Menorrhagia - Dysfunctional Uterine Bleeding
Dysfunctional Uterine Bleeding
Anyone who's experienced Menorrhagia - heavy prolonged menstrual bleeding - knows how unpleasant, disabling and frightening, it can be. Sometimes the bleeding is so heavy that it's necessary to miss work, school, or social activities.
Menorrhagia is defined as excessively heavy or prolonged bleeding (soaking through at least a pad an hour for several consecutive hours).
Menorrhagia is abnormal uterine bleeding, which may be caused by medical problems or hormone imbalances. Other types of abnormal uterine bleeding are too-frequent menstrual periods, bleeding between periods, and bleeding after menopause.CAUSESIn a normal menstrual cycle, there is a balance between estrogen and progesterone, two hormones in the body. These hormones regulate the buildup of the endometrium (uterine lining of blood and tissue), which is shed each month during menstruation. Menorrhagia can occur because of an imbalance between estrogen and progesterone. As a result of the imbalance, the endometrium keeps building up. When it is eventually shed, there is heavy bleeding. Because hormone imbalances are often present in adolescents and in women approaching menopause, this type of menorrhagia - known as dysfunctional uterine bleeding - is fairly common in these groups.
Another frequent cause of menorrhagia is uterine fibroids (growths). Together, hormone imbalances and fibroids account for about 80% of menorrhagia cases. Other causes include
- endometrial cancer.
- inflammation or infection of the vagina, cervix, or pelvic organs.
- polyps (small growths on the cervical or uterine wall).
- thyroid conditions.
- liver, kidney or blood diseases, and the use of blood-thinning drugs.
Most experts recommend seeing a doctor if a period lasts more than seven days and/or if periods are less than 21 days apart (unless that's normal for the woman.) Your doctor will probably ask about your past health and bleeding patterns, conduct a pelvic exam (examination of the internal reproductive organs), and do a pap smear and other tests. You may also have blood tests, and urine and stool tests for conditions of the gastrointestinal and urinary systems. A pregnancy test is likely if you are sexually active. Your doctor may remove a small amount of tissue from the endometrium for testing. You may also have investigations to determine whether you are ovulating or have any sexually transmitted diseases.
Although cancer is not a frequent cause of menorrhagia, it should be ruled out in older women (aged 35-40) or in younger women with longer duration of exposure to unopposed estrogen.TREATMENTSIf an underlying medical condition is causing menorrhagia, it should be treated. polyps are generally removed; fibroids may require myomectomy or hysterectomy. Hysterectomy and radiation are the usual treatment for endometrial cancer.
When a hormone imbalance is responsible for dysfunctional uterine bleeding, there are good hormonal treatment options.Before acting upon any of the information presented, you should consult with your personal healthcare provider. These questions are intended to help you formulate your own questions.
- I'm 38 and have had menorrhagia for the past year. It's a real problem. I want it treated, but I don't want a hysterectomy. What could be causing it What are my options
- I'm approaching menopause and have just started having menorrhagia. Is this likely to go away before too long, or does it need immediate treatment