How to deal with heavy menstrual bleeding
Heavy menstrual bleeding, medically called menorrhaegia is the excessive or prolonged bleeding during menstruation. This may be an alarming symptom which needs specialist check-up and evaluation and should never be neglected. In my clinical practice, patients often ask me, how they would understand that they are suffering from menorrhaegia and when they need to consult a gynaecologist. A woman should seek a specialist's help when she is having excessive flow of blood in her every cycle needing one or more sanitary pads or tampons every hour for several consecutive hours or need to use double sanitary protection to control menstrual flow or menstrual flow contains large blood clots. Also there may be prolonged flow for longer than seven days. Woman having menorrhaegia may experience some symptoms like tiredness, fatigability, shortness of breath and signs like pallor in face, palm and body skin. When it occurs in young girls, menorrhaegia is mostly caused by inherited bleeding disorders like vitamin K deficiency, deficiency of blood clotting disorders. Common medical conditions like thyroid disorders, hypertension can also lead to heavy menstrual bleeding. Moreover, use of medications like aspirin or anticoagulants like warfarin, pregnancy complications, use of intrauterine device like Copper T and misuse of oral contraceptive pills can cause it. Hormonal imbalance between oestrogen and progesterone, dysfunction of ovaries, benign tumours of uterus like fibroids and polyps and cancer of uterus and cervix can also contribute to heavy menstrual bleeding. While you consult a doctor, the doctor may ask you about your medical history and menstrual cycles. So, it is better to have your menstrual record with you. Specific treatment of menorrhaegia depends on age and fertility status of patient and also underlying causes of it. The modality of treatment is decided on personal preference of the patient and also on the choice and skill of gynaecologists. Menorrhaegia can be treated by medical or surgical options. In younger patients where further fertility is required, medical treatment is preferred. Medical treatment includes hormone therapy commonly contraceptive pill, anti-inflammatory drugs. In surgical treatment, depending on severity of condition, there are four options available: Dilatation and Curettage, Operative Hysteroscopy, Endometrial Ablation and Hysterectomy (removal of uterus). Among these options, the widely chosen one is Dilatation and Curettage commonly known as D&C. Hysterectomy is another preferred choice for menopausal women.
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