What is Menorrhagia?
What is Menorrhagia? Menorrhagia or excessive menstruation is the excessive or excessive amount of menstrual blood. During the menstrual period, the average amount of blood released is 30-40 ml. And a woman is considered experiencing excessive menstruation if the quantity of blood that he issued ranged between 60-80 ml.
Actually the amount can not be a definite benchmark because the amount of menstrual blood in every woman is different. However, to make it easier for you as a woman to recognize this condition, consider certain indications, such as the number of bandages you spend or the frequency of blood through your clothes because they are not covered by bandages.
From these indications you can compare it to your previous menstrual periods that you normally go through. If you are worried about menstruating excessively, then you should see a doctor.
Symptoms of menorrhagia
In addition to too much blood is released, excessive menstruation can also be accompanied by other symptoms, namely pain. Commonly known as pain or menstrual cramps, which in medical language is known as dysmenorrhea. Dysmenorrhea generally occurs when the uterine wall contracts and suppresses the surrounding blood vessels. As a result, the supply of oxygen stops and causes pain.
Although not always a sign of a serious condition, excessive menstruation can disrupt the daily life of women who experience it, both emotionally, psychologically, and socially.
Causes of menorrhagia
There are a number of conditions that have the potential to cause women to experience excessive menstruation, such as uterine fibroside, endometriosis, endometrial polyps, and the use of spiral or IUD (intrauterine contraceptive devices).
In addition to these four conditions, some others that may also cause excessive menstruation are:
- Polycystic ovary syndrome
- Pelvic inflammatory disease
- Blood clotting disorders
Meanwhile, for the causes of excessive menstrual cases are very rarely encountered is cervical cancer.
Diagnosis of menorrhagia
Diagnosis of menorrhagia can usually be performed by a doctor from any symptoms. To get information about the symptoms felt by the patient, the doctor will ask how much blood the patient is taking and how long the menstrual period is common to them. In addition, doctors will also ask how often patients need to replace their pads and whether the patient feels other symptoms that accompany, such as pelvic pain, post-sex pain, and whether or not bleeding between monthly menstrual schedules.
Further examination is usually done depending on the results of the initial examination and the patient’s own medical history. If the doctor suspects that there are other conditions that cause the patient to experience excessive menstruation, then follow-up examinations as follows are necessary, including:
- Examination of the inner pelvic area
- Blood examination
In addition to lowering or stopping the volume of bleeding and preventing the occurrence of iron deficiency anemia, menorrhagia treatment also aims to improve the quality of life sufferers.
But if the doctor does not suspect a serious problem that causes menorrhagia, or the condition does not interfere with daily activities of the sufferer, treatment is not necessary.
There are two ways to treat menorrhagia, namely through drugs and surgery. Drugs are often the primary choice especially if the examination is still running and has not shown definite results about the cause of menorrhagia. The doctor may administer the medication if the patient does not feel any symptoms that lead to serious conditions.
Some types of medications that can be used to treat menorrhagia are:
- Tranexamic acid tablets. This drug proved to reduce bleeding to almost 58%. Tranexamic acid works by helping the blood clotting process in the uterus. Side effects that may arise from the use of this drug is diarrhea and dispesia.
- Nonsteroidal anti-inflammatory drugs (NSAIDS). In addition to relieve symptoms of pain, this drug can also reduce production of one of the hormones that play a role in the occurrence of menorrhagia, the hormone prostaglandin. Examples of NSAID drugs that can be used are ibuprofen, naproxen, and mefenamic acid. This drug can reduce bleeding up to 49%. Possible side effects of using NSAIDs are similar to those of tranexamic acid, diarrhea and dispesia.
- Combined contraceptive pills. Pills containing these hormones progestogen and estrogen can prevent the release of eggs in the uterus every month. In addition to treating menorrhagia, this drug can also reduce menstrual pain and cope with irregular menstrual cycles. Side effects that may arise from the use of this drug is fluid retention, nausea, breast pain, and mood swings.
- LNG-IUS (Levonorgestrel-releasing intrauterine system). This is a kind of contraceptive that can reduce bleeding up to 96%. LNG-IUS works by slowing the growth of the lining of the uterus. This small plastic tool is used by inserting it into the uterus. In the womb LNG-IUS will then release the hormone progestogen slowly. Side effects that may arise from the use of this drug is the appearance of acne, pain or discomfort in the breast, and amenorrhoea (cessation of menstruation during the period of use).
- Injectable progestogen and norethisterone drinking agent (artificial progestogen). Their performance in treating menorrhagia is similar to that of LNG-IUS, which slows the growth of uterine cell wall. Common side-effects from the use of injectable progestogens are weight gain, delayed pregnancy (usually up to six months to a year after treatment is stopped), prahaid syndrome (breast pain, fluid retention, and flatulence). While the side effects of oral norethisterone drinking drugs are breast pain and acne growth.
- Analog GnRH (Gonadotropin releasing hormone). This is one of the drugs that is effective in reducing bleeding during menstruation. GnRH agonist therapy is not usually done routinely, but rather as a temporary treatment for patients who will take surgery to treat menorrhagia. Occasionally, in the case of benign tumors in the uterus or fibroids, GnRH agonist hormones may be given injectable form. Side effects that may result from this therapy is sweating, hot flashes of the body (hot flashes), and dry vagina.
The surgical procedure will usually be recommended by a doctor if menorrhagia is no longer treated with medication. There are various types of surgery for this condition, and some of them are:
- Embolization of the uterine artery. This procedure is intended to treat menorrhagia caused by fibroids. Fibroids are non-cancerous tumors that grow in the uterine lining. In the procedure of embolization of the uterine artery, fibroids are depreciated by blocking its arteries using micro-sized plastic beads. As a result the blood supply to the fibroids stops. The plastic beads are injected through a special tube inserted into the groin. Arterial artery embolization is the procedure most preferred by a doctor, because besides its high success rate in treating menorrhagia caused by fibroids, this procedure also rarely complicates.
- Myomectomy. In myomectomy, fibroids are removed surgically. This procedure can be performed by surgery through the abdominal wall, through the manufacture of small holes (laparoscopy), or through the vagina (hysteroscopy). In some cases, fibroids re-grow after myomectomy.
- Endometrial Resection. This procedure destroys the uterine wall using hot wire. After undergoing this procedure, pregnancy is not recommended.
- Endometrial Ablation This procedure is performed by permanently destroying the wall of the uterus. There are two types of endometrial ablation techniques. The first is to destroy the lining of the uterus by using a balloon that is inserted into the uterus and then heated. The second technique is to destroy the lining of the uterus by using radiation waves.
- Hysterectomy. Usually this procedure is taken when menorrhagia can no longer be handled by any means and the symptoms are very severe. Hysterectomy is a surgical removal of the uterus that will automatically stop menstruation forever and make the patient can not have children anymore.