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| heavy menstrual bleeding |
Heavy menstrual bleeding (menorrhagia) is one od the most common gynecologic abnormality that can take a heavy toll on the women it affects. Many women with heavy menstrual bleeding problem do not discuss their condition with their clinicians because they mistakenly believe that it is something they actually have to live with or some women also complain about their fear of hormonal and surgical therapy.
Definition
The definition of heavy menstrual bleeding refers to blood loss > 80 mL during menstruation. NICE (National Institute for Health and Clinical Excellence) of the UK proposed that heavy menstrual bleeding can be defined as excessive menstrual blood loss that interferes with patient's physical, emotional, socialm and material quality of life, and which can occur alone or in combination with other symptoms.
Epidemiology
About 30% of women experience heavy menstrual bleeding at some point of their lives. This condition affects more than 10 million women in USA each year, which is about one in five women; however only about 5% of women of reproductive age seek treatment for it annually.
Risk factors
There is a little facts about demographic risk factor of heavy menstrual bleeding. A study has reported that heavy menstrual bleeding has correlation with age, and others show no correlation of heavy menstrual bleeding with ethnicity, genetics, or parity. Lifestyle factors such as alcoholism and smoking are still unknown.
What causes heavy menstrual bleeding?
Here are the causes of heavy menstrual bleeding, according to FIGO classification system:
- Structural causes
- Endometrial or cervical polyps
- Adenomyosis
- Leiomyoma
- Malignancy and hyperplasia
- Non structural causes
- Coagulation disorders
- Ovulatory dysfunction
- Endometrial
- Iatrogenic
Treatment of heavy menstrual bleeding
Treatment of heavy menstrual bleeding should be based on many factors such as:
- Your medical history
- Causes and severity of heavy menstrual bleeding
- Tolerance for specific drugs or procedures
- Your future childbearing plans
Medication/drug therapies for heavy menstrual bleeding may include:
- Iron supplements, if heavy menstrual bleeding is accompanied by anemia
- Analgetics or nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen, ibuprofen, mefenamic acid, they help reduce menstrual blood loss and also relieve menstrual cramps (dysmenorrhea)
- Oral contraceptives, it can help regulate and normalize the menstrual cycles and also reduce prolonged menstrual bleeding
- Oral hormones (progesterone), it will correct hormonal imbalance and reduce menstrual bleeding
- Hormonal IUD (Mirena). It is an intrauterine device that contains progestin (levonorgestrel) which makes the uterine lining thin and reduce menstrual blood flow, relieve cramps.
