Understanding heavy menstrual bleeding
Heavy menstrual bleeding (called menorrhagia by health care professionals) is defined as soaking a pad and/or tampon every hour or less during each menstrual cycle. For many women, heavy menstrual bleeding is a huge obstacle to their lifestyles. The heavy bleeding can also lead to iron-deficient anaemia, the most common health-related threat of menorrhagia.
While most cases of anaemia are easily treated with oral iron supplements, sometimes the bleeding is so severe a woman’s entire volume of blood drops, leading to shortness of breath, severe fatigue and heart palpitations that require hospitalization.
There are several options you may want to try to reduce your heavy menstrual bleeding. These include:
- Ice packs. Put an ice pack on your abdomen for 20 minutes at a time, several times a day when bleeding is especially heavy.
- Vitamins.Try vitamin C supplements to help your body absorb iron and possibly strengthen blood vessels.
- Iron. Some research suggests low iron levels can increase menstrual bleeding, and that supplementing with the mineral can reduce menstrual bleeding.
- Always check with your health care professional before taking any medication—this includes taking herbal remedies and nutritional supplements—for managing health conditions or for general health and wellness concerns.
- Hysterectomy. Seventy-five to 80 percent of women with heavy menstrual bleeding do not need a hysterectomy, yet many women still opt for this surgical procedure, which is frequently recommended as a treatment option.. While very effective in ending uterine bleeding (without a uterus, your periods stop), hysterectomy is a major surgical procedure that requires hospitalization and weeks of recuperation. Additionally, hysterectomy is associated with a number of complications, with infection being the most common. Ask your health care professional to fully explain the surgery and potential benefits and risks to you. Though some women may prefer hysterectomy to other surgical options, be sure you understand all your options before making a choice. Other, less invasive surgical options are:
- Endometrial ablation. In this minimally invasive procedure, the lining of the uterus is destroyed via freezing, electricity, microwaves, radiofrequency (radio waves) or hot water. Ablation is performed on an outpatient basis or in a doctor’s office with mild anesthetic and has a very quick recovery. It enables a woman to keep her uterus and, in many instances, may halt her periods altogether. If you choose this treatment option, you should be sure to continue using contraception, as necessary; pregnancy following ablation is not recommended.
- Other surgical procedures, including myomectomy and uterine artery embolization, are recommended if fibroids are the cause behind the bleeding. Ask about these options, if necessary.
Questions to Ask Your Health Care Provider
- Is the amount of menstrual bleeding I’m experiencing abnormal?
- What tests do you need to conduct to diagnose my menorrhagia, and why are you doing them?
- Is this heavy bleeding affecting my iron levels? What can I do about that?
- Why are you recommending this particular treatment option for my heavy bleeding? If that doesn’t work, what do you recommend next?
- What are the disadvantages and risks associated with each recommended treatment?
- Even if you find a problem like fibroids causing my abnormal uterine bleeding, is it possible to avoid a hysterectomy?
- How many endometrial ablations of this type have you performed in the past year? What is your success rate? What kind of complications have you encountered?
Before considering surgery, ensure that your health care provider explains everything and all the procedures the surgery involves.