Causes and treatment of heavy periods (menorrhagia) – Part I

Q: What can be causing my heavy monthly periods?

Introduction

The medical term for abnormally heavy or prolonged periods is menorrhagia.

Menorrhagia can often be quite debilitating. It is associated with heavy blood loss and (severe) cramps. As a result, it is not unusual for such persons to be unable to attend work or perform basic household chores at the time of their monthly cycle.

However, this does not have to be the case, for there are several effective treatments.

Commonly associated with menorrhagia

• The need for the frequent change of fully soaked sanitary pads or the doubling of pads or for use of maternity pads.
• Having to change sanitary protection overnight
• Periods extending longer than 7 days
• Passage of large clots
• Having to live life around the menstrual flow
• Being anemic and experiencing associated symptoms – e.g., tiredness, light-headedness, shortness of breath.

Causes

Sometimes no obvious cause can be found for menorrhagia, however, there are several known conditions which can causes heavy monthly periods. These include:

•  Uterine fibroids: One of the most common causes here in the Caribbean. These are non-cancerous growths of the womb (uterus). When they are present under the lining or in the wall of the womb, they often cause heavy or prolonged periods.
• Hormone imbalance. There are two primary hormones which regulate the period. Oestrogen and progesterone. On occasion this fine-tuned balance between these hormones may be disrupted, resulting in excessive buildup of the endometrium (lining) of the womb. The result is heavy periods when this excessively thickened lining is shed.

Certain conditions result in hormone imbalances – e.g. PCOS (polycystic ovary syndrome), obesity, pre-diabetes, and thyroid issues.

• Adenomyosis: This is where the lining of the womb (endometrium) grows into the womb’s muscle. This often results in heavy and painful periods.
• Uterine polyps: These are non-cancerous growths of the lining of the womb that can cause heavy or prolonged menstrual bleeding.
• Intrauterine device (IUD): While a highly effective method of contraception, however in some women these devices can cause heavy and prolonged periods.
• Cancer of the womb: Cancer of the womb can cause heavy periods, especially in post menopause women.
• Inherited bleeding disorders: Women who have inherited bleeding disorders can have heavy periods.
• Medications: There are medications which can cause heavy periods – e.g. low-dose aspirin, hormonal, blood thinning (anti-coagulants).
• Several medical conditions: For example, liver and kidney conditions can cause heavy periods.

What Can Be Done To Determine The Cause?

• A thorough medical history and medical examination: The first step in making an accurate diagnosis and arriving at the appropriate treatment is a doctor carrying out a detailed interview and a comprehensive physical examination of the patient.
• Blood tests: Tests checking for anemia, iron levels, thyroid function, clotting disorders and other conditions may be ordered.
• Pap test: This often forms part of the evaluation.
• Endometrial biopsy: Tissue from inside the womb is taken and sent for analysis if an abnormality of the endometrium (lining) is suspected.
• Ultrasound: This is often used to asses the womb, ovaries and pelvis.

(Next week: Treatment)

Author: Dr. C. Malcolm Grant – Family Physician, c/o Family Care Clinic, Arnos Vale, www.familycaresvg.com, clinic@familycaresvg.com, 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp)
Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.