Heavy Menstrual Bleeding (Menorrhagia): Causes and Tips

Women who have a heavy menstrual bleeding often also suffer a lot from other period-related complaints. Here you can find out the causes and what helps!

What is a heavy menstrual bleeding?

In gynaecology, we speak of a heavy menstrual bleeding (“hypermenorrhoea”) if a tampon or bandage has to be changed within two hours (actually, a change about every four hours is sufficient). Normally women lose between 60 and 80 millilitres of blood per menstrual period, in hypermenorrhoea it is usually more than 80 millilitres. About nine to 14 out of every 100 women have a heavy menstrual bleeding, which on the one hand promotes iron deficiency through blood loss and on the other hand can aggravate typical menstrual problems.

Often these women are also affected by the so-called menorrhagia – an excessive bleeding for more than five to seven days. The cause is often the same for both phenomena.

Causes: What causes heavy menstrual bleeding?

A few girls have a heavy menstrual bleeding from their first menstruation, but many women suffer from it much later – for example after the birth of a child, after the insertion of the contraceptive coil or due to hormonal changes. The most common reason for increased menstrual bleeding is that the uterus cannot contract properly. The contraction causes the mucous membrane in the uterus to loosen, which makes it easier for blood to be washed out for a certain period of time.

The following factors can prevent the uterus from contracting:

• Benign tumours such as myomas or polyps
• Spiral in use
• Inflammation of the uterus or fallopian tubes
• Adhesions (congenital or as a result of endometriosis)
• In some cases heart, kidney or liver disorders, blood clotting disorders, hormonal changes or thyroid gland disorders

It is interesting to note that cancer-related changes do not usually trigger heavy menstrual bleeding.

Symptoms: What are the symptoms of heavy menstrual bleeding?

There are three basic symptoms that speak for heavy menstrual bleeding:

• Tampons and bandages of normal size must be changed permanently about every two hours.
• During the period, the woman suffers from severe fatigue, listlessness and physical weakness.
• The menstrual blood contains many thick blood clots.

Help, anaemia: What can happen due to a heavy menstrual bleeding?

Women who bleed excessively during menstruation can slip into iron deficiency. However, the body needs a lot of iron to build new red blood cells. If not enough is available, anaemia develops. The red blood cells transport oxygen through the body – if this supply decreases, we feel tired and exhausted. Paleness and cold hands and feet can also be a consequence.

Help with heavy menstrual bleeding: tips for everyday life

Depending on the cause, the excessive period can be treated. Benign growths, for example, can be removed surgically. The following treatment options also help to reduce the symptoms:

• Drugs to reduce the bleeding.
• Taking the pill – this inhibits the growth of the uterine lining and thus the bleeding.
• If you no longer wish to have children, the lining of the uterus can be sclerosed or removed.

The following tips will help to make everyday life easier in case of heavy menstrual periods and menstrual problems:

• If possible, work close to the toilet in case the bandage or tampon change suddenly becomes urgent. A home office may also be an alternative.
• Dark clothing conceals possible mishap stains.
• Waterproof underlay in bed in case blood is lost overnight.
• The combination of tampon and bandage can also provide security against heavy bleeding.
• At the workplace and in their handbag, affected women should always have appropriate hygiene articles in stock for safety reasons.