Menstruation, heavy and long (menorrhagia)

Description

Menstrual bleeding that is unusually heavy and lasts for a long time is called menorrhagia.

It is a menstrual disorder in which bleeding lasts for 7-14 days and more than 150 ml of blood is lost or more than five pads are needed per day.

Menorrhagia is usually caused by changes in the reproductive organs.

These include, for example:

• inflamed lining of the uterus - endometritis.
• muscular growths (benign) in the uterus - uterine fibroid
• proliferation of the endometrium - endometriosis
• Polyps
• Malignant changes in the uterus

Hormonal disorders are the cause of menorrhagia in about 10 percent of cases. Even rarer are blood coagulation disorders, high blood pressure, kidney or heart diseases.

An unusually heavy menstrual period lasting between 7 and 14 days.

To diagnose menorrhagia, the attending physician needs a precise description of the symptoms and may perform one of the following examinations to confirm the diagnosis:

• Examination of the vagina and cervix (possibly with a special microscope, colposcopy).
• Palpation
• Ultrasound
• Cancer smear
• Pregnancy test (if of childbearing age)
• General internal examination
• Computer tomography
• Magnetic resonance imaging

If a hormone disorder is suspected, blood and urine are also examined.

The treatment strategy depends on the cause of the menorrhagia.

If there are no organic changes, hormonal treatment is used, e.g. with gestagens to support the luteal phase. If there is no desire to have children, hormonal contraceptives such as the pill have also proved effective. If the general condition continues to suffer and the treatment does not work, in very rare cases and if family planning is complete, removal of the uterus can be considered.

In the case of fibroids or polyps (organic changes), surgical procedures or drug therapies are available. However, if a malignant change in the uterus is suspected, the lining of the uterus is first scraped out (abrasion or curettage).