Heavy Menstruation: Identification and Common Causes

Heavy menstruation is a common complaint amongst women and can result from a diversity of causes. Menstrual problems constitute one of the frequent causes of consultation amongst menstruating women. Heavy menstrual bleeding requires medical evaluation to exclude serious but treatable causes. In this article, I consider the definition of heavy menses as well as the common causes. The medical term used to describe this condition is menorrhagia. Quantification of bleeding Normal menstrual flow is generally taken as a total blood loss of about 25 to 80ml during the 3 to 7 days bleeding period. Of course no one ever actually measures this volume in daily life or in the hospital. By definition, bleeding above 80ml is considered heavy bleeding. To know this in practice, women often estimate their bleeding by the number of pads or tampons used as well as the degree to which they are soaked with blood. It is therefore important for each woman to know herself, that is, know what is normal menstrual blood loss for her so that she can easily recognise an abnormality. Common clues that should point to a possible heavy bleeding or menorrhagia include menstrual flow that soaks through one or more sanitary pads or tampons every hour,the need to double your sanitary protection to avoid wetting your panties,menstrual periods lasting longer than seven days and others. A consistent feature of heavy menstruation or menorrhagia is its regularity. It is predictable and occurs during menses as opposed to inter-menstrual bleeding or metrorrhagia. Causes of menorrhagia The most common cause of heavy menstruation is Dysfunctional Uterine Bleeding. This is a hormonal imbalance, frequent in the adolescent or perimenopausal period. there is usually no structural abnormality found with the genital organs. Other causes include

• Uterine growths such as fibroids and polyps. These are noon-cancerous growths which are usually not complicated to treat. Polyps are small growths from the lining of the uterus.
• Medications. Birth control pills and anticoagulants medications used to treat clotting problems. Birth pills are the usual hormones of menstruation given as pills and therefore can cause hormonal imbalances or excessive growth of the endometrium( hyperplasia).
• Pregnancy-related disorders. Early pregnancy complications include miscarriages, ectopic pregnancy and molar pregnancy. An early miscarriage may appear as a single episode of heavy menses. Women often are not aware of such pregnancies especially if no testing was done.
• Medical conditions. Chronic diseases like thyroid,kidney and liver disorders as well as coagulation diseases like Von Willebrands disease may also cause menorrhagia.
• Cancer of the vagina, cervix or uterus. This is the most feared cause and requires prompt evaluation and treatment.

The causes of heavy menstruation are many and require medical evaluation and appropriate treatment. Home care should not be attempted when the underlying cause remains unidentified.