Hypermenorrhea is defined as abnormally heavy menstrual bleeding in terms of amount and duration. Normal blood loss is 28–80 ml. However, menstrual bleeding is considered heavy if it exceeds 80 ml. Most women do not have heavy enough periods to be classified as hypermenorrhea.
What causes hypermenorrhea? There are many factors that can cause hypermenorrhea , including sudden weight changes, stress, and certain medications. In older women, hypermenorrhea can be a harbinger of menopause. Although it is a physiological phenomenon, increased menstrual flow during perimenopause should not be underestimated , and it is always recommended to consult a doctor and, if necessary, undergo an examination to ensure that this condition is not caused by other pathologies.
In women of reproductive age, certain gynecological diseases are often associated with the occurrence of hypermenorrhea , such as endometrial hyperplasia, uterine fibroids and polyps, adenomyosis . Other possible causes of hypermenorrhea include: genitourinary infections of any origin, including sexually transmitted diseases, and hormonal imbalance. In hormonal imbalance, the endometrium develops excessively, which leads to heavy menstrual bleeding during menstruation. Hormonal imbalance can be caused by numerous diseases, including polycystic ovary syndrome (PCOS), obesity, insulin resistance , thyroid dysfunction, adrenal dysfunction, and pituitary tumors.
What are the risk factors? Risk factors vary depending on age and the presence of other medical conditions. In a normal cycle, the release of an egg from the ovaries stimulates the body to produce progesterone, which is primarily responsible for the regularity of the cycle. The lack of release of an egg leads to insufficient progesterone levels and heavy menstrual bleeding. Hypermenorrhea in adolescent girls is usually caused by anovulation . Adolescent girls are particularly prone to anovulatory cycles in the first year after their first menstrual period ( menarche ). Other problems, such as bleeding disorders, liver disease, or kidney disease, may also be predisposing factors.
What are the signs of hypermenorrhea? Symptoms of hypermenorrhea may include: completely soaking one or more pads or tampons every hour for several hours at a time; having to wake up to change pads during the night; bleeding for more than a week; blood clots that are a quarter the size of normal. Symptoms of anemia, such as tiredness, fatigue, or shortness of breath, may develop.
When should you see a doctor? If heavy menstruation occurs repeatedly, it is recommended to see a gynecologist at the Bogolyuby Medical Center for appropriate diagnostic tests. Depending on clinical suspicion, hormone levels, pelvic ultrasound, and other tests, including a Pap smear and endometrial biopsy, may be indicated. To assess the causes of hypermenorrhea , it is necessary to accurately mark the beginning of each cycle (i.e., the day of the onset of menstruation) in your menstrual calendar.
Treatment of hypermenorrhea should be aimed at eliminating the underlying cause. If no specific pathology is identified, heavy menstruation may be a temporary phenomenon. Sometimes this problem can be dealt with simply by following a healthy diet, doing moderate exercise, managing stress, and changing your lifestyle. In more severe cases, that is, when heavy menstruation is caused by other problems, the doctor may prescribe pharmacological treatment, which includes: non-steroidal anti-inflammatory drugs (NSAIDs) and oral contraceptives. The latter help regulate the menstrual cycle and reduce the number of episodes of excessive or prolonged menstrual bleeding.
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