Hypermenorrhea • Increased menstrual periods

Hypermenorrhea means increased menstrual bleeding. The menstrual bleeding therefore occurs at the normal time interval, but the blood loss is significantly more than usual. When is treatment necessary?

Very heavy menstrual bleeding is known in medical jargon as hypermenorrhea and is defined as regular blood loss of more than 80 milliliters (ml) during menstruation. A total of 20 to 60 ml of blood is normal. The opposite is hypomenorrhea with a small amount of blood (less than 5 ml) and a shortened bleeding time.

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What is hypermenorrhea?

With normal bleeding, it takes an average of four hours for a full-sized tampon or pad to saturate. However, the bleeding intensity varies and is not the same every day.

With a blood loss of more than 80 milliliters, on the other hand, it takes less than two hours before normal-sized hygiene items have to be changed. More than five tampons or pads are then necessary a day. Hypermenorrhea often also leads to the separation of blood clots (coagula). Other accompanying symptoms can be severe menstrual pain.

However, heavy bleeding that does not yet meet the criteria for hypermenorrhea can also be perceived as distressing and lead those affected to the doctor’s office. Menorrhagia is present if the menstrual period is not only very heavy but also prolonged. The terms hypermenorrhea and menorrhagia are often used interchangeably.

Possible cause of hypermenorrhea

The triggers for heavy menstrual bleeding are very different. Only in rare cases do the symptoms indicate serious diseases such as uterine cancer or cervical cancer.

Causes of hypermenorrhea:

  • benign growths in the lining of the womb (polyps)
  • growths in the muscular layer of the uterus (fibroids)
  • endometriosis
  • fallopian tube inflammation
  • Cysts, for example on the ovary
  • Miscarriage (especially in early stages)
  • hormonal changes during menopause
  • copper spiral (intrauterine device)
  • general blood clotting disorder
  • starker Stress

Consequences: If hypermenorrhea persists for a long time, there is a risk of anemia

It is not uncommon for the heavy loss of blood to lead to fatigue, dizziness and iron deficiency – especially if the hypermenorrhea lasts for several days. Prolonged heavy menstrual bleeding can result in a lack of red blood cells (erythrocytes) and anemia due to iron deficiency.

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Diagnosis of suspected hypermenorrhea

If it occurs once, women should seek medical help. Because the cause of hypermenorrhea should always be clarified, preferably in a gynecological practice. This also applies to women who are trying to get pregnant. In some cases, the loss of the fetus at a very early stage of pregnancy is behind hypermenorrhea. Then a gynecological examination makes sense to remove any residues of the endometrium.

An ultrasound examination is used to detect possible changes or inflammation of the genitals. If it does not provide an exact cause of the hypermenorrhea, a curettage (removal) may be necessary. Here, mucous membrane is extracted from the uterus under anesthesia and examined under the microscope.


Therapy for increased bleeding

The treatment of hypermenorrhea depends on the symptoms and causes present. Inflammation of the fallopian tubes or uterus is usually treated with medication. Fibroids and polyps can often be surgically removed. Non-hormone-based active ingredients, which are also used for increased menstrual bleeding, are antifibrinolytics such as tranexamic acid. Painkillers such as ibuprofen or diclofenac can be taken for abdominal pain. An iron deficiency can be remedied with appropriate preparations.

It is also important for the choice of therapy whether the patient wants to have children, because some treatments are opposed to this. On the one hand, these are surgical methods such as removal of the uterus (hysterectomy) or removal of the lining of the uterus (endometrial ablation). On the other hand, hormone-based therapies that are also used for contraception are successful: the birth control pill and the hormone spiral.

Home remedies and tips for everyday life with hypermenorrhea

If there is no organic cause behind the hypermenorrhea, patients can also try herbal remedies. Preparations with monk’s pepper or ergot are possible – but these should only be taken after consulting a doctor. Shepherd’s purse, yarrow, lady’s mantle and tormentil can also be prepared as tea, for example. However, their effect on hypermenorrhoea and menorrhagia has not yet been sufficiently scientifically proven.

Relaxation techniques such as yoga also help some women during heavy menstrual periods. Anyone suffering from exhaustion and tiredness due to blood loss should ensure adequate rest and recovery. Foods with iron can help against iron deficiency, for example:

In everyday life and at work, dark clothing can be helpful during hypermenorrhea. If blood stains form, they are concealed and not so easily visible. In addition, affected women can leave hygiene items in their handbag or at work so that they always have enough tampons, pads or menstrual cups to hand.

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Source: Lifeline | Das Gesundheitsportal by www.lifeline.de.

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