Menorrhagia (long and heavy menstrual bleeding)

A long and heavy menstrual cycle is called in gynecology as Menorrhagia. Much mucous membrane builds up during the monthly cycle and there is long and heavy bleeding during menstruation. The opposite of menorrhagia is oligomenorrhea (short and weak menstruation).

What is menorrhagia?

The monthly cycle for women of childbearing age is typically twenty-eight days. The woman has four to seven days of this during her monthly menstrual period, during which the tissue built up over the month for a pregnancy is shed.

If this pregnancy does not occur, this now superfluous tissue is removed again under complicated hormonal processes. This process is repeated from the first menstrual period in early puberty to the last one before menopause, the so-called menopause. Most women experience little discomfort with monthly bleeding, but some experience heavy, painful bleeding.

This can be due to various reasons such as benign and malignant changes in the uterus or endometriosis. Menorrhagia also occurs due to hormonal disorders and a changed condition of the uterus after multiple births or abortions.

causes

If cysts, abscesses, or tumors have formed on and in the uterus, the menstrual cycle may increase. But even preliminary stages of cancer can cause these symptoms. Endometriosis is a special case of menstrual disorders.

Because of hormonal disorders, uterine tissue is built up throughout the woman's body. This serious and chronic condition needs to be monitored and treated by a gynecologist. Hormonal disorders can lead to increased menstrual bleeding, which creates an imbalance between progesterone and estrogen. Women who have already given birth to several children tend to have increased and prolonged menstruation.

The uterus is usually enlarged and builds up too much tissue during the cycle. The same symptoms often occur in women who have suffered one or more abortions. In addition, infections with viruses, fungi, bacteria and protozoa can lead to malfunctions.

Symptoms, ailments & signs

Menorrhagia is characterized by long and heavy menstrual bleeding, with a blood loss of over 80 milliliters. Normally this averages 60 milliliters. The higher loss of blood in menorrhagia is caused by a longer extension of the bleeding phase, which is between 7 and 14 days. Often the bleeding is also heavier at the same time.

With a combination of long periods of bleeding and heavy bleeding, women can lose up to 150 milliliters of blood during this phase. Although it is not a life-threatening condition, the constant loss of blood can severely reduce the quality of life. Chronic fatigue, exhaustion and exhaustion are usually observed as symptoms.

Circulatory problems can also occur, with blood pressure often being too low. The blood loss also leads to anemia because the body's own blood cannot be replicated so quickly. As iron is an inherent part of hemoglobin, the loss of blood also causes iron loss at the same time. This also inhibits further blood formation.

As a result of the anemia, there is also an increase in susceptibility to infection. In some cases with profuse blood loss, the loss of thick blood clots is also observed. In addition to tiredness and listlessness, menorrhagia is often a burden for many women in everyday life, at work and, above all, in sex life. This can also lead to depression and psychological problems.

diagnosis

As with all disease diagnoses, there is also one Menorrhagia the doctor-patient discussions, i.e. the anamnesis, come first. In the further course, the doctor can then, depending on the suspicions and indications, use the following examination methods:

• Palpation examination
• Ultrasonic
• pregnancy test
• Examination of the cervix and vagina
• Cancer examination by smear and colposcopy
• Magnetic resonance imaging (MRI) or computed tomography (CT)
• Blood test
• Examination of the hormonal balance

Complications

Menorrhagia complications can result from excessive blood loss.With a very heavy as well as very long menstrual period, women can lose so much blood that, on the one hand, circulatory problems can result. Since these are not based on a fundamental disease value, slight circulatory problems do not require any special medical treatment.

The iron deficiency can be more serious. Heavy blood loss causes iron levels to drop rapidly. The limit here is about an iron value of 12. If this falls below this, symptoms such as paleness, tiredness, concentration disorders and general weakness can occur. An iron deficiency also favors the occurrence of infections, since the immune system's performance is restricted in the case of permanent iron deficiency.

Iron has important functions in the area of ​​blood formation and should therefore be substituted accordingly. However, since an oversupply of iron can be just as critical as a deficiency, iron deficiency should also be diagnosed before taking appropriate preparations. In the context of menorrhagia, gynecological prevention should be used. In rare cases, menorrhagia is the result of a tumor in the tissue of the uterus, which is then associated with complications such as infertility or spread to other organs.

When should you go to the doctor?

Menorrhagia is not only uncomfortable, but also a reason to see a doctor. Even if it occurs for the first time, a doctor should clarify why the menstrual period lasted so long. The causes are often treatable, but if they are ignored, menorrhagia recurs and has a long-term negative impact on the patient's health. The doctor will first ask how often menorrhagia has already occurred, whether further symptoms and complaints have occurred in the meantime, and whether anything has changed in the discharge itself.

Depending on the suspicion, blood or tissue samples are then taken to find out whether it is a tissue change or a hormonal disorder. In connection with a newly taken hormonal contraceptive, it can already help to discontinue this in consultation with the gynecologist and to try an alternative instead. There is nothing wrong with seeing a doctor if menorrhagia occurs when the bleeding is still in full swing. This is not a problem for an examination and in the doctor's office there are enough options for the patients to clean themselves up again after the examination.

Treatment & Therapy

The various causes of Menorrhagia require different treatment. First, the doctor will try to stop the excessive bleeding by using medication. If cysts or cancer are suspected, tissue samples are taken afterwards or possibly even during the bleeding and examined in a laboratory.

Depending on the result, cysts are removed or an operation to remove cancerous ulcers must be performed. This can also result in chemotherapy or radiation. If there is the slightest suspicion of cancer, the gynecologist will act very quickly, as disseminated tissue can cause metastases.

If the menorrhagia is caused by hormonal disorders, the doctor will try to treat it with hormone preparations or homeopathic medication. In addition, the use of the so-called birth control pill comes into question, which reduces menstrual bleeding to a minimum.

In women who have given birth several times or who have suffered abortions, consideration must be given to scraping the uterus. Excess tissue is removed so that the mucous membrane can be completely rebuilt. However, this method is only used in rare cases, as scars form in the uterus, which can further exacerbate the menorrhagia.

In the case of infectious diseases of the genital organs, the gynecologist will treat the underlying disease with oral and local medication, whereby the sexual partner usually has to be treated as well.

You can find your medication here

Outlook & forecast

The further development of health in menorrhagia is largely tied to the cause of the long and heavy menstrual period. Both a good and a very bad prognosis can result. If the disease progresses well, the cause can be found in the area of ​​emotional complaints. With a high level of sensitivity and the presence of various stressors, the symptoms are often already relieved if there is an improvement in lifestyle, a rethinking takes place and psychotherapeutic help is used.

Spontaneous healing cannot be assumed for this disorder. It can occur if the bleeding is linked to the experience of a temporary exceptional situation. However, if the disease progresses unfavorably, it can also lead to premature death. The disturbance of the menstrual bleeding can indicate an existing cancer. If no medical care is initiated or if cancer treatment is only given at an advanced stage of the disease, the patient threatens to shorten the average life span.

Other tissue changes such as cysts or abscesses are usually free of symptoms if they are completely removed in a surgical procedure. In the course of life, menstrual irregularities can occur again up to the onset of menopause. The prognosis remains unchanged if the complaints return.

prevention

There are preventive measures to prevent some forms of the Menorrhagia. Responsible use of pregnancy prevention can save women an abortion. Breastfeeding the baby after birth has a direct impact on the return of the uterus to normal size. Infections of the urogenital tract very often result from changing sexual partners and poor hygiene. Infection with the HP virus can be prevented by vaccination or condoms. Regular preventive examinations of the vagina, uterus and ovaries protect many women from cancer or it is recognized early and treated in good time.

Aftercare

Long and heavy menstrual periods can be associated with above-average blood loss. The acute consequences can be severe circulatory problems. Those affected then complain of nausea, dizziness, racing heart and severe drowsiness. This can lead to complications in everyday situations such as driving a car or make it difficult to concentrate on the job. Those who lose blood often and for a long time can also develop iron deficiency.

Hence, the follow-up focuses on making up for the blood loss. To this end, affected women should have their blood values ​​checked regularly by their gynecologist. Special preparations can compensate for an iron deficiency and thus prevent long-term consequences. Mennorhagia can also lead to psychological complications.

Long and heavy bleeding can severely limit the everyday life of those affected and do not allow social situations to be unrestricted. Social withdrawal or even depression can result as complications in the psychological area. It can be useful to discuss this with the treating doctor in detail. From this point of view, too, it is important to have a mennorhagia medically clarified and specifically treated.

You can do that yourself

In addition to physical causes, psychological stress can also trigger menorrhagia. A healthy lifestyle with a balanced diet and regular exercise in the fresh air, learning relaxation techniques to reduce stress and sufficient sleep have a positive effect on the menstrual cycle and improve mental and physical well-being.

Herbal medicine knows numerous medicinal herbs that are mostly used as a tea preparation against heavy and long menstrual bleeding: These include lady's mantle, shepherd's purse, chaste tree and raspberry leaves. Cinnamon, cayenne pepper, and coriander seeds can be used as a spice or infusion to help prevent heavy bleeding. In menorrhagia, care should be taken to ensure sufficient intake of magnesium, iron and vitamins B, C and E, as these micronutrients influence the production and function of hormones and blood cells. Vitamins and minerals are abundantly contained in fresh fruit and vegetables, legumes, whole grain products and nuts - food supplements should only be used in exceptional cases.

Cold compresses also help reduce blood flow and pain: They can be applied to the lower abdomen up to four times a day for around 15 minutes. If the application of cold on the stomach is perceived as uncomfortable, foot baths with cold water or cooling calf compresses are an alternative. Pharmacy anti-inflammatory pain relievers may also decrease blood flow. If the self-treatment shows no effect, a gynecologist should be consulted.