On average, women have their periods every 28 days. Some women can have lighter periods, while other women may have heavier periods. The New York University Langone Medical Center notes that about 30 percent of women have heavy periods, though 10 percent of women have abnormal heavy vaginal bleeding called menorrhagia.
Differences Between a Normal Period and Menorrhagia
Women who have menorrhagia lose more blood during menstruation. MayoClinic.com explains that during a normal period, a woman will lose between 30 to 44 mL of blood; in comparison, a woman with menorrhagia will lose 81 mL during her period. With the heavier blood flow, women soak a tampon or sanitary pad every hour for several hours. Large blood clots may appear in the menstrual blood. Women with menorrhagia can have periods that lasts for more than seven days, compared to four to five days in a normal period.
Risk Factors
Certain women have a higher risk of having abnormal heavy vaginal bleeding. Epigee, a women's health website, notes that women in their adolescent or premenopausal years have a higher risk of menorrhagia. Being overweight can also increase the risk of menorrhagia. Other risk factors include hereditary bleeding disorders and using medications like blood thinners.
Causes
Epigee explains that the common causes of menorrhagia include a hormonal imbalance of progesterone and estrogen and uterine fibroids, which are benign tumors. Other conditions can contribute to the onset of menorrhagia. For example, MayoClinic.com notes that adenomyosis, in which the endometrium glands become embedded in the uterine muscles, can cause menorrhagia. An improperly placed intrauterine device, or IUD, can cause menorrhagia. Certain medications, like anti-inflammatory medications and anticoagulants, can contribute to the onset of the heavy menstrual bleeding. Women with ovarian dysfunction, uterine polyps or pelvic inflammatory disease can have menorrhagia. A history of certain cancers, like uterine, cervical and ovarian, or of pregnancy complications, like miscarriage or ectopic pregnancy, can result in menorrhagia. Other causes include kidney or liver disease, endometriosis and thyroid problems.
Complications
Abnormal heavy vaginal bleeding can lead to some complications. For example, some women may have menstrual cramps called dysmenorrhea, which cause severe pain. Women who have dysmenorrhea may need medication or surgery. MayoClinic.com points out that women with menorrhagia may develop iron deficiency anemia, in which they have a low blood hemoglobin. Symptoms of iron deficiency anemia include fatigue, pale skin and weakness.
Treatment
Since abnormal heavy vaginal bleeding can become disruptive, women may need treatment. For discomfort, women may take non-steroidal anti-inflammatory drugs, such as ibuprofen. Women may take blood clotting enhancers like tranexamic acid. The New York University Langone Medical Center explains that women with menorrhagia may receive hormone-related treatments, such as an IUD with progesterone, or hormonal therapy, which involves estrogen, progesterone or both.
Surgical options are also available for menorrhagia. Women may undergo an endometrial ablation, in which the doctor removes the lining of the uterus. Other options include dilation and curettage and operative hysteroscopy. The most extreme surgical option, hysterectomy, involves the removal of the uterus.
