Heavy menstrual bleeding

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Obesity, Sleep & Internal medicine
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Heavy menstrual bleeding
Synonyms	Menorrhagia
Pronounce	N/A
Specialty	N/A
Symptoms	Excessive menstrual bleeding, prolonged menstrual periods, anemia
Complications	Iron deficiency anemia, severe pain, fatigue
Onset	Menarche
Duration	Reproductive years
Types	N/A
Causes	Hormonal imbalance, uterine fibroids, adenomyosis, endometrial polyps, bleeding disorders, intrauterine device (IUD) use
Risks	Obesity, polycystic ovary syndrome (PCOS), thyroid disorders, pelvic inflammatory disease (PID)
Diagnosis	Medical history, physical examination, blood tests, ultrasound, hysteroscopy
Differential diagnosis	Dysfunctional uterine bleeding, endometrial cancer, coagulation disorders
Prevention	Hormonal therapy, lifestyle changes
Treatment	Nonsteroidal anti-inflammatory drugs (NSAIDs), oral contraceptives, tranexamic acid, hormonal IUD, endometrial ablation, surgical intervention
Medication	NSAIDs, oral contraceptives, tranexamic acid
Prognosis	Varies; often manageable with treatment
Frequency	Affects approximately 1 in 5 women of reproductive age
Deaths	N/A

Heavy Menstrual Bleeding (HMB), also known as Menorrhagia, is a medical condition characterized by abnormally heavy or prolonged menstrual bleeding. With HMB, menstrual bleeding lasts more than 7 days and/or is so heavy that it requires frequent changing of sanitary protection. This condition can significantly impact an individual's physical, emotional, and social life.

Causes

Heavy menstrual bleeding can result from a variety of causes, including but not limited to:

• Uterine fibroids: Noncancerous growths in the uterus can lead to heavier or prolonged menstrual bleeding.
• Polycystic ovary syndrome (PCOS): A hormonal disorder causing enlarged ovaries with small cysts on the outer edges.
• Endometriosis: A condition in which tissue similar to the lining inside the uterus is found outside the uterus, causing heavy periods.
• Adenomyosis: When the tissue that normally lines the uterus grows into the muscular wall of the uterus.
• Bleeding disorders: Conditions such as von Willebrand disease can cause heavy menstrual bleeding.
• Pelvic inflammatory disease (PID): An infection of the reproductive organs can result in heavy bleeding.
• Thyroid problems: Both hypothyroidism and hyperthyroidism can cause heavy menstrual bleeding.
• IUD (Intrauterine device): A non-hormonal IUD can increase menstrual flow.

Symptoms

Symptoms of heavy menstrual bleeding include:

• Soaking through one or more sanitary pads or tampons every hour for several consecutive hours
• Needing to use double sanitary protection to control menstrual flow
• Needing to wake up to change sanitary protection during the night
• Bleeding for more than a week
• Passing large blood clots (larger than a quarter)
• Restricting daily activities due to heavy menstrual flow
• Symptoms of anemia, such as tiredness, fatigue, or shortness of breath

Diagnosis

Diagnosis of heavy menstrual bleeding may involve:

• Medical history evaluation and physical examination
• Blood tests to check for anemia, thyroid problems, and blood-clotting disorders
• Pap test to check for changes in cervical cells
• Endometrial biopsy to take a sample of the lining of the uterus
• Ultrasound to obtain images of the uterus, ovaries, and pelvis

Treatment

Treatment for heavy menstrual bleeding may include:

• Non-steroidal anti-inflammatory drugs (NSAIDs): To help reduce menstrual blood loss
• Tranexamic acid: To reduce menstrual blood loss
• Oral contraceptives: To help regulate menstrual cycles and reduce bleeding
• Hormonal IUD (Intrauterine device): To reduce menstrual bleeding
• Iron supplements: To treat anemia caused by heavy menstrual bleeding
• Surgery: Procedures such as endometrial ablation, uterine artery embolization, or hysterectomy may be considered in severe cases

Prevention

While it may not be possible to prevent heavy menstrual bleeding, regular check-ups with a healthcare provider can help manage symptoms and underlying conditions. Maintaining a healthy lifestyle and managing stress levels can also be beneficial.

See Also

• Menstrual cycle
• Anemia
• Gynecology

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• Heavy menstrual bleeding
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  What is HMB

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  Prevalence

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  Heavy Menstrual Bleeding - Treatment Workflow

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  Treatment Choices

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  Efficacy of Treatments

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  Surgical Side Effects

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  Side Effects

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  Cancer Risks