Heavy Menstrual Bleeding

Heavy Menstrual Bleeding refers to heavier blood flows during menstrual periods. The medical term for heavy menstrual bleeding is Menorrhagia. Due to prolonged menstrual periods in women, it interrupts normal activities on a day-to-day basis. The bleeding could be prolonged to 7 days or more than that in some of them. The normal blood flow during periods usually varies from one woman to the other. If a woman uses more than 2 or 3 sanitary napkins at once during a period or becomes much weaker, we can say she is having heavy menstrual bleeding. There could be several reasons behind the cause of heavy bleeding in a woman. Here is an excerpt from a video interview with Dr. M.N.V. Pallavi, Chief Gynaecologist, Department of Gynaecology, Omni RK Hospital, Visakhapatnam on Heavy Menstrual Bleeding, its causes and symptoms.

Q. What is Heavy Menstrual Bleeding?

A. Heavy Menstrual Bleeding or Menorrhagia is referred to as abnormal prolonged and heavy bleeding in women during periods. It is the most common issue that we often find in some women. However, the menstrual cycle and the blood flow is not the same in all women. As a result of heavy menstrual bleeding, women get weaker and weaker. Their weakness might be to such an extent that they can’t even handle their routine activities. Due to heavy blood loss and cramps, women couldn’t perform any of their usual chores.

Q. What are the Symptoms of Heavy Menstrual Bleeding?

A. Some of the signs and symptoms of heavy menstrual bleeding could be:

• Bleeding for too many days i.e., for more than a week.
• The requirement to use double sanitary protection to handle the heavy blood flow
• The necessity to wake up in the middle of the night for changing the napkin
• Usage of 2 or 3 napkins every now and then in a day

Q. What are the most common causes of Heavy Menstrual Bleeding?

A. Some women experience heavy menstrual bleeding due to various reasons. It also depends on the early stages or years of their periods. Even during the menopause stage, some of them might confront irregularities in heavy bleeding.

1.Hormonal Imbalances

Mostly, the teenagers and the women between the age group between 25 to 30 years face a lot of hormonal imbalances. As a result, they end up getting irregular periods. In the case of such women, there will be imbalances in Estrogen, Progesterone and other female hormones. The women having a thick lining of the uterus may not get regular periods. Some of them will have irregular and heavy menstrual bleeding for every 15 days a month. Thyroid is another hormonal imbalance problem. High hormone levels or low hormone levels can cause irregularity in the cycle and leads to heavy bleeding during periods.

2. Fibroids

Fibroids are referred to as noncancerous tumors that happen in the lining of the uterus. Fibroids are the small tumors that are found in the uterus. The Uterine fibroids usually cause heavier blood flow than the normal bleeding and also causes prolonged menstrual bleeding. The size of the tumors may vary in women. They could be as small as grape seed or as big as a grapefruit.

3. Polyps

Polyps are quite similar to the fibroids. They are small noncancerous growths formed on the lining of the uterus. The extra growths on the lining can cause heavy and prolonged menstrual bleeding.

4. Pelvic Inflammatory Disease

If there are infections in Pelvis and some other sexually transmitted diseases could cause Pelvic inflammatory disease and leads to heavy menstrual bleeding.

5. Endometriosis

It is another major problem that can cause heavy menstrual bleeding. Besides bleeding, it causes severe pain to the woman during the period. It can also lead to ovarian cysts and they become bigger in size causing much pain. The Endometrial cysts reduce the fertility chances in a woman. Q. How to find out the cause of heavy menstrual bleeding? A. When a woman is suffering from heavy menstrual bleeding, the first thing every doctor does is performing a simple examination. They perform an ultrasound examination to find whether the cause of heavy bleeding is due to fibroid or polyps or hormonal imbalances.

Q. Can we use Painkillers Every Month for Menstrual Cramps?

A. If a woman has heavy menstrual bleeding, they undergo a lot of pain. Yes, one can use painkillers every month for menstrual cramps only if it is a normal pain that every woman has during periods. After confirming that the pain is not related to polyps, fibroids or other problems, one can continue using painkillers.

Q. Does a Person’s Weight Affect Cramps During Periods?

A. Yes, Obesity is one of the main reasons for women having irregularity in periods. Due to hormonal imbalances, they may have heavy menstrual bleeding. This eventually causes cramps during periods of obese women.

Q. Does Period Delaying Medicines Affect the Menstrual Cycle in the Future?

A. It is not good to use period delaying medicines on a regular basis. Upon the doctor’s advice, one can use these medicines occasionally. If you take these medicines regularly then, they may cause imbalances in the periodic cycle.

Q. How does Heavy Menstrual Bleeding Affect a Woman?

A. Heavy Menstrual Bleeding causes severe inconvenience as it affects the woman emotionally, physically and socially. Due to this problem, they become tired and fatigue. It even affects their work and couldn’t take part in some social events. During the periods, they might lose confidence and becomes emotionally depressed. All these aspects affect a woman with heavy menstrual bleeding.

Q. How to Treat Heavy Menstrual Bleeding?

A. One can treat heavy menstrual bleeding by making necessary lifestyle changes. It can be even treated through some medical and surgical options.

Lifestyle changes

A woman must eat right especially 14 days before getting a period. This way, women can prevent lots of hormonal imbalances through proper diet.

• It is advisable to consume grains, fresh fruits and vegetables.
• One must avoid junk food, heavy saturated fats, salt, and sugar. By following this type of diet and making the lifestyle changes, it can prevent the woman from having heavy menstrual bleeding.
• It is also essential to intake iron-rich and vitamin-C foods every month as it prevents women from having anemia.
• The necessary amount of exercise is also required to prevent some problems like premenstrual syndrome [PMS], heavy menstrual bleeding and menstrual cramps. Any form of exercises such as Yoga and exercise can help women.

Medical Options

There are lots of treatment options to treat heavy menstrual bleeding. Surgeries are not required all the time as there are many medical options. Some of the treatments include hormonal and non-hormonal treatments.

1. Non-Hormonal Treatments: In these treatments, women are given medicines to decrease bleeding during periods. It controls the heavy menstrual bleeding. However, it is only for temporary and short-term purposes. Non-hormonal treatments are only for a time being and short-term. Before controlling the problem, one must find out the underlying cause of heavy menstrual bleeding. Only then, it is possible to treat it permanently.

2. Hormonal Treatments: With proper hormonal medications, it is possible to treat hormonal imbalances in a woman. Some of them include contraceptive pills, progesterone supplements and more. These medications control the periodic cycle and prevent heavy menstrual flow. Besides these medications, there are a few latest and effective options. They help in thinning the uterus lining and prevent heavy menstrual bleeding. If the woman isn’t responding to any of these medical options, the final option is to go for a surgical treatment.

Surgical Options

These days, the doctors are mostly preferring minimally invasive or laparoscopic surgeries. They are harmless and painless options. By making less than 1 cm incisions on the abdomen, it is possible to make any kind of surgery, nowadays. Fibroids or Polyps: To remove fibroids or polyps, surgeons usually prefer laproscopy or cystoscopy surgeries. Through these surgeries, fibroids can be removed from the uterus that is causing heavy bleeding.

Hysterectomy: If a woman is more than 45 years old and finished childbearing and doesn’t want to take a risk of having fibroids in the uterus then, surgeons will perform Hysterectomy. This surgery removes the uterus in the woman and it is an effective way to prevent fibroids coming back in the future. This type of surgery is done only if the woman doesn’t want any more children. It is also done through laproscopic procedures. After the surgery, the woman can get discharged from the hospital in about one or 2 days.

Q. Is there any connection between Heavy Menstrual Bleeding and UTI?

A. No, UTI is referred to as Urinary Tract Infection. A woman will have some infection while passing urine. She might get pain during urination. On the other hand, heavy menstrual bleeding means excess blood flow during periods. So, there is no way a relation between these two.

Q. Does Veganism affect Menstrual Health?

A. Veganism is nothing but a type of vegetarian diet that includes a completely vegetarian food. It doesn’t include eggs, dairy products, meat and other animal-derived ingredients. As of now, there are no studies to prove Veganism affects menstrual health. However, drastic changes in one’s diet definitely affect the menstrual health in women as they bring hormonal changes. One must ensure that they follow a wholesome and nutritious diet. Regardless of a vegan or non-vegetarian diet, one must intake nutritious food. Make sure that you consume moderate food instead of taking excess nutritious food. Follow your diet according to your doctor or dietician’s suggestions.

Q. Is it normal to feel extreme emotions before or during periods?

A. Yes, it is referred to as PMS or Premenstrual Syndrome. When a woman is about to get periods, there will be several hormonal changes. They might affect every part of the woman’s body and sometimes, they affect their brain. During the period, a woman undergoes several ups and downs and becomes edgy. Sometimes, PMS could lead to severe depression and the worst condition is suicides. In such a case, a woman should consult a doctor and take the best treatment. A little bit of irritation is quite common during periods. With proper diet and exercise, one can overcome these conditions.

Q. What Medical Problems does a PCOD Woman Get?

A. PCOD is known as Polycystic Ovarian Disease or PCOS [Polycystic Ovary Syndrome]. It affects a lot of things in a woman and affects the rest of the body as well. A woman with PCOS may develop some health problems such as diabetes, increased cholesterol levels [abnormal lipid profiles], coronary arteries [heart diseases], endometrial cancer [Doesn’t have regular periods and it leads to massive uterus lining thickness]. All these are the major risks that a woman might get in the future. It is difficult for a PCOS woman to get pregnant. Even if she gets pregnant, there are higher chances of getting miscarriages. During pregnancy, she might even have hypertension, diabetes and other problems. So, women with PCOS must and should take the best care in their lifestyle. With a proper and healthy diet, normal weight maintenance and exercises, one can help regularize their cycles.

Q. When Women should consult a Gynaecologist regarding menstrual changes?

A. One must understand between a normal and abnormal menstrual cycle. Every woman has their own cycle and it varies during her lifecycle. Any cycle between 28 to 35 days is considered normal. Each month, a woman having 5 to 7 days of menstrual bleeding is normal. If a woman has the cycle for more than 35 days then, she must see a doctor know the cause. If the woman is bleeding for more than 7 days or bleeding heavier than usual then, it is the time to consult a gynecologist.

Q. How to know the menopause stage in women?

A. If a woman doesn’t get a period for 1 year besides pregnancy then, it is called the menopause stage. If you spot bleeding after 1 year of menopause then, it must be evaluated. One shouldn’t overlook and consult a doctor immediately. It might lead to some cancerous conditions. Bleeding after the menopause stage might be a sign of endometrial cancer or cervical cancer.

Q. Are sweet cravings related to PCOD or Diabetes?

A. Yes, if your family history has diabetes then, you must go check yourself for Diabetes. If you have a regular menstrual cycle then, you must check your sugar level. If you have an irregular cycle then, it could be a sign to PCOD.

Q. How could men support women during these stages?

A. Men should understand that women go through a lot of emotions due to hormonal imbalances. They don’t do it ostensibly but, they tend to be edgy and irritable due to the changes. Men’s support in the form of warm gestures, taking care of the household chores during a woman’s period will definitely help them through these stages.