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Menorrhagia

Menorrhagia is a condition characterised by abnormally heavy or extended menstrual bleeding.

Symptoms

The most common symptoms of menorrhagia are:

  • Menstrual flow that soaks one or more pads per hour for several consecutive hours
  • Needing to change your pad frequently during the night
  • Menstrual periods that last longer than seven days
  • Menstrual flow that includes large blood clots
  • Menstrual flow that is so heavy that it affects your ability to conduct normal day-to-day activities
  • Fatigue, weakness or shortness of breath (symptoms of anaemia that can be brought on due to the heavy blood loss)

Causes

The cause of menorrhagia is not always known; however, there are certain conditions that predispose a person to menorrhagia, for example:

  • Hormonal imbalance
  • Ovarian dysfunction
  • Uterine fibroids
  • Uterine polyps
  • Adenomyosis (where endometrial glands are found in the muscular wall of the uterus)
  • Intrauterine devices (IUDs)
  • Pregnancy complications
  • Cancer
  • Inherited blood disorders
  • Certain medications (anti-inflammatory medications and anticoagulants)
  • Other medical conditions such as pelvic inflammatory disease (PID), thyroid problems, endometriosis, and liver or kidney disease.

Diagnosis

Your doctor can perform a pelvic examination and may recommend other tests or procedures such as a pelvic ultrasound, biopsy, or hysteroscopy.

Treatment

Treatment options will depend on the underlying cause of menorrhagia, the severity of the condition and the overall health of the patient. Some common treatments include:

  • Iron supplements if the blood loss has caused iron deficiency
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to blood flow and cramping
  • Oral contraceptives may be prescribed to help reduce bleeding and regulate menstrual cycles
  • Oral progesterone may be given to help correct hormonal imbalance and reduce blood loss
  • The insertion of an intrauterine device such as Mirena, which thins the uterine lining and reduces the blood flow

Surgery may be needed if medication therapy is not successful.  Some treatments for menorrhagia can affect fertility so consultation with a gynaecologist is essential if you plan to have children in the future.

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