Menorrhagia

Flux menstruel trop abondant et trop long en cas de ménorragies

In women of childbearing age, menstrual cycle abnormalities are very common. Among the most common problems are periods that are too heavy and/or too long . These menstrual losses of excessive quantity and duration are known under the medical name of menorrhagia . Generally without serious impact on the health of the menstruating people concerned, they can however have a very negative impact on their daily life. But what is the exact nature of these bleeding periods ? How do they constitute abnormal periods ? What are the causes ? And what means(s) should we consider to treat them?

Menorrhagia: definition

Abnormally heavy and/or long periods

More often used in the plural, the term “menorrhagia” describes periods whose volume and/or duration are excessive. Indeed, menorrhagia is blood loss contemporary with menstruation that is more abundant and longer than normal periods. In essence, they only concern women of normal age, that is to say of childbearing age but not pregnant. We also talk about bleeding periods.

Different types of menorrhagia

There are several subcategories in the menorrhagia family, depending on whether the criteria of quantity and duration are simultaneously impacted or not.

  • Polymenorrhea are periods which combine an abnormality of abundance and an anomaly of duration.
  • Hypermenorrhea is menstruation of normal length but too heavy.
  • Macromenorrhea, conversely, are periods of normal abundance but of too long duration.

Menorrhagia is not to be confused with metrorrhagia, bleeding which is also of uterine origin but which occurs outside the menstrual period, such as metrorrhagia during the first trimester of pregnancy .

Menorrhagia: the symptoms

Menorrhagia is the menstrual disorder most often reported by menstruating people. These are so-called “abnormal” periods because they do not respect the commonly accepted standard averages for menstruation. They are in fact characterized by an abnormally abundant flow and an abnormally long duration of occurrence.

Reminder: the characteristics of normal rules

The average amount of blood lost during a menstrual period by a healthy woman of childbearing age is between 35 and 50 ml, the equivalent of 2 to 4 tablespoons. The variations usually observed and considered normal depending on the woman and the context range from 5 to 80 ml. From 5 to 35 ml, we speak of light to medium flow; 35 to 50 ml, medium to abundant flow; 50 to 80 ml, from abundant to very abundant flow. Periods last on average between 3 and 7 days. Menstrual losses are generally heavier during the first 2 days and then gradually decrease.

Menorrhagia: more than 80 ml and/or more than 7 days of menstrual flow

Menorrhagia, for its part, corresponds to cumulative blood loss of more than 80 ml over the same menstrual period, and/or to a duration of menstruation greater than 7 days. They involve the use of a large number of hygienic protections: more than 6 napkins or tampons per day. They can be accompanied by large blood clots and severe abdominal pain.

Menorrhagia: the causes

One or more of the health problems listed below can cause menorrhagia:

  • uterine polyps and uterine fibroids, growths developing in the uterus, respectively in the endometrium (the inner lining layer of the uterus) and the myometrium (the muscular layer of the uterus);
  • adenomyosis, a type of endometriosis affecting the myometrium;
  • endometrial, cervical and ovarian cancers;
  • blood clotting disorders, such as von Willebrand disease;
  • ovulatory dysfunction, linked to a hormonal imbalance, observed most often during the first years after menarche and at menopause;
  • side effects of medical treatments, including contraceptives such as the copper intrauterine device (IUD);
  • other conditions (pelvic inflammatory diseases, chronic liver diseases, inflammation of the cervix, etc.).

Menorrhagia: the consequences

When it persists, heavy and prolonged menstrual bleeding can cause iron deficiency. This deficiency can itself lead to anemia (an abnormally low hemoglobin level in the blood), which manifests itself as fatigue, a pale complexion, shortness of breath or even dizziness.

Beyond the physical consequences, menorrhagia often has a significant emotional and social impact. The constraints linked to this menstrual disorder are numerous and limiting: constantly worrying about your flow and the risk of leaking, having to change sanitary protection very regularly, avoiding travel and activities, etc. All of this can give rise to various negative emotions (embarrassment, shame, loss of self-confidence) and frequently leads to school or professional absenteeism.

Menorrhagia: treatments

Treatment for menorrhagia depends on the cause(s) of the bleeding. Depending on the results of examinations carried out by health professionals (endovaginal ultrasound, blood test, endometrial biopsy, hysteroscopy), different prescriptions will be offered: progestins, hormonal IUD, antifibrinolytics, non-inflammatory anti-inflammatories. steroids, lifestyle modification, surgery.

Do you yourself suffer from menorrhagia? Are these periods that are too heavy and/or too long ruining your life for a good part of the month? Be sure to consult a health professional – general practitioner, gynecologist, midwife – who can help you identify the causes of this excessive menstrual loss and find a possible treatment. And if you want a little comfort and reassurance, try menstrual lingerie , especially period shorties , specially designed for very heavy flows.

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Written by cd

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