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Don’t Leave It Untreated
Heavy Bleeding or Menorrhagia, during your menstrual period, isn’t uncommon. But if you have a very heavy flow or if the bleeding lasts more than 7 days, there might be something else going on. Several health conditions can trigger heavy menstrual bleeding. But menorrhagia isn’t just a symptom: The blood loss itself can lead to other problems. Here’s what you need to know.
HOW MUCH BLEEDING IS TOO MUCH?
Up to half of people who get periods have heavy bleeding. Most healthy people lose about 2.5 tablespoons during their periods. But if you have menorrhagia, you might lose 5 or more. During a heavy period, you might need to change your pad or tampon every hour for several hours in a row. You also might pass blood clots that can be bigger than a quarter. Eventually, you might notice symptoms of anemia, like fatigue, pale skin, and shortness of breath. These are all signs that you should talk to your doctor about heavy bleeding.
WHAT CAUSES HEAVY MENSTRUAL BLEEDING?
Several conditions can lead to heavy menstrual bleeding, including: • Hormonal imbalances caused by obesity, thyroid problems, and other conditions • Ovarian conditions • Uterine fibroids • Polyps • Cancer • Adenomyosis (when the inner lining of the uterus breaks through the muscle wall of the uterus) • Genetic disorders • Pregnancy complications • Intrauterine devices (IUDs) • Certain medicines.
Sometimes, heavy menstrual bleeding is a sign of a serious condition. If you have heavy periods, it’s important to talk with your doctor to figure out the root of the problem. Treating the root cause can keep the problem from getting worse or causing complications.
WHAT HAPPENS IF HEAVY BLEEDING GOES UNTREATED?
In addition to the complications that come with the root cause of menorrhagia, the blood loss itself can cause problems. These include:
Anemia: Too much blood loss can trigger a shortage of red blood cells, which are responsible for delivering oxygen throughout your body. When you don’t have enough red blood cells, your body tries to make more. To do this, it pulls a key ingredient – iron – from its backup supply. Iron deficiency anemia is when your body exhausts its iron supply.
Symptoms include: • Headaches • Fatigue • Weakness • Crankiness • Shortness of breath • Brittle nails.
You might also have: • Sore tongue • Restless or twitchy legs • Pica (a craving to eat ice, dirt, or other nonfood items) • Pale skin • Cold hands • Cracks at the corners of your mouth.
A blood test is needed to diagnose anemia. Doctors measure the number of red blood cells, a protein called hemoglobin, and other important markers. It’s important to tell your doctor if you think you have anemia. Without proper treatment, anemia can be dangerous and, in rare cases, life-threatening.
Pain: Some people with heavy bleeding also have painful cramps in the lower belly. This is called dysmenorrhea.
Problems carrying out daily tasks: Heavy bleeding can make it hard to do everyday activities. You might have to skip work, school, or other commitments because of cramps and fatigue. This can dramatically affect your quality of life.
Anxiety: You might worry about bleeding through your clothes or be afraid to leave your home without extra bags of pads or that you’ll forget them. These fears could lead to anxiety and stress.
WHEN SHOULD YOU TALK TO YOUR DOCTOR?
Talk with your doctor if you have:
To change your pad or tampon at least once an hour, for at least 2 hours in a row.
Bleeding that interferes with your daily life (for example, you have to double up on pads or miss your regular activities).
Bleeding between your usual periods.
Bleeding after menopause.
Any other unusual bleeding.
These can be signs of menorrhagia or another conditions. It’s important to identify the cause of heavy bleeding. Use a journal to record which days you bleed and how many pads or tampons you go through.
HOW IS HEAVY BLEEDING TREATED?
Treatment depends on what’s causing the bleeding, how it affects your day-to-day life, and other things. Options include:
Medications:
Some that can help with heavy bleeding are: • Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen • Tranexamic acid • Oral contraceptives • Oral progesterone • Hormonal IUD.
Gonadotropin-releasing hormone agonists and antagonists.
Procedures: In serious cases, surgery can help treat the root cause of heavy bleeding. For example, if your heavy periods are caused by fibroids, your doctor might be able to remove them. Surgical options include: • Dilation and curettage • Uterine artery embolization • Focused ultrasound • Myomectomy • Endometrial ablation • Endometrial resection • Hysterectomy.
MANAGING THE COMPLICATIONS OF HEAVY MENSTRUAL BLEEDING
There are a few ways you can manage menorrhagia complications like anemia. These strategies might not stop heavy bleeding alone, but they can help you feel better and protect your health:
Enjoy iron-rich foods: Your body’s main source of iron is the food you eat. To fight off anemia, eat plenty of iron-rich foods like fish, beef, beans, and tofu. But if you’re already iron deficient, you might need extra help from supplements.
Take an iron supplement: Iron supplements are safe, affordable tablets that can help treat or prevent anemia. They replenish your iron supply, allowing your body to make more red blood cells. It takes at least 3 weeks for supplements to start working and about 6 months for your iron levels to return to normal.
Iron supplements are most effective if you take them every other day. Some things, like coffee and milk, can make it difficult for your body to absorb the iron in the tablet. Don’t eat or drink them at the same time you take the supplement. Also, don’t use supplements that are labeled “slow release” or “enteric coated.” This coating also makes it more difficult to absorb iron. They can also cause an upset stomach. To avoid this, try taking them with food or lowering your dose. Keep in mind that iron supplements turn your poop very dark. Ask your doctor before starting any supplement. If you have a health condition that makes it difficult for your body to absorb iron, or if iron tablets cause severe side effects, your doctor might recommend iron supplements in liquid (ferrous sulfate liquid) or IV forms.
Try a multivitamin: Nutrients like folic acid, vitamin C, and vitamin B12 are important for growing new red blood cells. You can find these in many multivitamins. If you take separate iron supplements, make sure the multivitamin doesn’t also contain iron. Too much iron can lead to other complications. Ask your doctor for help managing all medications, supplements, and vitamins.
Use an NSAID: In addition to lessening blood flow, these medications can help with menstrual cramps. Many inexpensive options are available over the counter. You don’t need to use these medications every day, just during your period.
webmd.com
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