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Menorrhagia or heavy vaginal bleeding : Symptoms, Causes, Diagnosis, Risks, and Treatments

Menorrhagia or heavy vaginal bleeding : Symptoms, Causes, Diagnosis, Risks, and Treatments
  • October 17, 2023

Menorrhagia or heavy vaginal bleeding : Symptoms, Causes, Diagnosis, Risks, and Treatments

What is Menorrhagia?

Menorrhagia is an excessive increase in the amount and duration of menstrual flow. Normally, the blood flow is 25-80 ml. If it exceeds 80 ml, it is considered abnormal. The standard duration is 4-5 days, and if it extends beyond 7 days, it is also considered abnormal. It can occur at any age, especially in the middle age group, or after menarche in young girls with ovulatory conditions not yet established. These conditions can cause disruptions in daily functions due to ill health.

Symptoms

The most common symptom is anemia due to blood loss. Pallor, general weakness, lethargy, fatigue, tiredness, and interruptions in daily activities are some other symptoms of Menorrhagia.

Causes

The primary cause of Menorrhagia is hormonal imbalance, which stems from a disturbance in the Hypothalamic-Pituitary-Endometrial Axis, leading to disrupted estrogen and progesterone balance. This imbalance can result in increased bleeding and uterine thickening due to hormonal imbalances, with excessive flow known as Dysfunctional Uterine Bleeding (DUB). Abnormal growth in the uterine cavity, such as polyps, fibroids, hyperplasia, or tissue growth, can also cause abnormal flow. Some individuals may have uterine devices in the cavity that disrupt the normal flow. Inherited blood disorders and drug intake, such as aspirin and Hemophilia (bleeding disorders), where blood clotting is impaired, can also lead to abnormal flow.

Diagnostic Tests include:
  • Pelvic Exam
  • Rectal Exam
  • Pap Smear
  • Ultrasound Scan
  • Hysteroscopy
  • Vaginal infections should also be excluded
  • Hormonal Profile
Risks

Patients with Menorrhagia are considered to be at an increased risk of:

  • Iron Deficiency Anemia, as normal blood loss is 30-40 ml. An increase to 80 ml can lead to low hemoglobin.
  • Anemia, which can lead to other general health conditions.
Medical Prescriptions to Reduce Blood Loss
  • Antifibrinolytic agent: Tranexamic Acid
  • Anti-prostaglandin: Ponstan
  • Hormonal Therapy
  • NORETHISTERONE – YAZ
  • OCP (Oral Contraceptive Pills)
  • DANAZOL
  • Intrauterine progesterone, such as the Mirena Device
  • Endometrial ablation
  • Hysteroscopic polyp removal
  • Total abdominal hysterectomy
By Dr. Farzana Siddiqui