The amount of blood lost during menstruation varies among women. However, menstruation can be considered – and experienced – as too heavy: this is called menorrhagia. Are you concerned? What are the causes of these significant flows? And what can be done to fix it?
“The periods are considered abundant if the duration exceeds 7 days and/or the total quantity is greater than 80 ml per day”, describe the Hospices Civils de Lyon (HCP) on their website. But how to concretely measure this quantity? The HCPs state that this “corresponds to approximately 5 medium UPCs filled, or more than 5 super plus tampons or more than 5 super plus sanitary napkins”. More practically, on a daily basis, if you have to change sanitary protection every hour and if you lose large blood clots, you can consider your flow to be too important.
To confirm your suspicions, also consider calculating your Higham score. To do this, simply complete a table corresponding to a menstrual episode, in which you will indicate per day of menstruation, the number of pads or tampons used.
What causes menorrhagia?
The reasons for these too abundant periods are multiple and can be related to pathologies. That’s why, if you meet the criteria for a heavy period described earlier, or if you’re having trouble with your menstrual flow, see a doctor.
When the cause is organic, “ in the vast majority of cases, these are benign lesions of the uterus such as fibroids or uterine polyps”, reassure the HCPs. But these menorrhagia can also be caused by endometriosis, certain cancers or even genital trauma. These causes are suspected when the abundance of menstruation changes abruptly. “An underactive thyroid gland, coagulation problems, such as Von Willebrand’s disease (a hereditary hemorrhagic disease, editor’s note) or even diabetes” can also be the cause, says Dr. Benchimol, gynecologist in Paris, on his website.
So-called iatrogenic reasons, that is to say the undesirable effects produced by taking medication or wearing medical devices, can also cause excessive flow. This is the case, for example, of wearing a copper intrauterine device, treatment with anticoagulants or aspirin, or hormonal treatment for menopause.
What support ?
Depending on the cause of your menorrhagia, your doctor can offer you treatments adapted to the disorders highlighted. This may include symptomatic treatment, such as iron supplementation, as such blood loss can lead to anemia, ie a lack of hemoglobin in the blood caused by iron deficiency. Treatments promoting coagulation or intended to treat the thyroid, as well as hormonal treatment (oral contraceptive, IUD which releases progesterone) may sometimes be indicated.
In some cases, a procedure to thin the uterine lining may also be offered. Just like an operation to shrink or remove fibroids.