Heavy menstrual bleeding, also known as menorrhagia, can significantly impact a woman’s quality of life, affecting her physical health, emotional well-being, and daily activities. In this article, we’ll explore the causes, evaluation, and treatment options for heavy menstrual bleeding, empowering women to seek appropriate care and find relief from this common gynaecological concern.
Causes of Heavy Menstrual Bleeding:
Heavy menstrual bleeding can have various underlying causes, including:
- Hormonal Imbalances: Fluctuations in hormone levels, particularly oestrogen and progesterone, can disrupt the normal menstrual cycle and lead to heavy bleeding.
- Uterine Fibroids: Noncancerous growths in the uterus, known as fibroids, can cause heavy or prolonged menstrual bleeding.
- Uterine Polyps: Small, benign growths in the lining of the uterus, called polyps, can lead to abnormal uterine bleeding.
- Adenomyosis: A condition where the tissue that lines the uterus grows into the muscular wall of the uterus, causing heavy periods and pelvic pain.
- Endometriosis: A condition where the tissue that lines the uterus grows outside of the uterus causing pelvic pain and heavy periods.
- Bleeding Disorders: Certain blood clotting disorders, such as von Willebrand disease, can contribute to heavy menstrual bleeding.
Evaluation of Heavy Menstrual Bleeding:
When evaluating a woman with heavy menstrual bleeding, healthcare providers will typically perform a thorough medical history, physical examination, and may recommend additional tests, including:
- Blood tests to assess hormone levels, thyroid function, and blood clotting factors.
- Pelvic ultrasound to evaluate the uterus, ovaries, and pelvic structures for abnormalities such as fibroids or polyps.
- Endometrial biopsy to sample tissue from the lining of the uterus to rule out conditions such as endometrial hyperplasia or cancer.
Treatment Options for Heavy Menstrual Bleeding:
Management strategies for heavy menstrual bleeding aim to address the underlying cause and alleviate symptoms. Treatment options may include:
- Non Hormonal Treatment:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce menstrual bleeding and relieve pain.
Tranexamic acid or oral progesterone to help control heavy bleeding.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce menstrual bleeding and relieve pain.
- Hormonal Treatment:
- Combined oral contraceptives with oestrogen and progestogens to help regulate the menstrual cycle and reduce bleeding.
- Oral or injectable progestins to help stop the bleeding
- Gonadotropin-releasing hormone (GnRH) agonists to temporarily induce a menopausal state and reduce menstrual bleeding.
- Minimally Invasive procedures:
- Uterine artery fibroid embolisation, a minimally invasive procedure to block blood flow to fibroids, reducing their size and alleviating symptoms.
- High Intensity Focused Ultrasound: A procedure using a specialised machine to direct high frequency ultrasound waves to targeted tissue causing necrosis of the area. This is mainly used in adenomyosis.
- Surgery:
- Endometrial ablation, a procedure to destroy the lining of the uterus, is an option for women who do not wish to become pregnant in the future.
- Hysteroscopic surgery: Surgical procedure to remove uterine fibroids or polyps that are in the lining of the uterus causing the ongoing bleeding
- Myomectomy: Surgical procedure to remove the uterine fibroid whilst preserving the uterus either done via open surgery or laparoscopic surgery.
- Endometriosis surgery : Surgical procedure to remove the endometriotic tissue that is causing the ongoing symptoms
- Hysterectomy, the surgical removal of the uterus, may be recommended for women with severe symptoms or underlying conditions that do not respond to conservative treatments.
Empowering Women to Seek Care:
If you are experiencing heavy menstrual bleeding, it’s essential to seek evaluation and treatment from a healthcare provider experienced in managing gynaecological conditions. Remember, you are not alone, and effective treatments are available to help you find relief and improve your quality of life. Do not hesitate to advocate for your health and well-being by discussing your symptoms and concerns with a trusted healthcare professional.
In conclusion, heavy menstrual bleeding is a common gynaecological concern that can have a significant impact on a woman’s life. By understanding the causes, evaluation process, and treatment options for this condition, women can take proactive steps to manage their symptoms and achieve better menstrual health. Remember, you deserve to feel comfortable and confident in your body, and seeking appropriate care is the first step towards achieving that goal.
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