Excessive bleeding during menstruation

 Excessive bleeding during menstruation or periods is quite common in women, so many people consider it normal.  But this problem affects daily life.  If excessive bleeding goes untreated for a long time, it can disrupt normal life.


 It can also cause anemia.  Anemia can lead to various health problems ranging from weakness, which may become complicated in the future.  Therefore, if there is a problem of excessive bleeding during the period, it is important to take the doctor's advice at the right time.


 There is no specific reason behind excessive menstrual bleeding.  But some diseases of the uterus and ovaries like fibroids or endometriosis can cause this problem.  Therefore, if there are symptoms of excessive bleeding, treatment should be started after conducting tests as per the doctor's advice.  Treatment options include medications, some methods of birth control, and various operations. 


How much bleeding during menstruation is considered excessive:



 Excessive bleeding is difficult to define precisely, as symptoms vary from person to person.  What appears to be excessive bleeding to one may be normal to another.


 Menstruation usually lasts 2-7 days or an average of 5 days.  Most women bleed around 6-8 teaspoons on an average during menstruation.  Bleeding up to 16 teaspoons or 80 milliliters is considered normal.



Symptoms of excessive menstrual bleeding in

 Every month if—


 Bleeding of 80 ml or more or

 Menstruation lasts more than 7 days or

 Both things happen

 Then excess bleeding is assumed to be occurring.


 However, there is usually no need to measure the amount of bleeding.  Most women have an idea of ​​how much menstrual bleeding is normal for them.  They may notice any changes in the amount of bleeding.



 For ease of understanding, check if the following four things are happening—


1)Need to change sanitary products (tampons, pads) every 1-2 hours

 2) Blood clots larger than 1 inch or dark

 3) Bleeding on the bed or clothes, especially at night when the pad gets wet during sleep and stains the clothes or bed.

 4) Requiring the use of two sanitary products together.  For example: 2 pads or 1 tampon and 1 pad.




 Write down the number of pads or tampons you use on which days of the month, matching the information in the column on the left.  In this case, the day of onset of bleeding is considered as the 1st day of menstruation. This May Asked by your doctor.




How much bleeding during menstruation is considered excessive: 



 Excessive bleeding is difficult to define precisely, as symptoms vary from person to person.  What appears to be excessive bleeding to one may be normal to another.


 Menstruation usually lasts 2-7 days or an average of 5 days.  Most women bleed around 6-8 teaspoons on an average during menstruation.  Bleeding up to 16 teaspoons or 80 milliliters is considered normal.




 

 For ease of understanding, check if the following four things are happening—


 1) Need to change sanitary products (tampons, pads) every 1-2 hours

 2) Blood clots larger than 1 inch or dark

 3) Bleeding on the bed or clothes, especially at night when the pad gets wet during sleep and stains the clothes or bed.

 4) Requiring the use of two sanitary products together.  For example: 2 pads or 1 tampon and 1 pad.

 





When to consult a doctor

 if—



 Worry about bleeding

 Bleeding increases

 Other menstrual problems occur, such as abdominal pain or bleeding between periods

 Then go to the doctor.  The doctor will do some physical examination to know your disease and overall health.  If necessary, he will suggest blood tests and other tests.


 Causes of excessive menstruation

 In half of women who experience excessive bleeding during periods, no specific cause can be found.  However, several diseases and certain medical procedures can be responsible for this problem.


 The inner wall of the uterus is called the endometrium.  During menstruation, this layer is released through the vagina, which is seen as bleeding.  New levels are formed again in the next few days.  This process continues in cycles.


 The balance of two hormones, estrogen and progesterone, regulates this cycle.  If this balance is disturbed for any reason, the endometrium may thicken.  Then the amount of bleeding increases than normal.  The imbalance of these two hormones plays an important role in heavy menstruation due to various diseases and treatments.


 Some of the diseases and treatments responsible for excess menstruation are-


Diseases of the uterus and ovaries



 Fibroids: These are tumors that grow in the uterus.  These tumors usually do not turn into cancer.  Fibroids can cause various problems including abdominal pain, excessive bleeding during menstruation.


 Endometriosis: In this disease, tissue like the lining of the uterus is transplanted outside the uterus (eg fallopian tubes or ovaries).  Although pain is the main symptom of this disease, it can also be accompanied by heavy period bleeding.


 Adenomyosis: In this case, tissue like endometrium grows inside the wall of the uterus.  This can cause abdominal pain along with excessive bleeding during menstruation.

 Pelvic Inflammatory Disease (PID): Infection of the reproductive tract causes inflammation of the uterus, fallopian tubes, and ovaries.  Symptoms of this disease include abdominal pain, bleeding after intercourse or between periods, foul-smelling vaginal discharge, and high body temperature.


 Endometrial polyp: It is a type of growth inside the uterus or cervix.  These growths are not usually cancerous, but can be responsible for heavy bleeding.


 Cancer of the uterus: Also called endometrial cancer.  The most common of the symptoms is abnormal menstrual or vaginal bleeding.  It is especially common after menopause or permanent cessation of menstruation.


 Polycystic Ovary Syndrome (PCOS): This is a known disease.  This disease disrupts the normal function of the ovaries.  This results in irregular periods and may lead to excessive bleeding after menstruation resumes.


 Other Illness:



 Blood clotting disorders.  For example: Von Willebrand disease (Von Willebrand disease).

 

 Thyroid disease.  

 

Hypothyroidism is a disease of the thyroid gland in which the gland fails to secrete enough hormones.  As a result, problems like fatigue, weight gain, depression and excessive menstrual bleeding occur.



 Diabetes

 Side effects of medications and treatments

 Heavy period bleeding is a side effect of some medications and birth control methods.  For example –


 IUD (Intrauterine Contraceptive Device) or Copper T: It is a birth control method.  Excessive bleeding may occur during the first three to six months after copper is inserted into the uterus.


 Medications to prevent blood clotting: These medications include low-dose aspirin, warfarin, heparin, and rivaroxaban.


Cancer treatment: Some drugs used in chemotherapy.



 Various Herbal Medicines: Herbal supplements like Ginseng, Ginkgo and Soya mainly affect the body's hormones.  As a result menstruation may also be affected and excessive bleeding may occur.



Treatment of excessive menstrual bleeding

 There are various treatments available to stop excessive menstrual bleeding.  The doctor will determine the most appropriate treatment method based on various factors, including the cause of excessive bleeding, the patient's overall health status and preferences.


 Many people develop iron deficiency anemia due to excess blood loss.  It can be detected through a blood test.  Taking iron tablets is recommended in case of iron deficiency anemia.


 Treatment options for excessive period bleeding include—


 Medicines and birth control methods

 Intrauterine system (ius): This is a small, plastic device that is inserted into the uterus.  It reduces excess bleeding during periods by releasing a hormone called progestogen.

 

 Hormonal medications: Combined oral contraceptive pills (birth control pills) and cyclic progestogen pills.

 Other medications: tranexamic acid and non-steroidal anti-inflammatory drugs (NSAIDs)

 operation

 

 Endometrial ablation: This involves thinning, removing or destroying the lining of the uterus called the endometrium.

 Myomectomy: In this the fibroid is removed from the uterine wall.

 

 Uterine artery embolization: In this the blood vessel supplying blood to the fibroid is blocked, causing the fibroid to shrink.

 

 Hysterectomy: This operation removes the uterus



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