Hypermenorrhea is a heavy and long menstrual cycle affecting 10% of women, caused by hormonal imbalances or medical conditions. Symptoms include heavy bleeding and blood clots, and treatment options range from drug therapy to surgery depending on severity. Women of all ages can be affected.
Hypermenorrhea, also known as menorrhagia, is an excessively long or heavy menstrual cycle that occurs regularly. While about 30% of women have a heavy period, it is estimated that only about 10% of women suffer from hypermenorrhea. A typical menstrual cycle averages five days and has total blood loss of less than 1/3 cup (80 mL). However, a woman with a menstrual cycle that lasts more than seven days, with blood loss greater than 1/3 cup (80 mL) is considered hypermenorrhea.
The excessive bleeding of this condition is caused by hormonal imbalances or various medical conditions. Uterine fibroids and endometrial cancer can both cause thickening of the uterine wall, which leads to heavy bleeding. Vaginal inflammation, uterine polyps, and thyroid conditions can also be contributing factors
The most common symptoms include heavy menstrual flow that requires changing pads or tampons every one to two hours and large blood clots in the menstrual blood. It is best to see a doctor as soon as possible if you suspect that you have hypermenorrhea. Iron deficiency anemia can occur if the condition is left untreated, as excessive bleeding can reduce blood iron levels. Experiencing symptoms of anemia, such as shortness of breath and fatigue, along with other symptoms, may be an indication that the condition is present.
Some women are at a higher risk of developing the disorder. Teenage girls are most prone to the condition in the 12 to 18 months after their first period, as they don’t yet ovulate regularly. Women approaching menopause are also more likely to experience heavy bleeding, as hormonal imbalances are more common at this time. However, hypermenorrhea can affect women of all ages at any time during their reproductive life.
Treatment of hypermenorrhea depends on your overall health and the cause and severity of the problem. Drug therapy may be an option and includes iron supplements if anemia is present, nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce bleeding, oral contraceptives, and synthetic hormones such as progesterone. If drug treatment is unsuccessful, surgery may be required.
Surgical procedures are varied and will depend on the severity of the case. Dilation and curettage, also known as “D and C,” is done by dilating the cervix and scraping or aspirating excess tissue from the uterine walls to reduce menstrual bleeding. Endometrial ablation uses ultrasound energy to destroy the uterine lining permanently, which often results in a normal menstrual flow afterward. Endometrial resection uses an electrosurgical wire loop to remove the lining of the uterus and is typically used when heavy bleeding occurs, but there are no underlying uterine problems.
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