Menorrhagia is a medical condition that affects females only; it is characterized by an abnormal heavy flow of blood or prolonged bleeding during menstruation. This is a common condition in some women and not all heavy bleeding can be classified as menorrhagia because the loss of blood is not severe enough.
Menorrhagia is characterized by severe blood loss; women affected by this cannot go about their usual activities because of severe bleeding and cramping. According to World Health Organization; 18 million women aged 18 to 55 years have heavy or excessive bleeding and 10% of these women experience severe blood loss that can be classified as menorrhagia.
Symptoms of menorrhagia are;
- Using more than one sanitary pad every hour consecutively
- Use of double pads or other help to control the flow of blood
- Waking up several times during the night to change pad
- Bleeding for more than 7 days
- Passing blood clots that are larger than a quarter
- Unable to go about ones activities due to heavy flow of blood
- Feeling of tiredness, shortness of breath and fatigue
- Anemia or its symptoms
What are the causes of menorrhagia?
Well, the cause of heavy bleeding is still not known but there are some medical conditions that can lead to this, common medical conditions that can cause this are:
Medications: Some medications like anti-inflammatory drugs, hormonal drugs like estrogen and progesterone, anticoagulants like warfarin or enoxaparin can lead to prolonged menstruation or heavy bleeding.
Inheritance: It is believed that inheritance can play a role in this medical condition; some ladies inherit bleeding disorders like von Willebrand’s disease. This is a medical condition in which an important blood clotting factor is missing or impaired; this can cause abnormal flow of blood.
Cancer: Some type of cancer can cause heavy bleeding and they include uterine cancer and cervical; abnormal Pap test can also cause this condition.
Pregnancy complications: Miscarriage, ectopic pregnancy, unusual location of the placenta can cause heavy bleeding.
Intrauterine device (IUD): Non-hormonal uterine device for birth control causes menorrhagia as a side effect.
Adenomyosis: This is a major cause of heavy bleeding or painful menstruation; it occurs when the glands from the endometrium becomes embedded in the uterine muscles.
Polyps: These are small, benign growths that appear on the lining of the uterus (usually called uterine polyps); these can cause heavy bleeding or prolonged menstruation.
Dysfunction of the ovaries: Inability of the ovaries to release an egg during a menstrual cycle (called anovulation) or inability of the body to produce the hormone progesterone can result in heavy bleeding because of hormone imbalance.
Hormone imbalance: A normal menstrual cycle is characterized by the balance between the hormones estrogen and progesterone; this balance regulates the buildup of the lining of the uterus (endometrium) which is shed during menstruation. If there is an imbalance in these hormones; the endometrium excessively develops and it sheds away by heavy bleeding.
Other medical conditions that can cause hormone imbalance are thyroid problems, obesity, insulin resistance and polycystic ovary syndrome (PCOS).
Other medical conditions: That can lead to this condition are liver disease, kidney disease, endometriosis, thyroid problems, pelvic inflammatory disease and others.
How is menorrhagia diagnosed?
Doctors need to rule out menstrual disorders, medications and some medical conditions to be certain that it is menorrhagia; because these mentioned conditions can cause this or aggravate the condition. Tests carried out to diagnose menorrhea are:
Blood tests: A sample of the patient’s blood is checked for anemia (iron deficiency) and other medical conditions like blood clotting abnormalities and thyroid disorders.
Ultrasound: This is used to produce images of the pelvis, ovaries and uterus by sound waves.
Pap test: The procedure in this test involves taking cells from the cervix and testing for infection, inflammation or changes that can lead to cancer or are cancerous.
Endometrial biopsy: This involves a pathologist taking samples of tissues from the inside of the uterus and examining it.
Based on the results of these tests; further tests can be recommended by the doctor and they are:
Hysteroscopy: This test involves inserting a thin, lighted instrument through the vagina and cervix into the uterus; this will enable the doctor to see inside the uterus.
Sonohysterography: In this test procedure, a fluid is injected through a tube into the uterus through the vagina and cervix; then ultrasound is used to look for problems in the lining of the uterus.
What are the risk factors?
Aga and some medical conditions are risk factors for menorrhagia.
The presence of menorrhagia in adolescent girls is mainly due to anovulation; adolescent girls are prone to anovulatory cycles in the first year after their first menstrual period.
Older women experience menorrhagia due to uterine pathology like fibroids, polyps and adenomyosis; uterine cancer, bleeding disorders, side effects of medications and diseases of the liver or kidneys increases the risk of menorrhagia.
When to seek medical help
As said earlier, not all heavy bleeding are classified as menorrhagia because they are not severe; if you are experiencing heavy bleeding during your period and don’t know if to consult your doctor, look out for these signs and if you notice anyone of them, please consult your immediately.
- Heavy bleeding that requires the use of more than one sanitary pad every hour.
- Bleeding between period
- Irregular menstruation
- Vaginal bleeding after menopause
What medical complications can menorrhagia lead to?
If menorrhagia is not treated; it can lead to other medical conditions like:
Anemia: Heavy blood flow monthly reduces the number of red blood cells that are in circulation and this in turn will lead to Anemia. Due to reduced number of red blood cells; enough oxygen will not be available for every cell and tissues. The body will try to make up for the lost red blood cells by using your iron stores to make more hemoglobin to carry blood to all the cells and tissues; this can lead to iron deficiency anemia because heavy bleeding decreases the levels of iron in the body. Signs and symptoms of anemia are pale skin, weakness and diet.
Severe pain: Dysmenorrhea (painful menstrual cramps) usually comes along with heavy menstrual bleeding; most times these cramps are so severe that it requires medical evaluation.
How is menorrhagia treated?
There are many treatment options for menorrhagia and the specific treatment used on a patient depends on a number of factors like the personal opinion or preferences of the patient, the effects of the condition on the lifestyle of the patient, the patient’s future childbearing plans, overall health and medical history, the cause and severity of the condition, the tolerance level for specific procedures, medications and therapies and the likelihood that the patient’s period will become less heavy soon.
Medical treatments for this condition include:
Non-steroidal anti-inflammatory drugs (NSAIDs): Ibuprofen or naproxen sodium is given to help reduce the loss of blood; they also have added benefits of relieving the severe pains and cramps that comes along with it.
Hormonal IUD (Liletta, Mirena): This type of intrauterine devices releases a type of progesterone called levonorgestrel; this will make the lining of the uterus thin and decrease cramping and the flow of blood.
Tranexamic acid: Also known as lysteda; this drug helps in reducing the loss of blood; it only needs to be taken during menstruation.
Oral progesterone: This hormone corrects hormone imbalance and reduces the flow of blood.
Oral contraceptives: These drugs help to regulate menstrual cycles and reduce the episodes of prolonged or excessive bleeding.
Some women develop menorrhagia from hormone medication; in this case the drug is either changed or discontinued. Iron supplements are also given to women who have anemia due to menorrhagia; women with low levels of iron are also given these supplements before this condition leads to anemia. When menorrhagia is a sign of another medical condition like thyroid diseases; the condition is treated and it results in lighter periods.
Menorrhagia can also be corrected surgically
Sometimes, medical therapies can be unsuccessful; in these cases surgeries are performed on the patients and most of these procedures are done on an outpatient basis. Anesthetics are used and the patient can go home later on the same day.
The procedure that requires hospitalization is an abdominal myomectomy or a ‘8hysterectomy; surgical treatment options include:
Hysterectomy: This procedure involves the surgical removal of the uterus and cervix; this procedure is irreversible (permanent) and it causes sterility and ends menstrual periods. This procedure requires hospitalization and anesthetics are used. Premature menopause can occur when the ovaries are removed and this is known as bilateral oophorectomy.
Endometrial resection: This surgical procedure involves using an electrosurgical wire loop to remove the lining of the uterus; endometrial ablation and endometrial resection are beneficial to women but pregnancy is not safe after this procedure.
Endometrial ablation: This procedure involves the destruction (ablation) of the endometrium (the lining of the uterus); this is done by using a laser, radiofrequency or heat on the endometrium to destroy the tissues. Women have lighter periods after this procedure and the use of reliable or permanent contraception until menopause is recommended because getting pregnant after this procedure can lead to health complications.
Myomectomy: This is the surgical removal of uterine fibroids; this can be done laparoscopically (using open abdominal surgery, through several small incisions) or hysteroscopically (through the vagina). The method used depends on the size of the fibroids; the location and the number of the fibroids.
Dilation and curettage (D&C): This procedure involves the dilation of the cervix and scraping or suctioning tissues from the lining of the uterus to reduce menstrual bleeding. This is the most common surgical procedure used to treat menorrhagia and it can be repeated if heavy bleeding reoccurs.
Focused ultrasound surgery: This procedure is similar to uterine artery embolization; it treats heavy bleeding caused by fibroids by shrinking the fibroids. This involves using ultrasound waves to destroy the tissues of the fibroids and no incisions are required in this procedure.
Uterine artery embolization: This procedure treats heavy bleeding caused by fibroids; it shrinks fibroids in the uterus by blocking the uterine arteries and cutting off their blood supply. To do this, a surgeon passes a catheter through the femoral artery (the large artery in the thigh) and guides it to the uterine arteries, where the blood vessel is injected with materials that will decrease the flow of blood to the fibroid.
Natural remedies for Menorrhagia
There are effective naturopathic remedies out there that are good in relieving the symptoms and reducing the flow of blood; they involve no removal of your parts and they give no harmful side effects, they include:
- Banana flower: This is considered to be one of the most effective cures for heavy or prolonged bleeding; cook one banana flower and take it with a cup of fresh curd to increase the level of progesterone and decrease the bleeding.
- Basil: This plant deals with heavy flow and reduces the pain due to its rich content of Caffeic acid; add two tablespoon of basil leaves to a pint of boiled water, cover tightly and let it steep for a while. When it cools, take a cup hourly during your period, you can also use it to spice foods during your period.
- Parsley: Boil fresh parsley leaves in distilled water to prepare the juice; drink at least 100ml of this juice thrice daily to reduce heavy flow.
- Aloe vera: Drink aloe vera juice made from the gel before and during your period to reduce heavy flow and reduce cramps.
- Coriander seeds: Boil 20 grams of this seed in two cups of water; let it boil till the volume of the water reduces by half, then you drink it when it cools.
- Tomato juice: Is rich in vitamins that can reduce blood flow; take one glass of this juice daily during your period.
- Fenugreek seeds: This seed stops heavy blood flow and relieves cramping; add 5 tablespoons of fenugreek seeds to one liter of boiling water and boil for 7 to 10 minutes; cool the liquid, strain it and drink. It should be taken every day during your period and honey can be added for taste.
- Tamarind: This is one of the best home remedies for heavy bleeding and clots; it prevents excessive flow of blood. Soak 8 to 10 pieces of tamarind in 500ml water overnight. You can 4 to 5 pieces of dry plum to make it effective. In the morning, sieve it, add 3 tablespoons of honey and drink it on an empty stomach during your period.
- Amla juice and honey: Take 1-2 tablespoons of Amla juice (gooseberry) with honey on an empty stomach; this mixture is effective at stopping heavy bleeding.
- Comfrey: This wonderful herb stops heavy bleeding by constricting blood vessels. Put two teaspoons of comfrey leaves in a cup of hot water, cover and step for 20 minutes, strain it and drink it when cool. Take it once daily.
- Unripe papaya: Eats unripe papaya during your period to ease heavy bleeding; it facilitates smooth contractions of the uterus which reduces the pain. This is why pregnant women are advised against consuming pawpaw especially I the first trimester.
- Omega-3: These fatty acids relieves the symptoms of heavy bleeding; take foods rich in fatty acids like oily fishes, flaxseeds and the supplements.
- Apple cider vinegar: This drink effectively slows the flow of blood and regulates period; put 2 tablespoons in a glass of water, drink this solution three times daily for effective results.
- Sage: This herb prevents excessive bleeding and blood clotting; add 1 teaspoon of sage to a cup of boiled water, steep for 5 to 7 minutes and consume it every three hours for three days.
- Marigold: This herbaceous flower has been used for centuries to prevent loss of blood through heavy menstruation; boil 5 marigold flowers in about half liter of water for 7 to 10 minutes, strain the infusion and take it when it cools. You can also use it to make tea or coffee or you can use it to cook during your period. Take 120ml of this three times daily. To make this effective, start taking it 2 or 3 days before your period and also during your period.
- Cayenne pepper: this wonderful spice reduce heavy bleeding and balance the flow of blood; add half teaspoon of cayenne powder to a glass of warm water, add honey for taste and take it daily.
- Magnesium rich foods: Magnesium is an important mineral that balances the female hormones, progesterone and estrogen; a deficiency in this mineral has been linked with heavy menstruation. Before and during your period; eat lots of magnesium rich foods like water melon seeds, sesame seeds, cocoa, oat, pumpkin, squash etc.
- Yarrow: This herb stops unusually heavy flow by constricting the blood vessels; it shouldn’t be taken in excess to avoid too much vasoconstriction, once a day is okay. Boil water and add some fresh yarrow leaves to it and leave it to continue boiling till when the colour changes; add honey to it and take it when cool.
- Rosehip tea: Drink three cups of this tea daily to effectively handle menorrhagia; it is also rich in vitamin C which helps the absorption of iron from food thereby preventing anemia that can result from heavy bleeding. Start taking this tea three days prior to your period and continue till your period stops.
- Mango bark: The juice of fresh mango bark is one of the best natural remedies that cure heavy menstrual flow.
- Lady’s mantle tea: Lady’s mantle is an herb that that is used often to treat menstrual issues; also known as “woman’s herb”, this tea has strong contracting, coagulating and astringent properties that can help normal flow of blood. Boil one ounce of the dried leaves in a pint of boiling water and take this tea thrice daily during your period.
- Cinnamon: Cinnamon cures heavy bleeding and controls heavy menstrual cycle; add half teaspoon of ground cinnamon in a cup of boiled water, add honey for taste and take it when it cools, drink this twice daily.
- Chaste berry: This is a popular herb that is widely used in Europe to balance hormones; it induces the production of progesterone, inhibit the release of estrogen, reduce uterine bleeding thereby stopping heavy menstrual flow.
- Cold compress: Cold temperature constrict blood vessels and this can stop heavy menstrual bleeding; put some ice cubes in a thin towel and place it over your abdomen for 10 to 15 minutes; repeat this process every four hours until you are relieved.
- Raspberry leaves: They have phytochemicals that relax the uterine muscles; take the tea three times daily during your period.
- Ginger: This powerful herb is effective in reducing the flow of blood; boil some crushed or grated ginger roots in water for few minutes and take; you can add honey for taste.
- Hawthorn flowers: This is one common home remedy for heavy bleeding during menstruation; it also regulates the discharge of blood clots and reduces abdominal pain. Put some hawthorn flowers in a boiling water and let it boil for 5 to 10 minutes, let it cool then you drink it. You can add saffron flowers to make it more effective.
- Mustard seeds: These seeds help a lot in relieving heavy flow; take 40 grams of pure mustard seeds and grind them into fine powder; take two grams of this powder with milk twice a day during your menstrual cycle to reduce bleeding.
- Bamboo leaves: This is an excellent remedy for heavy menstruation; boil the leaves or the nodes in water and take twice daily during your period.
Other supplements that help this condition are flavonoids, vitamin C, iron, vitamin A, B vitamins, Vitamin E, Vitamin K and some Chinese herbal formulas.
These remedies are very effective and work wonders in fighting menorrhagia but please note that if you use these remedies and the symptoms still persist, please consult your doctor. These herbal remedies should only be taken by a woman that is not pregnant or breastfeeding. If any of this remedies work for you; you are free to stick with it.