Heavy Menstrual Flow: Causes, Symptoms, and When to See a Doctor

Q: Heavy Menstrual Flow: Causes, Symptoms, and When to See a Doctor

Hello： Based on the statement, there are indeed abnormalities. <br>Your concerns can be confirmed through a physician's consultation and examination. <br>A pelvic examination may be necessary; if refused, a rectal examination can be considered. <br>If both the pelvic and rectal e

Heavy menstrual bleeding?

Hello doctor, I would like to ask about my menstrual changes this year.
My menstrual flow has increased significantly compared to two years ago.
Previously, my periods were regular, lasting 4 to 5 days with a need to change pads 4 to 5 times a day.
However, this year, my periods either come every 20 days or take over a month to arrive, with a much heavier flow and a lot of blood clots.
I sometimes need to change pads 6 to 8 times a day, and I've also started experiencing menstrual cramps, which I rarely had before.
Additionally, I often consume cold drinks and fried foods.
Could this be affecting my condition? If I need to see a gynecologist, will an internal examination be necessary?

Zhou, 20~29 year old female. Ask Date: 2012/07/12

Dr. Zhong Wenzhen reply Obstetrics and Gynecology

Hello: Based on the statement, there are indeed abnormalities.
Your concerns can be confirmed through a physician's consultation and examination.
A pelvic examination may be necessary; if refused, a rectal examination can be considered.
If both the pelvic and rectal examinations are declined, the physician can utilize a combination of palpation, ultrasound, X-rays, laboratory tests, and other methods to achieve a diagnosis and treatment.
Wishing you peace and good health.

Reply Date: 2012/07/12

More Info

Heavy menstrual flow, also known as menorrhagia, can be a concerning symptom for many women and can arise from various underlying causes. Given your description of experiencing significantly heavier menstrual bleeding than in previous years, along with the presence of blood clots and increased menstrual pain, it is essential to understand the potential causes and when to seek medical attention.

Causes of Heavy Menstrual Flow
1. Hormonal Imbalances: Fluctuations in hormone levels, particularly estrogen and progesterone, can lead to heavier periods. Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can disrupt hormonal balance.

2. Uterine Fibroids: These benign growths in the uterus can cause increased bleeding and pain during menstruation. They are quite common and can vary in size.

3. Endometrial Polyps: Similar to fibroids, these are growths on the lining of the uterus that can lead to heavy bleeding.

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

5. Coagulation Disorders: Conditions that affect blood clotting, such as von Willebrand disease or other bleeding disorders, can lead to heavier menstrual bleeding.

6. Pelvic Inflammatory Disease (PID): An infection of the reproductive organs can cause abnormal bleeding and pain.

7. Medications: Certain medications, particularly anticoagulants or hormonal therapies, can affect menstrual flow.

8. Lifestyle Factors: Diet and lifestyle choices, such as a high intake of processed foods or excessive caffeine, can also impact menstrual health.

Symptoms to Monitor
In addition to heavy bleeding, you mentioned experiencing increased menstrual pain and the presence of blood clots. Other symptoms that may warrant medical attention include:
- Bleeding that lasts longer than seven days.

- Needing to change your pad or tampon every hour for several consecutive hours.

- Passing large blood clots (larger than a quarter).

- Symptoms of anemia, such as fatigue, weakness, or shortness of breath.

When to See a Doctor
It is advisable to consult a healthcare provider if you experience any of the following:
- Significant changes in your menstrual cycle, such as increased flow or irregular periods.

- Severe menstrual pain that disrupts your daily activities.

- Symptoms of anemia.

- Any other concerning symptoms, such as unusual discharge or fever.

Diagnostic Approach
When you visit a gynecologist, they may recommend a variety of diagnostic tests to determine the cause of your heavy menstrual flow. These may include:
- Pelvic Examination: This may involve an internal exam to check for abnormalities in the reproductive organs.

- Ultrasound: A pelvic ultrasound can help visualize the uterus and ovaries to check for fibroids or polyps.

- Blood Tests: These can assess hormone levels, check for anemia, and evaluate clotting factors.

- Endometrial Biopsy: In some cases, a small sample of the uterine lining may be taken to check for abnormalities.

Internal Examination
Regarding your question about whether an internal examination is necessary, it often depends on your symptoms and the doctor's assessment. An internal pelvic exam can provide valuable information about the health of your reproductive organs and may be recommended based on your symptoms.

Lifestyle Considerations
You mentioned consuming cold drinks and fried foods. While these dietary choices may not directly cause heavy menstrual flow, a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health and may help regulate menstrual cycles. Staying hydrated and managing stress levels are also important.

In conclusion, heavy menstrual flow can be a sign of various underlying conditions, and it is essential to seek medical advice to determine the cause and appropriate treatment. Monitoring your symptoms and maintaining a healthy lifestyle can also contribute to better menstrual health.

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