Problem Periods (Menorrhagia)
Although many women experience heavy or prolonged bleeding during menstrual periods, few seek medical attention for the problem. The medical term for heavy and/or prolonged periods is menorrhagia. The cause for menorrhagia is found in only about half of those who do seek medical advice. The problem needs to be addressed for a number of reasons. The uterus has such a rich blood supply that a large amount of blood can be lost from it in a very short period of time. Also, heavy periods can sometimes be a warning sign of a serious medical problem.
Normal menstrual periods usually begin between 10 and 16 years of age, start about once every 21 to 35 days, and last 3 to 7 days each month.
Signs of Menorrhagia Include the Following:
- Heavily saturating tampons or sanitary pads during a period
- Staining of clothing or sheets due to heavy periods
- Becoming anemic due to blood loss during periods
- Periods that last for more than 7 days each month
Some physical or hormonal causes for heavy bleeding during periods may include:
- Abnormalities of the uterus such as fibroids or other non-cancerous tumors
- Irregularities in the hormonal cycle
- Use of IUDs
Drugs can increase menstrual bleeding because they affect the blood clotting system including:
- Nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil® or Motrin®) and other over-the-counter medications that contain these drugs.
- Anticoagulants (like warfarin or coumadin, or heparin or low molecular weight heparin)
Finally, two recent studies on menorrhagia found that between 17 and 20% of the women may also have inherited bleeding disorders. One study in The Lancet (Kadir, 1998) found an even higher rate of such disorders for women who experienced menorrhagia consistently from the time their periods first began.
Until fairly recently it was commonly believed that only men could have inherited bleeding disorders. It is now known that both men and women are affected by these disorders. Von Willebrand’s Disease, platelet disorders, and deficiencies of clotting factors VIII, IX, X and XI are all found in women. Von Willebrand’s Disease is usually a mild bleeding disorder that is believed to affect at least 1% of the population and men and women in equal numbers.
In addition, half of all female carriers of hemophilia A and B may have levels of factor VIII or IX below the normal range. As many as one in five of these carriers have a clotting factor level low enough to cause symptoms similar to mild hemophilia.
Symptoms of a bleeding disorder include:
- Easy bruising
- Bleeding from gums
- Frequent or prolonged nosebleeds
- Heavy menstrual periods
- Prolonged bleeding after surgery, dental work, or childbirth
Women who have one or more of these symptoms should talk to their health care providers about whether or not testing for a bleeding disorder is indicated. All females who are known or potential carriers of any inherited bleeding disorder should ask about having their clotting factor levels checked regardless of whether they have symptoms or not. Knowing the status of your blood clotting system can prevent serious problems in the event of trauma, surgery or pregnancy.
For more information:
Go to the Hemophilia and Inherited Bleeding Disorders health topic.