Heavy, Prolonged or Frequent Menstruation: what to do?

Do you have abundant menstruation? We explain the possible causes and solutions…

menstrual cycle

Hormonal, ovarian and endometrial changes of the female menstrual cycle.

Menstruation is the typical genital bleeding that affects all women with a cadence of about 28 days (menstrual cycle) during their reproductive years, a fairly large ranging from Menarche until the age of Menopause. It is the Endometrium cyclic disintegration, the mucous membrane that lines the Uterus inside and every month undergoes changes such that so it can afford and sustain a possible pregnancy. The result of the conception failure it is the menstraul bleeding.

In this article we talk about abundant (Menorrhagia), prolonged or frequent Menstruation (Hypermenorrhea, Polymenorrhea, Spotting).

Menstrual cycle alterations are fairly frequent and many women in the course of one’s life experience at least one episode of menstrual irregularity. These single or repeated episodes are always a time of anxiety, however, because the regularity of the menstrual cycle is always conceived as a state of well-being. Vice versa, any alteration causes anxiety and troubles.

In fact, changes in menstrual cycle are caused by different factors, among them the most common ones are:

  • Endometrial Polyps;
  • Endometrium Hyperplasia (overgrowth);
  • Uterine Fibromatosis;
  • Ovarian Cysts;
  • Ovarian Endocrine Diseases or Thyroid, Prolactin or Pituitary Gland disorders;
  • Medicines;
  • Ectopic Pregnancy;
  • Genital Tumors;
  • Blood Disorders.

A menstrual irregularities, frequent or abundant menstrual flow (too close together) or minor but prolonged bleeding always require attention and a gynecological consultation.

Medical examination is the main point. Often at the same time it is performed a Transvaginal Pelvic Ultrasonography. Other investigations, differential diagnosis path is oriented from these initial assessments. Exams often required, in addition to the pregnancy tests, are the hormonal assays (i.e. FSH, LH, PRL, TSH, 17 BETA ESTRADIOL preferably on the 2nd or 3rd day of the cycle to evaluate the ovarian reserve), hysteroscopy and blood chemistry tests.

Abundant Menstruation have a significant impact on daily life, sometimes limiting the capacity for work. A very common consequence is Anemia (Iron Deficiency Anemia) resulting in Asthenia (weakness), decreased performance and short attention span.

Therapy is closely related to the diagnosis and therefore can be medical and / or surgical. Functional disorders controlled by endocrine therapy and surgical therapy are generally conservative.

Endometrial Hyperplasias and Luteal Phase Deficiency are well controlled with cyclic administration of Progesterone or with the most modern medicated intrauterine devices. In emergencies are widely used Tranexamic Acid and non-steroidal anti-inflammatory drugs (NSAIDs).

Surgery is involved in a selective manner in removing of polypoid formations or fibroids while unfortunately, in tumor lesions is related to the typology of tumor and its stadiation.

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Filiberto Di Prospero
Medical Doctor, Consultant in Gynecology and Obstetrics, Endocrinology and Metabolism. Director of Gynecologic Endocrinology Unit at Civitanova Marche General Hospital (Italy). Private clinics in Civitanova Marche, Rome and Milan.

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