Heavy Menstrual Bleeding: Risks of Shock and When to Seek Help

Q: Heavy Menstrual Bleeding: Risks of Shock and When to Seek Help

Hello, Miss： Thank you for your inquiry. <br>I would like to respond to your questions and provide the following suggestions： <br>1. <br>The definition of a normal menstrual cycle is as follows： it occurs every 21 to 35 days, lasts 1 to 7 days, and the total blood loss is approxi

Excessive menstrual blood loss can lead to shock?

Hello, doctor! I had a uterine fibroid removed three years ago due to prolonged menstrual periods, and since then my periods have been normal and I no longer experience menstrual pain.
However, for the past two months, my periods have become shorter with less flow, resembling deep brown residue, and then they would stop.
At the beginning of this month, my flow increased significantly, bright red in color, and each time I stood up it felt like a heavy flow, similar to a hemorrhage, with several large blood clots being expelled daily.
I am unable to concentrate at work, frequently need to use the restroom, and sometimes feel a sudden sensation of something releasing from within me while talking to others.
This situation has persisted for over half a month (from September 5 to September 22).
This week (September 23 to September 27), the flow has decreased slightly, and I thought it was coming to an end, but I still experience 1 to 2 episodes of heavy bleeding with clots in a single day, with no signs of stopping.

1.
Is this menstrual blood or abnormal bleeding?
2.
Is there a risk of excessive blood loss leading to shock?
3.
Should I see a doctor for an examination since it hasn't stopped?
Thank you for your answers, doctor!

Xiao Mi, 30~39 year old female. Ask Date: 2008/09/27

Dr. Zhong Wenzhen reply Obstetrics and Gynecology

Hello, Miss: Thank you for your inquiry.
I would like to respond to your questions and provide the following suggestions:
1.
The definition of a normal menstrual cycle is as follows: it occurs every 21 to 35 days, lasts 1 to 7 days, and the total blood loss is approximately 30 to 80 milliliters (for reference, a bottle of yogurt is 100 milliliters).
If any of these three criteria are not met, it is not considered a normal menstrual period.
2.
Cases of uterine bleeding leading to shock are often encountered in outpatient emergency settings and are not rare occurrences.
Therefore, please remember that abnormal uterine bleeding can cause severe anemia and even shock.
3.
If there is significant bleeding that poses a critical health risk, waiting for the bleeding to stop before seeking medical attention may be too late.
4.
It is advisable to seek medical attention early.
Wishing you safety and happiness!

Reply Date: 2008/09/27

More Info

Heavy menstrual bleeding, also known as menorrhagia, can be a significant health concern, especially for women who have a history of uterine issues, such as fibroids. Your symptoms, including the sudden increase in menstrual flow, the presence of large blood clots, and the vivid red color of the blood, suggest that you may be experiencing a more severe form of bleeding that could potentially lead to complications such as anemia or even hypovolemic shock if not addressed promptly.

1. Is this menstrual blood or abnormal bleeding?
The characteristics of your bleeding—specifically the heavy flow, large clots, and the sudden change from lighter to heavier bleeding—indicate that this is likely not just a normal menstrual cycle. Instead, it could be classified as abnormal uterine bleeding. The deep coffee-colored discharge you experienced previously could have been old blood, but the current fresh red blood suggests active bleeding. It is essential to differentiate between normal menstrual bleeding and abnormal bleeding, as the latter may require medical intervention.

2. Could this lead to excessive blood loss and shock?
Yes, heavy menstrual bleeding can lead to significant blood loss, which in turn can cause hypovolemic shock. This condition occurs when the body loses more than 20% of its blood volume, leading to symptoms such as rapid heartbeat, low blood pressure, confusion, and weakness. Given that you have been experiencing heavy bleeding for over two weeks, it is crucial to monitor for signs of shock. If you feel dizzy, lightheaded, or faint, or if you notice any other concerning symptoms, you should seek immediate medical attention.

3. Should you see a doctor?
Absolutely. Given the duration and severity of your symptoms, it is imperative to consult a healthcare provider as soon as possible. A medical professional can perform a thorough evaluation, which may include a physical examination, blood tests to check for anemia, and possibly imaging studies to determine the cause of the bleeding. Conditions such as uterine fibroids, polyps, hormonal imbalances, or even more serious issues like endometrial cancer can cause heavy menstrual bleeding, and timely diagnosis is crucial for effective treatment.

In the meantime, it is essential to take care of yourself. Ensure you stay hydrated, and consider iron supplements if you are feeling fatigued, but only after consulting with a healthcare provider. Avoid strenuous activities and keep track of your bleeding patterns, as this information will be helpful for your doctor.

In summary, your symptoms indicate that you are experiencing abnormal uterine bleeding, which can lead to serious complications if not addressed. It is vital to seek medical attention promptly to assess your condition and receive appropriate treatment. Your health and well-being are paramount, and timely intervention can help manage your symptoms and prevent further complications.

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