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Menorrhagia

                                   

Menorrhagia is a common disorder in women. In this condition blood flow lasts longer than 7 days. She may also pass blood clots larger in size than a quarter. In Menorrhagia there is menstruation at regular cycle intervals but with excessive flow and duration. Menorrhagia can lead to anemia if not treated.

Causes

  • Hormone imbalance: There may be an imbalance in oestrogen and progesterone levels.  As a result of the imbalance, the endometrium develops in excess. When it is eventually shed, there is heavy menstrual bleeding. 
  • Ovarian dysfunction: If the ovary does not release an egg, no progesterone is produced, resulting in a hormone imbalance.
  • Uterine fibroids: These are noncancerous, or benign, tumors.
  • Uterine polyps: These benign growths can result in higher hormone levels.
  • Endometriosis.
  • IUD
  • Infection: pelvic inflammatory disease
  • Cancer

Sign and symptoms

  • Bleeding for more than eight days.
  • Needing to change your pad or tampon during the night.
  • Have to change or restrict your daily activities due to your heavy bleeding.
  • Constant pain in lower part of stomach.
  • Lacking energy
  • Shortness of breath
  • Menstrual flow that includes large blood clots.

Diagnosis

  • Pelvic exam
  • Blood test to check thyroid, check for anemia and how the blood clots
  • Pap test to check cells from cervix for changes
  • Endometrial biopsy to check uterine tissue for cancer or abnormalities
  • Ultrasound 
  • Sonohysterography: During this test, a fluid is injected through a tube into uterus by way of your vagina and cervix. Doctor then uses ultrasound to look for problems in the lining of uterus.
  • Hysteroscopy to check for polyps, fibroids or other problems

Treatment

Drug therapy 

  • Non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen or naproxen sodium , help reduce menstrual blood loss.
  • Tranexamic acid. Tranexamic acid helps reduce menstrual blood loss and only needs to be taken at the time of the bleeding.
  • Oral progesterone. The hormone progesterone can help correct hormone imbalance and reduce menorrhagia.
  • Hormonal IUD
  • Antifibrinolytic medicines to reduce bleeding.

Surgical treatment

  • Dilation and curettage: In this procedure, doctor opens (dilates) cervix and then scrapes or suctions tissue from the lining of uterus to reduce menstrual bleeding. 
  • Uterine artery embolization treats fibroids.
  • Myomectomy: Is a surgical intervention to remove uterine fibroids through several small abdominal incisions, an open abdominal incision, or through the vagina.

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