Heavy Bleeding

Menorrhagia is a medical term used when a woman suffers abnormally prolonged or heavy bleeding during her menstrual cycle. It isn’t uncommon to experience heavy bleeding during a monthly cycle. However, if the loss of blood is severe enough, it may mean you have a condition known as menorrhagia.

Symptoms of Heavy Bleeding (Menorrhagia)

When a woman suffers menorrhagia, heavy bleeding, you cannot perform routine daily activities due to the severe loss of blood and cramping, which accompanies this loss. There are treatments for this condition your doctor at Gyn LA can discuss with you.

There are several symptoms and signs you would experience with menorrhagia:

• You cannot sleep through the night without having to change your sanitary protection
• You have to change your sanitary protection every hour for several hours in a row
• You will experience symptoms of anemia, including fatigue, tiredness, and shortness of breath
• Your bleeding will continue for longer than a week
• You have to double your sanitary protection to control the blood flow
• You may notice the passing of blood clots more massive than a quarter
• You have to alter your daily activities due to heavy bleeding

You should contact your physician at Gyn LA if you are experiencing vaginal bleeding that requires a replacement tampon or pad every hour. You should also alert them if you are having irregular vaginal bleeding between your periods. Any bleeding after menopause should be reported to your doctor right away.

What Causes Heavy Bleeding?

In most women, it is hard to determine the cause behind their heavy bleeding; however, there are a number of conditions which can be present and cause menorrhagia:

• Ovaries not functioning properly

If your ovaries are not releasing an egg during your menstrual cycle, your body is unable to produce a hormone called progesterone. This hormone is released during a normal menstrual cycle, and without it, you experience a hormone imbalance that could result in heavy bleeding.

• Polyps

Polyps or small, benign growths on the lining of your uterus can cause excessive and prolonged bleeding during a menstrual cycle. These growths are known as uterine polyps.

• IUDs

The intrauterine device used for birth control is non-hormonal. It has a high-risk factor of causing menorrhagia. If you are using this device and develop menorrhagia, you should speak with your gynecologist at Gyn LA. You may need to find an alternative method of birth control.

• Cancer

Cervical or uterine cancer can cause excessive or heavy bleeding during a menstrual cycle. This symptom is especially common if you are postmenopausal or have had an abnormal Pap smear in the past.

• Medications

Anti-inflammatory medicines and certain others, such as hormonal medications can contribute to heavy bleeding. Some of the ones known to have a high-risk factor for causing heavy and prolonged bleeding include warfarin, enoxaparin, and estrogen.

• Uterine fibroids

Uterine fibroids are noncancerous tumors of the uterus and typically appear during a woman’s childbearing years. These tumors have been associated with heavy bleeding or prolonged bleeding during a menstrual cycle.

• Adenomyosis

Adenomyosis is a condition that develops when glands from your endometrium become embedded in your uterine muscles. This condition is painful and will cause heavy bleeding during the menstrual cycle.

• Complications during pregnancy

If you experience a single late period that is unusually heavy, it could be due to a miscarriage. Another reason for heavy bleeding while you are pregnant could mean your placenta is in an unusual location. The bleeding could be an indication that your placenta is lying low or that you have placenta previa.

• Genetics

Genetics are behind some bleeding disorders. Von Willebrand’s disease is one disorder where an important blood-clotting factor is deficient in your system. This disease would result in heavy bleeding during a menstrual cycle.

• Medical conditions

There are a number of medical conditions that will result in heavy bleeding. Liver and kidney disease are two of the more common ones associated with menorrhagia.

Risk Factors Associated with Heavy Bleeding

The risk factors of experiencing heavy bleeding or developing menorrhagia vary with age and medical conditions you may develop. The release of the egg from your ovaries is what will stimulate your body’s production of progesterone, and the one process most responsible for keeping your periods regular. If there is any interference with the egg being released, insufficient progesterone can cause you to suffer heavy bleeding.

Adolescent girls are at risk of menorrhagia because of anovulation. These young females are prone to anovulatory cycles during menarche, which the time of a young girl’s life when she first begins menstruation. During this time, her periods may be unpredictable and irregular.

• Anovulation

Anovulation is when a female’s ovaries do not release an oocyte (female germ cell involved in reproduction- an immature egg cell) during her menstrual cycle. Ovulation does not take place with this occurrence.  

Another risk factor for menorrhagia in older women is due to uterine pathologies such as adenomyosis, polyps, or fibroids. There can be other issues as well, including medication side effects, bleeding disorders, cancer, or possibly kidney or liver disease.

Complications from Heaving Bleeding

Other medical conditions can develop when one suffers from prolonged or heavy bleeding:

• Severe pain

A condition known as dysmenorrhea can be associated with heavy bleeding during your menstrual cycle. This condition causes severe pain. These painful cramps may require a medical evaluation.

• Anemia

Through heavy bleeding, you may develop anemia as the blood loss results in reducing your number of circulating red blood cells. Circulating red blood cells are measured by hemoglobin, which is a protein that allows your red blood cells to carry oxygen to your tissues.

When your body attempts to make up for the lost red blood cells, it creates an iron deficiency anemia in your system. Your body begins using your iron stores in its attempt to generate more hemoglobin. Menorrhagia can decrease your iron levels to a point where you at risk of iron deficiency anemia.

Symptoms of anemia include weakness, fatigue, and pale skin. Your diet plays a significant role in iron deficiency anemia; however, heavy bleeding during a menstrual cycle complicates this issue.

Diagnosing Heavy Bleeding (Menorrhagia)

If you are concerned with heavy bleeding, you should make an appointment with your gynecologist at Gyn LA. They will most likely ask about your menstrual cycles at your appointment.  If possible, before talking to your doctor about possible menorrhagia, or for any concerns regarding heavy bleeding, you should keep a diary of your non-bleeding and bleeding days. Note in the journal how often you had to change your sanitary protection on each day of your cycle.

Along with going over your medical history and the discussion of your cycles, your doctor will do a physical exam and one or more procedures or tests:

• Pap smear

A Pap smear involves looking at cells taken from your cervix, which is the narrow end of your uterus at the top of your vagina. These cells are collected and then tested for inflammation or infection.

A pap smear takes only a few minutes and involves your doctor inserting a speculum into your vagina. This instrument will hold the walls of your vagina apart, so the doctor is able to see your cervix. Using a soft brush and flat scraping device, they will take a sample of the cervical cells. The doctor will look for any abnormalities that may be a result of or lead to cancer.

• Ultrasound

An ultrasound will provide an image through sound waves of your pelvis, ovaries, and uterus. These images allow your doctor to look for any abnormalities that may be causing excessive bleeding. Diagnostic ultrasound uses high-frequency sound waves to produce pictures of your body’s structure. These images give the doctor valuable information, which enables them to diagnosis and treat a variety of conditions and diseases.

• Blood tests

Blood tests will be conducted through samples of blood collected from you. These samples will help to determine if you have an iron deficiency or any other conditions that could relate to heavy bleeding. Other disorders to check for would be thyroid disorders or other blood clotting abnormalities.

• Endometrial biopsy

An endometrial biopsy involves your doctor taking a sample of tissue from your uterus to have examined by a pathologist for any abnormalities that could be causing heavy bleeding.

These four tests would be the initial testing your doctor may find necessary to diagnose the cause of your heavy bleeding. Other possible testing procedures may be required determined on the outcome of those initial four:

• Hysteroscopy

A hysteroscopy involves inserting a thin instrument with a light attached through your vagina and into your cervix and uterus. This instrument will allow the doctor to see the inside of your uterus to determine if any conditions exist that would cause you to bleed heavily.

• Sonohysterography

A sonohysterography is where a fluid is injected through a tube into your uterus. The injection is done through your cervix and vagina, and will then require an ultrasound. The fluid looked at by the doctor through the ultrasound will outline any problems or issues occurring in the lining of your uterus that is causing excessive bleeding.

Only after all other medical conditions and menstrual disorders have been ruled out through these tests, can your doctor diagnose your condition as menorrhagia.

Treatment for Heavy Bleeding (Menorrhagia)

There are a number of factors that the doctor will look at to determine how to treat menorrhagia once it is diagnosed. These factors include:

• Your medical history and overall health
• What is causing your heavy bleeding and how severe the condition is
• Your specific tolerance for certain therapies, procedures, and medications
• The likelihood that your cycles are going to become less heavy soon
• What are your plans for having children
• How the treatments will affect your lifestyle
• Your personal opinion or preference to suggested treatments

Medications are an option for treating menorrhagia, and these therapies include:

• Tranexamic acid

Tranexamic acid reduces menstrual blood loss. The medicine only needs to be taken when you begin to bleed.

• Oral progesterone

Progesterone is a hormone supplement. Oral progesterone can be used to correct hormone imbalance and reduce heavy bleeding during a cycle.

• NSAIDs (nonsteroidal anti-inflammatory drugs)

NSAIDs include naproxen sodium (Aleve), or ibuprofen (Advil or Motrin IB), and will help reduce blood loss during the menstrual cycle. NSAIDs are also able to help relieve pain associated with a period.

• Oral contraceptives

Oral contraceptives not only help a woman avoid pregnancy, but they can also be used to regulate a woman’s menstrual cycle. These contraceptives can reduce prolonged or excessive bleeding.

• Hormonal IUD

The IUD is an intrauterine device used as a contraceptive. It releases progestin called levonorgestrel to make the uterus lining thin. It decreases menstrual blood flow as well as cramping associated with a menstrual cycle.

There are a few surgical treatments for menorrhagia if medications do not work for your situation. These treatments include:

• Uterine artery embolization

If fibroids are causing your menorrhagia, your doctor’s goal would be to shrink those in our uterus. They would be shrunk by blocking your uterine arteries and cutting off their blood supply. The surgeon passes a catheter through a large artery in your thigh and guides it to the uterine arteries. The blood vessel there will then be injected with materials that are able to decrease blood flow to the fibroid.

• Myomectomy

A myomectomy involves surgically removing uterine fibroids. Your surgeon may perform this as abdominal surgery depending on the number, location, and size of the fibroids. As abdominal surgery, they will make several small incisions in your abdomen, or they may choose to go through your vagina and cervix to reach the uterus.

• Curettage and dilation (D & C)

With a D&C, your doctor will dilate your cervix and scrape tissue from the lining of your uterus to minimize menstrual bleeding. This procedure is common and is often used to treat active bleeding successfully. If menorrhagia returns, the D&C may have to be repeated.

• Focused ultrasound surgery

The focused ultrasound surgery is similar to uterine embolization and is used to treat bleeding caused by fibroids. The ultrasound is used to shrink the fibroids and destroy their tissue. With this procedure, there are no incisions required.

Most of these procedures are done on an outpatient basis. There are a few more options that may work well for your situation. Talk with your gynecologist at Gyn LA to determine your best options.

Find Help Near Me for Heavy Bleeding

If you are experiencing heavy bleeding and severe cramps during your menstrual cycle, you can find help at Gyn LA 310-375-8446. We provide a unique blend of expertise and have extensive experience in dealing with women in all stages of life. Call us today and start feeling better tomorrow.