Heavy bleeding during periods is not uncommon. In fact, in the initial days, the flow is usually a bit much, until the body adjusts to the cycles. But there comes a time when if you experience unusually heavy bleeding, you must check with a doctor.
Dr Amit Kamat, consultant obstetrics and gynecology, Fortis Hospital, Kalyan explains that when the cycle begins, it is normal for periods to be heavy or irregular. “Periods are not associated with ovulation right when they start, as the hormones that monitor it have not quite found their space yet. An occasional heavy flow is not bothersome,” he says.
When does heavy bleeding become a problem?
Heavy Menstrual Bleeding (HMB)
It is clinically referred to as menorrhagia. A woman usually experiences loss of menstrual blood which is greater than 60 – 80 ml per cycle in this condition. Its occurrence increases with age, and can be a sign of an underlying health problem that needs treatment, says Dr Kamat, adding that HMB can cause the patient to become anemic. “It is also important to check on problems like low blood platelets.”
What causes menorrhagia?
It affects about 1-5 women and is a common problem in the 30-50-year age group. About 50 per cent of women with heavy menstrual bleeding have no abnormalities in their uterus. It may be related to hormonal or chemical levels in the endometrium (the internal lining of the uterus) or conditions not yet identified.
“In the other 50 per cent, it is related to fibroids, cancer, pregnancy problems such as ectopic pregnancy, pelvic inflammatory disease, polycystic ovary syndrome (PCOS) or use of intrauterine device (IUD).”
When to call your doctor?
The doctor says bleeding lasting for more than seven days, or the need to change pads every hour or so, is a signal to call your doctor. Spotting can also be an issue and certain symptoms may look like other medical conditions.
To make correct diagnosis, your doctor may advise:
– Blood tests for disorders like anemia, thyroid and clotting
– Ultrasound for checking the uterus, ovaries and pelvis
– Pap smear to check on cervical infection, inflammation, dysplasia and cancer
– Endometrial biopsy to evaluate the lining of the uterus
– Hysteroscopy to inspect the uterus lining
“The cause will define the treatment. Your doctor will look at medical history, lineage, general health and other factors before beginning treatment,” Dr Kamat says.
* Birth control pills can help regularise periods and reduce the bleeding.
* Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) can treat dysmenorrhea (painful menstrual cramps) and help reduce blood loss; sometimes these may increase the risk of bleeding.
* Oral contraceptives can regulate menstrual cycles and reduce episodes of excessive or prolonged bleeding.
* Iron supplements to treat anemia
* Dilation and Curettage (D&C) is a surgical procedure for scraping the lining of the uterus.
* Uterine artery embolization to treat fibroids, which cause heavy bleeding, by blocking the arteries that feed them.
* Hysteroscopy involves inserting a camera into the uterus to evaluate the lining, assisting in the removal of fibroids, polyps, and the uterine lining.
* Myomectomy is a surgical intervention to remove uterine fibroids through several small abdominal incisions, an open abdominal incision, or through the vagina.
* Hysterectomy to remove the uterus.
“While common, there is a lack of knowledge about heavy menstrual bleeding. Some women are hesitant to talk about it. Talking to a healthcare professional is important to make the correct diagnosis and begin treatment,” Dr Kamat concludes.