Hypermenorrhea (also known as menorrhagia) refers to unusually heavy or prolonged menstrual bleeding . Women with hypermenorrhea typically lose more than 80 milliliters of blood per menstrual cycle or have periods that last longer than seven days.
Symptoms of hypermenorrhea 🚩
• Heavy menstrual bleeding: Heavy bleeding that often requires changing pads or tampons within one to two hours.
• Prolonged menstruation: bleeding that lasts longer than seven days.
• Blood clots: Large blood loss can lead to the formation of blood clots larger than a 1 euro coin.
• Iron deficiency anemia: Due to the high blood loss, anemia can occur, causing symptoms such as fatigue, paleness and shortness of breath.
Causes of hypermenorrhea 🕵️♀️
1. Hormonal imbalances: An imbalance between estrogen and progesterone can cause the uterine lining to thicken excessively and lead to heavy bleeding.
2. Uterine fibroids: Benign tumors in the uterine wall can lead to heavy and prolonged bleeding.
3. Polyps: Small, benign growths on the uterine lining can increase bleeding.
4. Adenomyosis: A condition in which the uterine lining invades the uterine muscles, causing severe bleeding.
5. Coagulation disorders: Blood clotting disorders such as von Willebrand disease can cause hypermenorrhea.
6. Medications: Certain medications, such as anticoagulants, can lead to increased bleeding.
7. Intrauterine devices (IUDs): Copper IUDs can cause heavy menstrual bleeding as a side effect.
8. Cancer: Rare, but cervical or uterine cancer can also cause hypermenorrhea.
Diagnosis of hypermenorrhea 🔍
1. Anamnesis and physical examination: Recording of the medical history and a gynecological examination.
2. Blood tests: To check for anemia and clotting disorders.
3. Ultrasound: To identify fibroids, polyps or other structural abnormalities.
4. Endometrial biopsy: A sample of the uterine lining can be examined for abnormalities or cancer.
5. Hysteroscopy: A direct inspection of the uterine cavity with a thin, lighted instrument.
Treatment options 💊
1. Medicinal therapy:
- Non-steroidal anti-inflammatory drugs (NSAIDs): To relieve pain and reduce bleeding.
- Hormone therapy: Oral contraceptives, progesterone or hormonal IUDs can help regulate bleeding.
- Antifibrinolytics: Medicines such as tranexamic acid that reduce blood loss.
2. Surgical treatment:
- Endometrial ablation: removal or destruction of the uterine lining.
- Myomectomy: Surgical removal of fibroids.
- Hysterectomy: removal of the uterus, a definitive solution but leading to infertility.
3. Complementary therapies:
- Iron supplements: To treat or prevent iron deficiency anemia.
Prevention and management 🛡️
• Regular gynecological examinations: To detect and treat problems early.
• Healthy lifestyle: A balanced diet and regular exercise can support hormonal balance.
• Medical advice: If bleeding is unusually heavy or prolonged, you should always consult a doctor.
Symptoms of hypermenorrhea 🚩
• Heavy menstrual bleeding: Heavy bleeding that often requires changing pads or tampons within one to two hours.
• Prolonged menstruation: bleeding that lasts longer than seven days.
• Blood clots: Large blood loss can lead to the formation of blood clots larger than a 1 euro coin.
• Iron deficiency anemia: Due to the high blood loss, anemia can occur, causing symptoms such as fatigue, paleness and shortness of breath.
Causes of hypermenorrhea 🕵️♀️
1. Hormonal imbalances: An imbalance between estrogen and progesterone can cause the uterine lining to thicken excessively and lead to heavy bleeding.
2. Uterine fibroids: Benign tumors in the uterine wall can lead to heavy and prolonged bleeding.
3. Polyps: Small, benign growths on the uterine lining can increase bleeding.
4. Adenomyosis: A condition in which the uterine lining invades the uterine muscles, causing severe bleeding.
5. Coagulation disorders: Blood clotting disorders such as von Willebrand disease can cause hypermenorrhea.
6. Medications: Certain medications, such as anticoagulants, can lead to increased bleeding.
7. Intrauterine devices (IUDs): Copper IUDs can cause heavy menstrual bleeding as a side effect.
8. Cancer: Rare, but cervical or uterine cancer can also cause hypermenorrhea.
Diagnosis of hypermenorrhea 🔍
1. Anamnesis and physical examination: Recording of the medical history and a gynecological examination.
2. Blood tests: To check for anemia and clotting disorders.
3. Ultrasound: To identify fibroids, polyps or other structural abnormalities.
4. Endometrial biopsy: A sample of the uterine lining can be examined for abnormalities or cancer.
5. Hysteroscopy: A direct inspection of the uterine cavity with a thin, lighted instrument.
Treatment options 💊
1. Medicinal therapy:
- Non-steroidal anti-inflammatory drugs (NSAIDs): To relieve pain and reduce bleeding.
- Hormone therapy: Oral contraceptives, progesterone or hormonal IUDs can help regulate bleeding.
- Antifibrinolytics: Medicines such as tranexamic acid that reduce blood loss.
2. Surgical treatment:
- Endometrial ablation: removal or destruction of the uterine lining.
- Myomectomy: Surgical removal of fibroids.
- Hysterectomy: removal of the uterus, a definitive solution but leading to infertility.
3. Complementary therapies:
- Iron supplements: To treat or prevent iron deficiency anemia.
Prevention and management 🛡️
• Regular gynecological examinations: To detect and treat problems early.
• Healthy lifestyle: A balanced diet and regular exercise can support hormonal balance.
• Medical advice: If bleeding is unusually heavy or prolonged, you should always consult a doctor.
