> Menorrhagia and menstruation abundant: symptoms, causes and cures

Cos’è menorrhagia

For menorrhagia refers to heavy bleeding, excessive and prolonged that occurs during the menstruation:. In general, the majority of women do not suffer from this disorder or, at the very least, the phenomenon does not è così serious to be diagnosed as menorrhagia. Is a problem, however, più prevalent among women in for pre-menopausal women.

Normally, the woman suffers from menorrhagia accusation, in addition to a heavy bleeding, abdominal cramps. It is, at times, a condition that interferes with the activitiesà daily. If you feel that your disorder is of concern for the health, have recourse to the doctor, in fact, there are several effective remedies.

Caution, do not confuse the menorrhagia with the breakthrough bleeding, the latter is, in fact, a condition of abnormal bleeding that occurs outside the period.

Sintomi

The classic symptom of menorrhagia is that which occurs during menstruation, a loss of blood is abundant, at times accompanied by pain. A condition that può continue for a period longer than normal.

typically this situation is recognizable:

  • duration of menses greater than one week.
  • the

  • From the need to replace the absorbent of the night, waking up.
  • the

  • From the needà to change a pad every hour for more hours in a row.
  • the

  • By blood clots in the menstrual flow.
  • the

  • From the symptoms of anemia, such as the feeling of tiredness and fatigue, or from lack of breath.
  • the

  • To be a limitation of activity; regular

If you do bleed so as to saturate the towels after an hour, and the thing repeats itself for a couple of hours, go to the doctor. Go to the doctor even if you do bleed irregularly between one cycle and another, and, if you are in menopause, any vaginal bleeding should be subject to health control.

Complications

women who have menses absent for long periods can have side effects. The first true indicator of the amount; of blood lost is anemia, what is the value of hemoglobin of less than 12.

The dose of iron (iron working) and ferritin (the iron deposit) are, as a rule, low even in women with normal menstruating. Anemia canò be made manifest with:

    the

  • Fatigue.
  • the

  • mood Disorders a depressive character.
  • the

  • Loss of hair
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  • Dry mucous membranes

Cause

You may have breakthrough bleeding menstrual medium without any cause, especially in età youth, but there may also be causes recognizable.

hormone Imbalance. During the menstrual cycles, the alternation of oestrogen and progesterone causes an increase the regular of the mucous membrane that lines the inside of the uterus (endometrium). In this case, the endometrium (which is not used for the implantation of a pregnancy) will beà ejected at the time of menstruation without excessive losses of blood. If there is secretion of progeterone, such as, for example, in the cycles without ovulation, the endometrium grown irregularly verrà expelled in an irregular way, causing an increase of the losses.

Dysfunction of the ovaries. How già said, in the absence of ovulation, the endometrium, subjected to a hyper-stimulation of estrogenic (absolute in young women, and the relative perimenopause), sfalderà irregularly, causing heavy bleeding during menstruation. The cause of the majority of cases, except for the perimenopause, not è failure ovarian, but the dysfunction of mechanisms that regulate the ovulation at the level of central (pituitary and hypothalamus).

    the

  • the uterine Fibroids. These are neo benign growths of the uterus and extremely frequent. Are more frequent after the age of 30, but even if rarely some women may suffer before. Depending on the location, uterine fibroids can cause menstruation is very abundant.
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  • Polyps. These are small formations, starting from the endometrium, usually from one to three-four inches, which may cause menstruation abundant that irregular bleeding patterns. Are usually removed to prevent a degeneration of the tumor, even if rare.
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  • the Adenomyosis. It is a condition in which the normal boundaries between the endometrium and the myometrium (the muscle layer that lies beneath the endometrium and which is responsible for the activity; contractile uterine) are altered. This può cause menses are very abundant, and è più frequent in adult women who have had pregnancies.
  • the

  • the intrauterine Device (IUD). Also known as spiral, può to have as a side effect of the cycles is very abundant. In these cases, può be removed and replaced with a IUD medicated to the progestogen, on the contrary, reduces the amount; of blood ejected with the menses.
  • the

  • the Complications of pregnancy. If menstruation abundant occurs after a delay of menstruation, it is necessary to think about the possibilityà of a miscarriage. If you do not è never seen the room gestational and the symptoms do not resolve in a short time spontaneously, or after a medical or surgical treatment, keep in mind the possibilityà of an ectopic pregnancy is not always easily diagnosable by ultrasound.
  • the

  • the Cancer. As the cancer give a very più frequently bleeding irregular, in case of doubt, sarà very useful to keep in mind this eventualità
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  • the bleeding disorders congenital. There are diseases that are not related to the reproductive system that can give bleeding abundant. A type example is the Von Willebrand disease (a disease that results in a delayed clotting of the blood).
  • the

  • the Medicines. A cause of menstruation abundant that può be neglected is the intake of nonsteroidal anti-inflammatory drugs, and anticoagulants.
  • the

  • the Other medical conditions. Can be direct or indirect cause of menstruation abundant pelvic infections and diseases of kidney, thyroid and liver.

risk Factors

The cause of the più frequent menstruation abundant è surely the cycle anovulatory (i.e. without ovulation).

estrogen is produced continuously by the ovaries and stimulates the growth of the inner lining of the uterus (the endometrium). The progesterone which stabilizes the endometrium and compact allowing for easy release, it is secreted only if there is ovulation. This explains whyé in the lack of ovulation si avrà a endometrium irregular sfalderà irregularly at the time of menstruation, causing an abundant loss of blood.

più common to have anovulatory cycles at the beginning and at the end of the fertile life. In adolescents, becauseé the cycle is still perfectly adjusted, and the willà with the time, in adult women becauseé not è più running and andrà to exhaust itself in time.

Diagnosi

The diagnosis of menorrhagia is made through the history of the woman concerned. The amounts and categories of absorbent are used, especially during the night, and the days of duration of the cycle, any absence from work due to the impossibilityà to control the loss when it is out of the house, are clear signs of menorrhagia.

The necessary examinations are:

    the

  • complete Blood count with platelets to assess the degree of anemia.
  • Test of coagulation.
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  • Tests for the control of thyroid hormone and other hormones.
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  • Ultrasound-pelvic and transvaginal evaluation of the genital apparatus is internal. Depending on the result of this, you willà need to have a hysteroscopy.
  • the

  • the Pap test, if you do not è was performed according to the required interval.

Cures and treatments

medical Treatment

The treatment of abnormal bleeding depends on the condition. In young girls if the symptomatology is not too intrusive, it is possible to expect that the cycle has returned to normal spontaneously. If the losses and the pain interferissimo with the activity; school and sports, sarà can reduce them through the use of progestogens (the pill). It is necessary to remember that, if the menses are particularly abundant, may be useful in some investigation.

In women più large, especially if the symptom occurs after menstruation and normal years, sarà necessary to investigate the cause. Very often, even in this case, the administration of progestogens sarà able to reduce the bleeding, but in many cases, renderà necessary to a cure of the basic cause.

symptomatic treatment with antiemorragici it is usually a good idea to stop a situation acute, but not può be defined as a treatment that cures the patient. Willà be necessary to make an integration by preparations of iron and many types of anti-inflammatories (FANS) can relieve pain and often reduce the blood loss.

When the cause is in the anovulatory cycles, due to the lack of the stabilizing effect of progesterone on the endometrium, to have an exfoliation regular è possible to administer synthetic progestins by mouth or intramuscularly in the second phase of the cycle.

può administering the progestin via an intrauterine system (IUD or Spiral Mirena), which releases this hormone constantly to the inside of the uterus. In the first period of its use, può cause spotting, but the menstrual bleeding is immediately less. With the passing of months, the spotting ends, and in any case you get to the total absence of menstruation. This total absence, brings the benefit of the end of the anemia.

recently has been introduced the use of Ulipristal acetate (Hesmya) for the reduction of fibroids. The very high cost, and the transitorietà of the effect could be limited toò to use.

In women in perimenopause with more than 50 years and that, in general, can not or do not want to make use of hormone replacement therapy (HRT), è can the use of GnRH analogues, inhibitors that are central to the production of hormones that cause menopause drug with all the side effects resulting (hot, vaginal dryness, insomnia, etc..). It is also necessary to notify the women that their use seems to anticipate the menopause.

surgical Treatment

The surgical treatment of può be necessary, or during a period of extremely abundant in a woman’s già anemizzata from previous cycles, or when the drug therapy does not effect, or when the woman does not want to take medications, or it is necessary to suspend them for the side effects.

    the

  • the Review of the cavità uterine (curettage). This intervention consists in the dilatation of the cervix and removal, using a teaspoon metal più or less sharp, of the endometrium is irregular, which results in the loss of rich blood. The advantage of this procedure consists in the immediate reduction of the loss and the ability to send to histological examination of the removed material. Relief forò è usually temporary and, if you do not remove, or do not treat the causes, menorrhagia recurs in subsequent cycles.
  • the

  • the uterine artery Embolization. It is possible to reduce the size of uterine fibroids by closing the blood vessels that nourish the fibroids themselves. This procedure is performed by interventional radiologists and è the più of the times, it is very effective.
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  • the uterine artery Embolization. For women whose menorrhagia is caused by fibroids, the goal of this procedure is to reduce any fibroids in the uterus, blocking the uterine arteries to cut off their blood supply. Another procedure of reducing the size of the fibroids is “bombardarli” with ultrasound, in this case there is no engraving.
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  • the Myomectomy. Fibroids can be removed surgically or laparoscopically, or by laparotomy. In case you are immediately under the endometrial lining, può run by hysteroscopy.
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  • the endometrial Ablation. It is possible to reduce the internal mucous of the uterus procedures are destructive (cryotherapy, thermal ablation). This method is indicated only for women who do not desire pregnancy in the future and should be associated to a contraception effective.
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  • the Resection endometrial. In this case, the endometrial lining is removed surgically through electrocautery. Also in this case, a subsequent pregnancy sarà the più of the times impossible, but still to be avoided.
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  • the Hysterectomy. The removal of the uterus is to be carried out only in case of associated pathology that is not otherwise treatable (fibroids of large size, conditions of pre-cancer of the endometrium).
    In the past, hysterectomy has been made in inappropriately as also in the case of the sterilità not to be a problem in the uterus contributes to the static and the functionalityà of the pelvic floor and its removal in può have side effects.

IN ARGOMENTO:

Dysmenorrhoea, menstrual pain: causes, treatments, medications and remedies

False menstruation, symptoms and characteristics

uterine Fibroid. Symptoms, medical and surgical therapies,

Menorrhagia: symptoms, causes, diagnosis, and treatment

The right diet for premenstrual syndrome and menopause

14 dicembre 2015

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