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Menorrhagia is the term used to describe heavy menstrual bleeding. A heavy period is the result of abnormal uterine bleeding, an entire sanitary pad can become soaked within an hour and the woman may then have to change pads frequently for many subsequent hours.

This condition may be caused by any number of reasons. The endometrium  (the lining of the uterus)  may become thickened, breaks down resulting in heavy bleeding.

Other causes of heavy bleeding are fibroids, polyps, cervical or endometrial cancer, thyroid disease, hormonal imbalance and local vaginal causes. There remains a large group of women where no identifiable cause can be found. We group these women into a large group called  Dysfunctional Uterine Bleeding or DUB.

How do I know when menstrual bleeding is abnormal?

You may be experiencing abnormal uterine bleeding if you are changing pads and/or tampons more often than one or two hourly or having a period lasting more than 7  days. With the heavy bleeding, you may be passing clots or flooding (when the blood runs down your legs.).Soiling the bed at night may also indicate that bleeding is excessive.

Uterine Bleeding is always abnormal when;

  • Bleeding occurs between periods
  • Bleeding occurs following sex
  • Spotting occurs at any time during the menstrual cycle
  • Bleeding is heavier than normal  or lasts for more days than usual
  • Bleeding occurs after menopause
  • Periods are extremely painful.

What causes abnormal uterine bleeding?

In Adolescents, young women and women approaching menopause abnormal bleeding is usually a result of a hormonal inbalance.They may not be ovulating (producing eggs).

Other causes include;

  • Fibroid tumors
  • Cervical or endometrial polyps
  • Hormonal imbalance
  • Cervical cancer
  • Endometrial cancer
  • Dysfunctional uterine bleeding
  • Local vaginal causes.

A single episode of heavy menstrual bleeding usually does not require treatment, however excessive uterine bleeding that continues for over 24 hours does.

Investigations & Treatment

A visit to the doctor will involve a history, examination, swabs and a smear test, blood tests and possibly an ultrasound.

From all information gained, a plan should be drawn up and a treatment plan worked out. The treatment will depend largely on the severity of the condition, the age of the women and her desire for children.

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