MENORRHAGIA

The menstrual cycle isn't the same for every woman. Menstrual period may be regular or irregular, light or heavy, painful or pain-free, long or short and still be considered normal.

Normal menstrual flow :

• Occurs every 21 to 35 days.
• Lasts four to five days.
• Produces a total blood loss of about 2 to 3 tablespoons ( 30 to 44 milliliters ).

Menorrhagia is an abnormally heavy and prolonged menstrual period at regular intervals, with a blood loss of greater than 80 ml ( 5 1/2 tablespoons ) or lasting longer than 7 days from normal menstrual.
Menorrhagia also called hypermenorrhea for prolonged duration, although most use both terms interchangeably in the clinical setting.

The signs and symptoms of menorrhagia may include :

• Menstrual flow that soaks through one or more sanitary pads or tampons every hour for several consecutive hours.
• The need to use double sanitary protection to control your menstrual flow.
• The need to change sanitary protection during the night.
• Menstrual periods lasting longer than seven days.
• Menstrual flow that includes large blood clots.
• Heavy menstrual flow that interferes with your regular lifestyle.
• Tiredness, fatigue or shortness of breath (symptoms of anemia).

Causes may be due to abnormal blood clotting, disruption of normal hormonal regulation of periods or disorders of the endometrial lining of the uterus. Depending upon the cause, it may be associated with abnormally painful periods ( dysmenorrhea ).

The conditions may cause menorrhagia include:

1. Hormonal imbalance.
In a normal menstrual cycle, a balance between the hormones estrogen and progesterone regulates the buildup of the lining of the uterus ( endometrial ), which is shed during menstruation. If a hormonal imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding.

2. Dysfunction of the ovaries.
Lack of ovulation ( an ovulation ) may cause hormonal imbalance and result in menorrhagia.

3. Uterine fibroids.
These noncancerous ( benign ) tumors of the uterus appear during your childbearing years. Uterine fibroids may cause heavier than normal or prolonged menstrual bleeding.

4. Uterine fibroids.
These noncancerous ( benign ) tumors of the uterus appear during your childbearing years. Uterine fibroids may cause heavier than normal or prolonged menstrual bleeding.

5. Polyps.
Small, benign growths on the lining of the uterine wall ( uterine polyps ) may cause heavy or prolonged menstrual bleeding. Polyps of the uterus most commonly occur in women of reproductive age as the result of high hormone levels.

6. Adenomyosis.
This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and pain. Adenomyosis is most likely to develop if you're a middle-aged woman who has had many children.

7. Intrauterine device ( IUD ).
Menorrhagia is a well-known side effect of using a nonhormonal intrauterine device for birth control. When an IUD is the cause of excessive menstrual bleeding, you may need to remove it.

8. Pregnancy complications.
A single, heavy, late period may be due to a miscarriage. If bleeding occurs at the usual time of menstruation, however, miscarriage is unlikely to be the cause. An ectopic pregnancy implantation of a fertilized egg within the fallopian tube instead of the uterus also may cause menorrhagia.

9. Cancer.
Rarely, uterine cancer, ovarian cancer and cervical cancer can cause excessive menstrual bleeding.

10. Inherited bleeding disorders.
Some blood coagulation disorders such as von Willebrand's disease, a condition in which an important blood-clotting factor is deficient or impaired can cause abnormal menstrual bleeding.

11. Medications.
Certain drugs, including anti-inflammatory medications and anticoagulants ( to prevent blood clots ), can contribute to heavy or prolonged menstrual bleeding. Improper use of hormone medications also can cause menorrhagia.

12. Other medical conditions.
A number of other medical conditions, including pelvic inflammatory disease ( PID ), thyroid problems, endometriosis, and liver or kidney disease, may cause menorrhagia.

Aside from the social distress of dealing with a prolonged and heavy period, over time the blood loss may prove to be greater than the body iron reserves or the rate of blood replenishment, leading to anemia.

Symptoms attributable to the anemia may include :

• Shortness of breath
• Tiredness
• Weakness
• Tingling
• Numbness in fingers and toes
• Headaches
• Depression
• Becoming cold more easily
• Poor concentration

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