to undergo surgical menopause, resulting in complete termination of menstrual periods.