Menorrhagia

Overview

Menorrhagia is an excessive flow or duration of bleeding during menstruation. Women with menorrhagia usually have significant impact in their life due to too much bleeding or prolonged period of bleeding. A patient who has menorrhagia can have a regular and consistent cycle of menstruation but abnormal flow and duration of bleeding.

Signs and Symptoms

Blood soaking through pads or tampons causing the need to change them for every hour for consecutive hours, Need to use more than one sanitary pads at a time to contain the flow, Wake up at night to change sanitary pad or tampon, Prolonged bleeding for more than a week, Signs of anemia

Common Causes

Imbalance hormone, Dysfunctional Uterine Bleeding, Fibroids or polyps in the uterus, Adenomyosis, Using Intra Uterine Device as contraceptive, Bleeding disorder, Uterine or cervical cancer, Side effects of medications, Polycystic Ovarian Syndrome

Risk Factors

Anovulation, Uterine pathology such as fibroids and cancer are more common in older age women

Investigation Techniques

Full blood count, Iron studies, Clotting factors, Thyroid function test, Hormone assays, Pap smear, Ultrasound

Treatment and Prevention

Medical treatment of menorrhagia: Non-steroidal anti-inflammatory drugs (NSAIDs), Tranexamic Acid, Combined Oral Contraceptive Pills, Progesterone only Pills Surgical treatment of menorrhagia: Dilatation & Curettage, Resection of fibroids of polyps, Uterine artery embolization, Endometrial ablation, Hysterectomy

Psychological Issues

Stress, Anxiety