Menorrhagia is a condition in which there is heavy menstruation. This is a symptom of an underlying problem but not the problem itself. There can be many causes of excessive bleeding for women. A gynecologist, physician who specializes in the reproductive health of women, should be the one to diagnose the problem.
Diagnosis of irregular menstruation relies on several methods. The doctor will take a comprehensive history that will include questions such as: the age she started her period (menarche), how long the period lasts (days), how many days there are between periods, any recent changes in her normal monthly schedule, if she is sexually active, the date of the last pelvic exam, if she is pregnant or was recently pregnant, and if she is on birth control pills and what kind.
The doctor may also ask the patient to keep a calendar of her bleeding history to keep track of any pain during the month, length of her periods, bleeding between periods and how many days are between periods. Patients are also asked to rate the amount of flow on the days of her period.
Diagnostic tests also include ultrasounds that can be done in the office to visualize fibroids or uterine wall changes. Doctors can also inject fluid into the uterus and perform an ultrasound procedure called a sonohysterogram. This test will help to evaluate the uterine walls and any structural abnormalities.
Some common causes of heavy menstruation include uterine fibroids, endometrial hyperplasia, hormonal imbalances and polyp growths on the walls of the uterus. Non-typical causes are Von Willebrand disease which is an inherited coagulation disorder, pelvic inflammatory disease (PID), liver cirrhosis, lupus, Intrauterine Device (IUD) birth control and diabetes.
Another non-typical cause of heavy menstruation is a Vitamin K deficiency. Vitamin K will cause bleeding disorders and has been associated with abnormal uterine bleeding.
There are several reasons why patients may be deficient in Vitamin K that includes using anticoagulants, salicylates, long-term antibiotics, metabolic diseases, or a large intake of Vitamin K antagonists such as Vitamin E or Vitamin A. One of the symptoms of hypothyroidism is heavy menstruation. Women who have hypothyroidism, after treatment, lose the problem of heavy bleeding.
Treatment for irregular menstruation is based on the cause. After a thorough exam, history and testing the doctor can give the patient a accurate diagnosis and treatment plan based on current medical practice. The goal of treatment is to decrease the heavy menstruation and increase the patient’s comfort.
