Menorrhagia
means abnormally heavy periods during menstruation. This is
not always easy to define as what constitutes a heavy period
can vary enormously from one woman to another. Menorrhagia does
not mean a longer period than normal, but if "long" and "abnormally heavy" go hand in hand, anaemia (see Anaemia) will result. It is not uncommon for women to present to a doctor with anaemia without mentioning the heavy periods which they do not, themselves, consider abnormal. It is even more common for women to see the doctor complaining of heavy periods though their blood tests show no significant blood loss. Menorrhagia can be caused by hormonal imbalance as may be experienced after childbirth or miscarriage, during puberty, around the menopause, or, perhaps, when an unsuitable contraceptive pill is taken. It can also be caused by pelvic disease and those conditions found in secondary dysmenorrhoea (see Dysmenorrhoea) including fibroids (non-malignant muscle tissue tumours of the uterus) and the IUCD (intra-uterine contraceptive device). Hypothyroidism ( see Thyroid problems) can cause menorrhagia as can conditions affecting blood clotting.
Women with heavy periods should see the doctor. All women with heavy periods should have a blood test carried out to see whether or not they are anaemic, and an internal examination should be carried out. If there is any question of an underlying cause to the bleeding they should be referred to a gynaecologist for further investigation. For quite a lot of menorrhagia, progesterone medication works very well. The same kind of medication can be used to delay a normal period if the person concerned is going on holiday etc. The oral contraceptive pill may be changed. Drugs which lessen the bleeding such as mefenamic acid or tranexamic acid can be used. In patients with an IUCD, it is usually advised that the device be removed. All cases of anaemia must also be treated. This may vary, according to the severity of the loss, from iron tablets, to iron injections and, in severe cases, blood transfusion. Menorrhagia of this severe type can come on very suddenly, and very heavily, and constitute an acute emergency requiring admission to hospital. |
