The term hypermenorrhea refers to excessively heavy menstruation. In this, there is a significant increase in blood loss as well as additional shedding of tissue. The causes are changes in the reproductive organs or other mental and physical disorders. Depending on the individual reason for the symptoms, hypermenorrhea can be treated differently.
What is hypermenorrhea?
Hypermenorrhea is understood by experts to be an excessive loss of female menstruation. On average, women lose up to 150 milliliters of blood during their period. If this amount is sometimes significantly exceeded, physicians speak of hypermenorrhea. This also applies if more than five pads are used daily or a tampon becomes so full in less than two hours that it has to be changed. Secreting larger clots of blood (blood clots) can also be a sign of increased menstrual bleeding. Hypermenorrhea may be accompanied by period pain and other symptoms, but it does not have to be. If particularly heavy bleeding occurs, even for several days, it can have a significant impact on quality of life. The causes of hypermenorrhea are usually organic in nature and thus represent a symptom of an underlying disease or a tissue change. In some circumstances, however, severe stress can also cause unusually heavy bleeding to occur.
Causes
Hypermenorrhea is caused by an organic change in the reproductive organs in up to 80 percent of cases. This may be benign fibroids (tumors) or polyps in the uterus, for example, or inflammation of the organ, but the fallopian tubes may also be affected by endometriosis (growths) or inflammation of the fallopian tubes, for example. Serious diseases such as uterine cancer can also lead to increased menstrual bleeding. In some women, however, the contraceptive device is also responsible for the symptoms. The IUD in particular can have a direct influence on the strength of menstruation. If the patient has a hormonal disorder in which, for example, too little progestin is produced or present, the hypermenorrhea may also be due to this. In some circumstances, however, other causes outside the reproductive organs can also be identified as the cause. For example, severe stress or a general blood clotting disorder may cause increased menstrual bleeding.
Symptoms, complaints, and signs
Hypermenorrhea is primarily manifested by markedly increased menstruation, during which the patient must change her hygiene products very frequently. Sanitary napkins and tampons are already soaked after a few hours and can sometimes hardly withstand the amount of blood. It is not uncommon to find larger clots of blood and tissue in the blood, which also come off with the urine when the patient goes to the toilet. Pain, lower abdominal cramps and other typical menstrual symptoms can occur in this context; however, hypermenorrhea can also occur independently of other symptoms. If very heavy bleeding occurs over a period of several days, the patient may suffer from circulatory problems and temporary anemia (anemia). This may also result in a lack of red blood cells.
Diagnosis and course of the disease
The diagnosis of hypermenorrhea is comparatively simple and can usually be detected by the patient herself. If a gynecologist is consulted, he will, in addition to a detailed conversation, also perform an ultrasound examination to detect or rule out any changes or inflammation of the reproductive organs. An internist may need to be consulted to clarify the cause if it is not to be found in the gynecological area. The course of hypermenorrhea or the underlying disease depends on its nature. They all require medical treatment, because particularly serious diseases can lead to infertility or even cause a life-threatening condition.
Complications
Hypermenorrhea in most cases causes not only physical, but also psychological discomfort in the patient. Increased monthly bleeding occurs in the woman, which may also be associated with severe pain. The affected person suffers from strong cramps in the area of the lower abdomen. The urine may also be discolored red.Due to hypermenorrhea, the quality of life is greatly reduced for a short time. Circulatory problems continue to occur if the affected person loses too much blood. In the worst case, this can lead to a loss of consciousness. As a rule, hypermenorrhea also has a negative effect on the patient’s psyche and can thus lead to mood swings and general irritability. In this case, if necessary, the partner may also suffer from psychological discomfort. There are no further complications during the treatment itself. This usually takes place with the help of medication. If it is a tumor, it can be removed. However, complications may arise in this case if the tumor has already spread to other parts of the body.
When should you go to the doctor?
In the case of hypermenorrhea, even if it occurs only once, the doctor should be consulted to clarify the cause. Blood loss is not problematic in the case of normal menstrual bleeding, but it can lead to crying problems if it is much higher and exceeds the healthy level. Of course, it can happen that a menstrual period is heavier than usual, but this is no reason for concern. However, if this happens more frequently or even regularly, then the cause should be clarified in the long term. The consumption of pads or tampons can be an indication of the need for a visit to the doctor, because hypermenorrhea is said to occur from 5 pads per day or when a tampon is soaked up in less than 2 hours. If lumps are observed in the menstrual blood, this also indicates hypermenorrhea, which must be examined by a doctor. If dizziness, nausea, severe abdominal pain or even brief fainting occurs shortly before or during such heavy bleeding, do not wait any longer to see a doctor. Women who are currently trying to become pregnant should have it ruled out that the pregnancy did work out, but that they lost the fetus again very early. This may also be behind presumed hypermenorrhea, and the affected patient should then be examined for possible residual endometrium.
Treatment and therapy
Treatment of hypermenorrhea is cause-related and accordingly depends on the condition responsible for the increased bleeding. Inflammation of the uterus or fallopian tubes can often be treated with medication. After the infection has subsided, the bleeding also becomes noticeably weaker. If fibroids in the uterus are the cause of the symptoms, surgical removal of the tumors is advisable in many cases, even if they are benign. Polyps can also be removed in this way, which also leads to a significant improvement in symptoms. Hormone imbalances can be compensated for with medication. In particularly severe cases, scraping out the uterus may be the last resort to get hypermenorrhea under control. This involves removing the mucosa in layers using either a special instrument, a suction cup or a laser. However, this measure should only be taken if no other therapy is effective, because it results in a complete absence of menstruation. This also means that the patient cannot have children after a curettage. After the procedure, it is not uncommon to experience fever, pain and postoperative bleeding, which is why constant medical monitoring is essential in the first few days.
Outlook and prognosis
Hypermenorrhea is problematic for the affected patient during the period because of the high blood loss. She may suffer from circulatory problems with dizziness and fainting during this time, and the usual symptoms of menstruation may also be increased during hypermenorrhea. Furthermore, during hypermenorrhea, it is difficult for many women to manage their daily lives, as they need to be near a toilet all the time and can expect soiling of clothing and underwear to happen anyway. If a patient suffers from hypermenorrhea occasionally or regularly, this condition is unlikely to improve on its own without the administration of low-dose hormones. Exceptions exist in young women whose cycle is just settling. During puberty, hypermenorrhea is uncomfortable but may regulate on its own in early adulthood. In the case of severe hypermenorrhea, it can be assumed that there is a bleeding focus in the uterus that triggers the bleeding.Hypermenorrhea will therefore not disappear without a curettage, which is usually necessary quickly due to the severe symptoms alone. Afterwards, the patient’s condition improves with the administration of hormones over a period of several months, once she is properly medicated. If all this does not help and hypermenorrhea continues to occur even with treatment, then removal of the uterus is a conceivable last option – which, of course, makes all symptoms disappear for good.
Prevention
Hypermenorrhea can only be prevented to a limited extent. A healthy lifestyle certainly helps to reduce the risk of disease in the abdomen as well. Reducing stress in work and personal life can also lead to an increased sense of well-being and improved health. If the complaints occur and visibly interfere with the patient’s daily life, it is advisable to consult a doctor. Only in this way can a more serious cause for the heavy bleeding be ruled out and appropriate therapy initiated.
Follow-up care
After hypermenorrhea has subsided, the patient must take it easy for a few days. It is important to rebalance nutrient depots, which can sometimes be severely depleted by blood loss. It is best for those affected to adjust their diet in order to quickly make up for the loss and not risk any further health complications. Above all, fruit, vegetables, fish and protein-rich foods with sufficient minerals such as gruel or nuts should be consumed. Patients who regularly take medication should adjust their intake in consultation with their doctor. Especially shortly after hypermenorrhea, hormonal balance and the immune system may be severely out of balance. It is advisable to ensure sufficient exercise and avoid stress. Typical triggers of heavy bleeding should now be particularly avoided. If the symptoms recur or do not subside completely within a few days or weeks despite comprehensive aftercare, a visit to the doctor is recommended. Regular visits to the gynecologist are also part of the aftercare. The physician will take a medical history and, if necessary, also perform a physical examination. If symptoms persist, a blood or saliva sample will provide information about possible causes, which can then be specifically treated.
What you can do yourself
First, a gynecological examination should rule out organic causes for hypermenorrhea. If there is no physical cause or if it cannot be remedied, self-treatment with various medicinal herbs helps in many cases. Typical “women’s herbs” such as shepherd’s purse, yarrow, lady’s mantle and bloodroot can be enjoyed as a tea preparation or taken in the form of drops or dragées. Professional herb, bird’s knotweed and cinnamon also have a positive effect on heavy menstrual bleeding, and monk’s pepper has a regulating effect on hormone balance. On days with very heavy bleeding, it can be helpful to wear dark clothing: Especially in everyday working life, this can avoid embarrassing situations caused by visible blood stains on clothing. It is also advisable to always keep a supply of hygiene products at the workplace or in your handbag. If sanitary pads or tampons are not sufficient, they can be well combined on critical days. If severe fatigue occurs as a result of the heavy loss of blood during or after the period, affected women should make sure they get sufficient rest and recovery phases during this time. To counteract deficiency symptoms, lost iron can be replaced by eating iron-rich foods such as legumes, wheat bran, pumpkin seeds, flaxseed, meat and liver. Red berries and beet also contain a lot of iron, and vegetable iron can be better absorbed by the body in combination with vitamin C.
