Menstruation is the normal shedding of the uterine lining that occurs on a regular basis during the female reproductive life (from puberty until menopause).
Normal menstruations last around 3 – 7 days. During the menstrual cycle, the female uterus gets prepared to support the pregnancy due to sex hormones (progesterone and estrogen). If the pregnancy happens, menstruations will stop until childbirth, abortion or miscarriage of the pregnancy. Otherwise, if the pregnancy does not happen, the uterus will shed every month and menstrual blood, tissues, mucus and fluid will get out of the uterus, through the vagina.
Menorrhagia is an abnormally heavy and prolonged menstrual period with excessive menstrual bleeding that lasts longer than 7 days. The amount of blood lost during menorrhagia exceeds 80 ml which may be caused by hormonal imbalance, abnormal blood clotting, disorders of the uterus lining (endometrium), etc.
Every woman once in herlife has experienced menorrhagia, even though it is more common in young girls and before menopause. However, menorrhagia can occur in any period of a woman’s life.
It is hard to measure the amount of blood that is lost with menstruation. However, if the blood loss exceeds 80 ml, if the bleeding has large clots, if the pads are changed every hour, or if a female must change her pad at night, such menstruation is considered menorrhagia. With menorrhagia the amount of the lost blood is greater than the body’s iron reserves, which eventually leads to anemia.
The most common cause of menorrhagia is hormonal imbalance and uterine myoma.
Hormonal imbalance as the main cause of menorrhagia is usually seen during the beginning and the end of the reproductive life of a female. Normally the balance between estrogen and progesterone allows the growth of the endometrium (the uterine lining that sheds every month with menstruations). If the endometrium is thicker the bleeding with be heavier.
Myoma is a benign uterine tumor that is relatively frequent, causing prolonged and abundant menstrual bleeding.
Stress is also one of the things that can cause menorrhagia. It is known that stress causes hormonal imbalance, resulting in overproduction of either estrogen or progesterone.
Perimenopause is known to be one of the times during the female reproductive life where menorrhagia is a common thing for many women. In the perimenopause the levels of estrogen are higher, while the levels of progesterone are lower, due to ovulation being less consistent.
Other possible causes of menorrhagia include: inherited bleeding disorders, pelvic inflammatory disease, ovarian cysts, uterine polyps, IUD, endometriosis, uterine cancer, etc.
Signs and symptoms of menorrhagia include:
Menorrhagia leads to anemia, caused by insufficient iron in the body. Signs and symptoms of anemia will depend from the amount of blood lost and from the levels of Hemoglobine and Erythrocytes in the blood. These signs and symptoms vary, but they usually include: weakness, fatigue, headache, ringing in the ears, rapid pulse, decrease the resistance of the organism, etc.
Menorrhagia associated with endometriosis, ovary function disruption, myoma, etc., may contribute to infertility in women.
Dmitry Bronfman, MD, is a board-certified gynecologist who specializes in all aspects of contemporary women’s health, preventive medicine, pelvic pain, minimally invasive and robotic surgery, and general, adolescent, and menopausal gynecology.
Brooklyn Abortion Clinic