Heavy Menstrual Bleeding: Causes and Concerns

Excessive menstrual bleeding?

Hello doctor! About three to four months ago, I started experiencing heavy menstrual bleeding.
Usually, the first three days have the heaviest flow, which is significantly more than what I used to have.
Then, on the fourth day, the flow starts to decrease dramatically, resembling what would typically be the amount on the sixth or seventh day, and sometimes my period ends by the fifth day.
Previously, my cycle lasted seven days.
This month, on the first day of my period, I had to change my sanitary pad every three hours because the flow was excessively heavy, almost like a continuous stream of blood, completely soaking the pad.
What could be causing this issue? These symptoms have only started in the last two to three months.
😞 Could you please help me understand? 😢😖 🙏🙏

Xiao Min, 10~19 year old female. Ask Date: 2022/03/07

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the possible reasons for heavy menstrual bleeding may include hormonal imbalance, emotional factors, diet, age, and others.
However, it is crucial to rule out conditions such as uterine tumors, endometrial hyperplasia, cervical lesions, and vaginal lesions.
If the bleeding persists, it is advisable to consult a physician for further evaluation.
Thank you! Wishing you safety and health.
Dr.
Zhang

Reply Date: 2022/03/07

More Info

Heavy menstrual bleeding, also known as menorrhagia, can be a concerning issue for many women. It is characterized by excessive menstrual blood loss that can interfere with daily activities and may indicate underlying health problems. Based on your description, it seems that you have experienced a significant change in your menstrual pattern over the past few months, with increased blood flow, especially during the first few days of your period.
There are several potential causes of heavy menstrual bleeding, and understanding these can help you determine the next steps for management and treatment. Here are some common causes:
1. Hormonal Imbalances: The menstrual cycle is regulated by hormones, and any imbalance can lead to heavier bleeding. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt hormonal levels.

2. Uterine Fibroids: These are non-cancerous growths in the uterus that can cause heavy bleeding. They can vary in size and number, and their presence can lead to increased menstrual flow and discomfort.

3. Endometrial Polyps: Similar to fibroids, these are growths on the lining of the uterus that can cause heavy bleeding. They can be benign but may require removal if they cause significant symptoms.

4. Adenomyosis: This condition occurs when the tissue that normally lines the uterus grows into the muscular wall of the uterus, leading to painful and heavy periods.

5. Coagulation Disorders: Some women may have underlying bleeding disorders that affect their ability to clot blood properly, leading to heavier menstrual bleeding.

6. Intrauterine Devices (IUDs): Certain types of IUDs, especially non-hormonal ones, can lead to heavier menstrual bleeding as a side effect.

7. Pelvic Inflammatory Disease (PID): This infection of the reproductive organs can cause irregular bleeding and may be accompanied by pain and other symptoms.

Given that you have experienced a significant increase in menstrual flow, particularly with the description of soaking through pads within a few hours, it is essential to seek medical attention. Heavy menstrual bleeding can lead to anemia due to blood loss, which can cause fatigue, weakness, and other health issues.

When you visit your healthcare provider, they may perform a thorough evaluation, which could include:
- A detailed medical history and physical examination.

- Blood tests to check for anemia and hormonal levels.

- Imaging studies, such as an ultrasound, to assess for fibroids or other abnormalities in the uterus.

- A pelvic exam to check for any signs of infection or other issues.

Treatment options will depend on the underlying cause of your heavy bleeding. They may include hormonal therapies (such as birth control pills), medications to help reduce bleeding, or surgical options if necessary (like a hysterectomy or removal of fibroids).

In summary, heavy menstrual bleeding can be caused by various factors, and it is crucial to address this issue with a healthcare professional. Early intervention can help manage symptoms effectively and improve your quality of life. Don't hesitate to reach out to your doctor for further evaluation and personalized treatment options.

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