Heavy Menstrual Bleeding

Overview

Heavy Menstrual Bleeding is heavy bleeding of more than 80mL per cycle or which lasts longer than 7 days. Heavy menstrual bleeding which occurs in a cyclic pattern is known as menorrhagia.

Signs and Symptoms

Usage of sanitary pads more than usual, Frequent change of sanitary pads, Bleeding for longer days than usual, Passing blood clots, Pallor, Fatigue, Fainting

Common Causes

Dysfunctional uterine bleeding, Uterine fibroids, Adenomyosis, Chronic tubo-ovarian mass, Pelvic endometriosis, Intrauterine devices, Oral contraceptive use, Hematological disorders, Medications such as anti-inflammatory drugs and anticoagulant drugs, Disturbance in the hypothalamo-pituitary-ovarian-endometrial axis

Risk Factors

Age, Hormonal factors, Presence of bleeding disorders, Certain medications

Investigation Techniques

Full blood count, Vaginal examination, Ultrasound, Pap test, Endometrial biopsy, Hysteroscopy

Treatment and Prevention

Tranexamic acid, Nonsteroidal anti-inflammatory drug (NSAID), Combined oral contraceptives, Oral progesterone, Treating underlying condition

Psychological Issues

Stress, Anxiety, Depression