Heavy periods, profuse mensuration or menorrhagia the facts

Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding (1). It is an extremely common conditions with varying presentations; some women have prolonged bleeding, and others have short but extremely heavy periods. The royal women’s hospital suggests that it is so common that 1 in 5 women experience heavy periods.

Menorrhagia is not to be confused with menorrhagia or dysfunctional uterine bleeding, which is bleeding outside the period.

Signs and symptoms of menorrhagia may include:

• Soaking through one or more sanitary pads or tampons every hour for several consecutive hours (However in Chinese medicine terms anything greater than 6 sanitary pads, 30+ mls, or 6+ tampons per day is heavy)
• Needing to use double sanitary protection to control your menstrual flow
• Needing to wake up to change sanitary protection during the night
• Bleeding for longer than a week
• Passing blood clots larger than a quarter
• Restricting daily activities due to heavy menstrual flow
• Symptoms of anaemia, such as tiredness, fatigue or shortness of breath (1)

Causes of Menorrhagia

In some cases, the cause of heavy menstrual bleeding is unknown, but a number of conditions may cause menorrhagia. Common causes include:

• General disorders such as blood dyscrasia, severe anaemia, psychological disorders, matrimonial disharmony and states of emotional trauma
• Local causes such as uterine myomas, endometrial polyps, other vertical or uterine neoplasms, where benign or malignant, retroverted uterus, first mensural period after birth or abortion, chocolate cysts in the ovaries, and granulose cell tumour in the ovaries
• Endocrine disorders, such as in the early stages of hyperthyroid and acromegaly, in the late stage of hypothyroidism, and in myxedena over age of 40 years.
• Intrauterine contraceptive devices (commonly know as IUD)
• Problems with oral contraceptives (3) 

Treatment of Menorrhagia

The western medicine treatment of menorrhagia is based on the correction of underlying ethology. Common treatments include medications such as oral contraceptives, or oblation. Other treatments include IUD removal or neoplasms removed. Menorrhagia in older women may results in total hysterectomy. However treatments can be difficult in younger women where cause is unknown or older women who do not want total hysterectomy.

It is important to not that many women in late 30’s and 40’s can have uterine fibroids. Anything larger than a ‘robins egg’ and if excessive bleeding is not brought under control by Acupuncture and Herbal Medicine, could consider an myomectomy surgical removal. However since women with 1 fibroid often have small ‘seed’ fibroids, which cannot be seen during surgery women surgically treated often go onto see one or more of these seeds develop into larger fibroids. So should continue treatment post surgery to decrease the chances of these growing and heavy bleeding to resume. 

It is important that heavy periods are properly investigated, as some of the less common causes can lower your iron levels and red blood cells. We recommend seeing your GP or gynaecologist before starting Acupuncture & Chinese herbal treatments to rule out more sinister causes.

Acupuncture & Chinese Herbal Medicine treatment of Menorrhagia

More information on treatment to come

References

1. https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829
2. https://link.springer.com/article/10.1186/s12905-018-0627-8
3. https://www.thewomens.org.au/health-information/periods/heavy-periods