Abundant menstruation is possible. Very heavy periods - causes and dangerous symptoms, diagnosis, methods of therapy and prevention

By the regularity of menstruation, the amount of blood loss, soreness, one can judge the health of a woman. Normally, menstruation lasts up to 7 days, they should not be accompanied by a pronounced violation of well-being, loss of strength. During this time, up to 150 ml of blood is lost. This volume manages to be compensated by the internal reserves of the body and is not reflected in the analyzes. But what to do with heavy periods that exhaust, break the usual rhythm of life?

What is considered a pathology?

The duration of the cycle is on average 28 days, but the duration may vary on an individual basis. Directly on the monthly accounts for 4-7 days. If the discharge is observed for more than the maximum period, pathology should be suspected.

Menstruation may be accompanied by minor pain, but should not disturb the usual rhythm of life. If you are forced to take time off from work, to spend time lying in bed, then this is also a reason to see a doctor.

The amount of blood loss is critical. It should not lead to the development of anemia, the signs of which are dizziness, tachycardia, darkening of the eyes, shortness of breath. How to determine whether it is heavy periods or bleeding: you need to calculate how often the pads change. If a tampon or sanitary napkin overflows within an hour, this is not normal.

The detachable endometrium may look like small strands or clots. But sometimes bleeding occurs with the release of large dark clots and a small amount of light blood. This condition also has its reasons.

Why does the nature of the secretions change?

The causes of heavy periods can be different - from minor functional disorders to severe pathologies.

Pathology of the uterus

With severe myomatosis, an increase in the internal area of ​​\u200b\u200bthe uterus occurs, a change in its shape. Therefore, the endometrium is separated longer, there is more of it, which means that the bleeding is more abundant. Endometriosis is a pathological growth of the endometrium. It grows into the muscular layer of the uterus. The separation is accompanied by pain, profuse blood loss. Both pathologies develop against the background of hyperestrogenism, which contributes to endometrial hyperplasia. This condition is also characterized by intermenstrual bleeding.

Causes of heavy periods with clots may be in a change in the shape of the uterus. If there are, which interfere with the normal outflow of blood, it lingers inside, has time to curl up and comes out in the form of clots.

It is worth alerting when heavy periods with clots appear after 45 years. Especially if the woman has already entered the period of menopause, and menstruation has been absent for a long time. These changes may be due to cancer.

Abortion and childbirth, the presence of an IUD

If there were complications during the birth of a child or in the postpartum period, such as bleeding or inflammation, the former can be very profuse. After a caesarean section, such changes in the nature of the discharge are also the result of trauma to the uterus. When breastfeeding, menstruation is absent for a long time. But on initial stage Period recovery may take longer than usual.

A change in the duration and intensity of menstruation is observed after intrauterine manipulations:

• abortion:
• scraping;

Also, do not forget about the possibility of spontaneous abortion. Sometimes a woman is unaware of her pregnancy. Often this situation is observed with an irregular cycle. Then a delay of several days is perceived as the norm. But the fetus is not attached to the uterine cavity, after a short delay, more pronounced than usual bleeding begins.

The presence of an intrauterine device increases the likelihood of changes in the abundance of blood loss. Only in the case of using an intrauterine system with gestagens "" for endometriosis and myoma, the volume of blood lost will decrease, and the number of critical days will be reduced.

Medications

Application medicines, which thin the blood, can make menstrual bleeding longer. This applies to Aspirin, a group of antiplatelet agents and anticoagulants that are used in the treatment of thrombosis and blood clotting pathologies.

Medical abortion is carried out with the help of drugs that lead to the death of the fetal egg and its natural rejection. Sometimes, with incomplete menstruation, there are abundant. This condition must be monitored by ultrasound, with the development of complications, it will be necessary to health care.

Abundant periods after a course of Duphaston are a consequence of the effect of the drug on the endometrium. Under the influence of the hormone, the growth of blood vessels in it increases. A looser mucous membrane during menstruation is actively rejected.

Hormonal changes

In the period of formation monthly cycle in adolescents, bleeding of different nature may alternate. The same can be said about women who are on the verge of menopause.

Diseases and hypovitaminosis

Pathologies of the endocrine organs, blood coagulation systems, including congenital ones, can affect the volume of blood loss during menstruation. The lack of vitamins C, K, P, as well as calcium, disrupts the process of blood clotting, which threatens to worsen the condition during menstruation.

There are also data on the influence of the nature of nutrition. A diet with a predominance of lactic acid products - kefir, cottage cheese, yogurt - leads to an increase in the synthesis of substances in the liver that thin the blood. The result is a deterioration in its coagulability.

Principles of therapy

The gynecologist chooses treatment tactics only after establishing the cause pathological condition. It is unacceptable to decide on your own what to drink during heavy menstruation. Self-medication will lead to the progression of the pathology and its transition to a severe form.

Medications

Hemostatic drugs belong to different groups. The choice of a particular remedy may depend on the cause of heavy menstruation.

• Askorutin

Is an vitamin preparation, the action of which is aimed at strengthening the walls of blood vessels. But the effect develops gradually, not earlier than after 3 weeks of regular intake. Therefore, it is used for prophylactic purposes, as well as after intrauterine manipulations. The analogue is the drug Rutascorbin.

• Vikasol

Vitamin preparation, a source of vitamin K. This is a component of prothrombin, a protein that ensures blood clotting. For appointment medication you need to bring the diagnosis and prove that the cause of bleeding is precisely the deficiency of the vitamin.

• Hemostatic tablets Dicinon (Etamzilat)

Accelerates blood clotting, but does not affect thrombosis and does not constrict blood vessels. It is allowed to use it for metrorrhagia, heavy bleeding in women with. But the drug is prohibited for use in pregnant and lactating women. Despite the fact that Etamzilat does not increase the likelihood of blood clots, it is not used for thrombosis. The drug increases coagulability due to the platelet link, therefore, in patients with thrombocytopenia, the effect of therapy will not appear. In mild cases, Dicinon can be used in the form of tablets, with severe blood loss, treatment begins with intravenous injections, then they switch to intramuscular and oral tablets.

• Tranexam

In the form of tablets, it is used in cases of bleeding associated with the activation of fibrinolysis - the dissolution of a clot that formed at the site of a bleeding vessel.

Additional actions of the drug are: analgesic, anti-inflammatory, anti-allergic and anti-infectious.

Tranexamic acid is used for heavy menstruation and uterine bleeding. But it can cause thrombosis. Therefore, with pathologies of the coagulation system, the presence of thrombosis in the past, its use is not recommended.

For symptomatic therapy, iron preparations, folic acid, vitamin C are used. They are necessary to restore blood, treat anemia. Iron and ascorbic acid are antagonists - in the presence of vitamin C, the absorption of ferrum is more active. Folic acid affects the division of new red blood cells, the formation of complete hemoglobin.

Phytotherapy

With heavy and prolonged periods, the use of herbs can help reduce blood loss, improve blood clotting, and compensate for the deficiency of certain substances. But they are not a panacea, the effect of herbal remedies is mild, and it is impossible to calculate the exact dosage: the amount active substances varies greatly depending on the period of collection, drying conditions and storage of substances. Herbal preparations may slightly reduce the severity of symptoms, but will not cure endometriosis, fibroids and endometrial hyperplasia, and will not dissect intrauterine adhesions.

To reduce blood loss ethnoscience suggests using nettle. A decoction, an infusion is prepared from it, which they begin to take a few days before the onset of menstruation.

Corn stigmas have a hemostatic effect. A decoction is prepared from them, which is taken several times during the day.

Water pepper extract is sold in a pharmacy in the form of an alcohol solution. It is able to reduce the duration and severity of bleeding. Take it as prescribed by a doctor with a slight increase in blood loss, as well as after an abortion,. The duration of admission is determined individually.

Yarrow has a similar effect as nettle. For medical use, it is better to buy ready-made pharmaceutical raw materials, which are collected in compliance with all sanitary requirements, and the concentration of useful substances is maximum. Yarrow is used in the form of decoctions and water infusions.

As an astringent and hemostatic agent, viburnum extract, a decoction of shepherd's purse and peppermint are used.

Some healers suggest using self-prepared herbal remedies for douching. Such treatment can be very harmful. Reverse current along with menstrual blood can bring an infection that will lead to the development of inflammation.

Lifestyle

To prevent and eliminate heavy bleeding, you need to change your lifestyle. For a while, you should completely abandon alcoholic beverages, coffee and strong tea. Those who are actively involved in sports, on critical days, need to abandon training or reduce their intensity. The same rule applies to lifting weights.

Hot baths, a sauna, a bath, any thermal procedures increase the volume of blood loss. This also includes active insolation, many warming physiotherapy.

other methods

If the bleeding has become pathological, emergency medical attention is needed. Reducing drugs in this case are not prescribed. The only way to stop the bleeding is curettage - the mechanical removal of blood clots that prevent the uterus from contracting. In severe cases, transfusion of blood, plasma or its components may be required in the development of pathological signs of blood loss.

In adolescence, curettage of the uterine cavity is not used. For girls, there is a way to stop bleeding with the help of medications. Combined oral contraceptives have hemostatic properties. But they are not taken according to the usual scheme - 1 tablet per day, but according to a special system, several tablets per dose at short intervals.

Update: October 2018

According to statistics, heavy periods are diagnosed in a third of the fairer sex. As a rule, it is abundant menstruation with clots that is observed, that is, an excess of menstrual blood, not having time to leave the uterus, begins to coagulate, as a result of which clots form. In any case, it is necessary to determine why the periods have become very plentiful and to carry out the appropriate treatment.

Abundant menstruation: how to determine?

Menstruation is evaluated according to the following criteria:

• duration (no longer than 7 days);
• profusion of discharge (normally, menstruation is abundant only for the first 2 to 3 days);
• the amount of blood loss (total volume per day does not exceed 120, maximum 150 ml);
• intervals between menstruation (at least 21 days);
• soreness of menstruation (normally mild discomfort or moderate pain is possible);
• intermenstrual bloody issues(they are absent in the normal menstrual cycle).

Based on the above signs, you can independently determine whether there is a heavy menstruation. Abundant menstruation is a syndrome that can be observed in many gynecological and not only diseases. Therefore, this condition does not apply to diseases, but requires the identification of the causes of heavy periods. Abundant periods are characterized (they are also called menorrhagia or hyperpolymenorrhea) by the following signs:

• menstruation lasts a week or longer;
• spotting is significant, with large clots;
• the volume of blood lost is large, 150 ml or more, requires the replacement of pads or sanitary tampons every hour, including at night;
• shortening menstrual cycle(less than 3 weeks);
• the appearance of spotting not only on the days of menstruation;
• the occurrence of significant pain during menstrual days;
• the entire period of spotting is characterized by profusion;
• the occurrence of menstruation or other bleeding a year or later after the onset of menopause.

Reasons for heavy periods

Why do heavy periods occur? There are many factors that are "guilty" in the occurrence of hyperpolymenorrhea. These can be problems associated either with the state of the reproductive system, or with general condition health, as well as with heredity and psycho-emotional overload:

Heavy menstruation in adolescence

Menorrhagia in adolescents is quite common and reaches 37%. As a rule, heavy menstruation is observed in the first 3 years after menarche, but another situation is also possible when the first menstruation is heavy.

The main role in the occurrence of menorrhagia in adolescent girls is played by:

• chronic and acute infectious diseases
• improper diet leading to the development of hypovitaminosis
• mental trauma
• intellectual overload.

Infectious diseases (tonsillitis, flu, rheumatism, and others), stress and other factors disrupt the hypothalamic-pituitary system, which in turn affects folliculogenesis and hormone synthesis in the ovaries. As a result of the above, they are produced monotonously, maintaining the same level and for a long time. is produced in insufficient quantities, its deficiency occurs, as a result of which the uterine mucosa does not go through the stage of secretory transformation (the second phase of the cycle), but hyperplasia.

Abundant menstruation occurs due to stagnation of blood and plethora, expansion of capillaries, necrotization of individual sections of the endometrium and its uneven rejection. In addition, prolonged menstruation is also facilitated by a decrease in the contractility of the uterus in case of its underdevelopment (hypoplasia). Abundant menstruation in puberty can vary in intensity and duration, and clinical picture depends on the degree of blood loss.

Menorrhagia in adolescents quickly leads to:

• anemia - weakness, fatigue, decreased appetite, pale skin and mucous membranes, increased heart rate
• blood clotting disorder— decrease in the level of platelets and prothrombin index.

Abundant menstruation in premenopausal age

Premenopausal age is the period lasting from 45 to 55 years, when the female body loses the ability to conceive and smoothly passes into the phase of the end of menstruation.

If 12 months have passed since the last menstruation, which were characterized by the absence of spotting, then this period of time is called menopause.

The next stage will be postmenopause, when the production of sex hormones decreases sharply and any spotting from the genital tract is considered a pathology.

What happens to menstruation in premenopause? The hypothalamic-pituitary-ovarian system undergoes processes of involution, or, roughly speaking, aging, which leads to malfunctions of its functioning. The cyclic release of gonadotropins, the maturation of follicles and the production of sex hormones in the ovaries is disturbed.

As a result, relative hyperestrogenemia develops (estrogens, as you know, are produced in the first phase of the cycle) against the background of absolute hyperprogesteronemia (due to luteal insufficiency with inferiority of the corpus luteum). All this leads to disruption of the processes of proliferation (phase 1) and secretory transformation (phase 2 of the cycle) of the endometrium and the occurrence of hyperplasia of the uterine mucosa.

• A woman in premenopause notices that her periods have become more abundant and longer.
• In addition, in premenopause, in addition to menorrhagia (cyclic bleeding), acyclic bleeding or metrorrhagia may also occur, which are associated with impaired uterine contractility.
• Various tumors and tumor-like formations (myoma, polyp, endometrioid foci) change the structure of the uterine wall, replacing a portion of the muscle layer connective tissue or endometrioid. As a result, the uterus, both during and outside of menstruation, is not able to adequately contract, which causes heavy bleeding during menstruation or after the action of various factors (coitus, physical overstrain, stress).

Example from practice: I had a patient of 48 years old who suffered from heavy menstruation for several years, which, of course, led to the development of anemia. The ambassador of the ultrasound of the pelvic organs was diagnosed with: “Glandular hyperplasia of the endometrium. Suspicion of an endometrial polyp. The patient was recommended a consultation at the regional hospital, where she was prescribed and carried out a therapeutic and diagnostic procedure, followed by curettage of the uterine cavity. But even after the surgical treatment, the situation did not change. Hemoglobin remained in the range of 90-100 g/l, despite the intake of iron-containing preparations, and menstruation was characterized by abundant discharge. Six months after a second consultation with regional gynecologists, the woman was offered to remove the uterus. After amputation of the uterus, a histological study of the preparation was carried out and a conclusion was made: Multiple myomatous nodes small size(0.5 - 1 cm) against the background of widespread adenomyosis. Adenomatous polyp (5 cm) of the uterus. Within 6 months after the operation, hemoglobin reached normal levels, and menstruation stopped immediately after the removal of the uterus. It becomes clear that an endometrial polyp of this size could not be removed hysteroscopically, and even if it was excised, the concomitant endometriosis of the uterus and myomatous nodes would serve as a supporting factor in menorrhagia.

Menorrhagia after childbirth and caesarean section

Physiological causes

After childbirth, the nature of menstruation changes, they become somewhat more intense and longer. This is due to the anatomical transformations of both the uterus itself and its cervix. After the birth of a child, the cervical canal shortens and becomes wider, which explains the increase in menstrual flow. In addition, the uterus itself, and, consequently, its cavity becomes larger than before pregnancy, the area of ​​\u200b\u200bthe uterine mucosa increases, which automatically leads to an increase in bleeding during menstruation.

Pathological causes

But in some cases, menstruation after childbirth becomes too plentiful and prolonged. This is due to the occurrence of complications during childbirth, as a result of which the contractile activity of the uterus is disturbed due to its overstretching (large fetus, or multiple pregnancy) or anomalies of the labor force (discoordination, weakness of contractions, clinically narrow pelvis).

These factors affect the involution of the uterus in the postpartum period and provoke heavy menstruation. Also, the occurrence of menorrhagia after childbirth is also affected by how the pregnancy proceeded.

• Malnutrition, low hemoglobin, stress and various complications of pregnancy cannot but affect both the formation of the menstrual cycle and the nature of menstruation.
• After a caesarean section, a suture remains on the uterus, which also plays a role in its contractility. Therefore, menstruation after abdominal delivery becomes plentiful, since the scar on the uterus is mostly represented by connective tissue that is not able to contract.

Menorrhagia after abortion and intrauterine interventions

As you know, pregnancy causes the strongest hormonal changes, and its interruption, both in the form) and in the form of a miscarriage, is a stress for the body, which cannot but affect the hormonal balance.

It should be noted right away that any intrauterine intervention (hysteroscopy or curettage for the purpose of diagnosing or removing the fetal egg / remnants) is accompanied by the appearance of spotting in the postoperative period, which women often mistake for menstruation.

• Norm - normal menstruation after intrauterine manipulation begins on average in a month, and spotting after uterine curettage lasts 3 to 7 days, maximum 10. Such discharge is usually moderate and even meager, painless or causes slight discomfort.
• Abundant periods- in case of heavy periods after an abortion / curettage or hysteroscopy, you should immediately consult a doctor. The most likely cause of menorrhagia is inflammation of the uterus.

In this case, the monthly will be:

• plentiful, dark red or "dirty", like meat slops and accompanied by an unpleasant odor.
• a woman will be disturbed by pain in the lower abdomen of a cramping nature
• fever and symptoms of intoxication (weakness, lack of appetite, dyspepsia).

If the diagnosis of endometritis is not confirmed, this indicates failures in the hypothalamic-pituitary-ovarian system, which disappear after the appointment for a period of 3, maximum 6 months.

Heavy menstruation while on medication

A common cause of heavy periods is taking certain medications, which most women forget or don't even know about.

Anticoagulants and antiplatelet agents

First of all, to such medicines include blood thinners - anticoagulants and antiplatelet agents.

• Anticoagulants (heparin, phenylin, syncumar) either prevent thrombosis (direct-acting anticoagulants) or suppress the secretion of blood coagulation factors (indirect-acting).
• Antiplatelet agents (aspirin, trental, chimes) inhibit the aggregation and adhesion (clumping) of platelets, making the blood more fluid. It is enough to cancel or at least reduce the dosage of the listed drugs, as menstruation becomes moderate and short.

Hormonal drugs

• Combined oral contraceptives

Secondly, the occurrence of menorrhagia causes the use of hormonal drugs. Often, heavy menstruation occurs against the background of the use of combined oral contraceptives, which is associated either with an incorrectly selected drug (more often these are high-dose COCs: rigevidon, regulon), or if the regimen is violated (postponed menstruation or not taken a pill on time).

• Hormonal drugs after intercourse

Very often, the cause of menorrhagia is the abuse of fire-fighting contraception (postinor, escapelle). Since in such hormonal pills contain huge doses of progestogen - levonorgestrel, their intake causes disorders in the menstrual cycle, which leads not only to the occurrence of massive menstrual bleeding, but often requires long-term treatment to restore the cycle and ovulation.

• Duphaston

In some cases, women note that menstruation has become more abundant and longer against the background of taking, and postmenstrual daub has also appeared. A similar effect from taking duphaston is possible, which is associated with the reinstallation of the hormonal background and the “addiction” of the body to the intake of progestogen from the outside. Do not be afraid, after 2, maximum 3 months, menstruation returns to its original parameters.

Treatment

If the monthly is very plentiful - what to do? In any case, you should consult a gynecologist. Only a doctor after a thorough history taking, clarification of complaints, gynecological examination and additional examination methods can find out the cause of menorrhagia, select an adequate treatment and monitor its effectiveness.

Therapy for heavy menstruation depends on the factors that led to the development of menorrhagia, concomitant diseases, the use of certain drugs, the use of contraceptive methods, as well as the severity clinical signs and age of the patient.

• If a pathology of the blood, liver or thyroid gland corrective therapy of the underlying disease is prescribed.
• If the cause of hypermenorrhea is an intrauterine device, it is removed.
• When taking certain drugs, a different treatment regimen with these drugs is selected or treatment is canceled by them.

Conservative treatment

It is carried out for girls and young nulliparous women, and provides for the provision of symptomatic and hormonal hemostasis.

As a symptomatic hemostasis, hemostatic drugs are used for heavy menstruation.

• Dicynon - this can be dicynone in injections and tablets, tranexamic and aminocaproic acids.
• Vitamins - vikasol (vitamin K, which promotes the formation of prothrombin by the liver), vitamins that reduce the permeability of the vascular wall (C and P or a complex drug - askorutin).
• Herbal infusions that reduce menstrual flow (, corn stigmas, yarrow, shepherd's purse, meadow geranium and others). Infusions should be taken ½ - 1 cup three times a day 2 - 3 before the onset of menstruation and the entire period of discharge.
• NSAIDs - non-steroidal anti-inflammatory drugs (, indomethacin, naproxen) have proven themselves well in the treatment of heavy menstruation. Taking these drugs reduces blood loss by up to 40% and reduces the duration of menstruation.
• Treatment of anemia - anti-anemic therapy is carried out in parallel, for this purpose iron-containing preparations are prescribed (see iron preparations for anemia).

Hormonal drugs

Hormonal preparations for heavy menstruation are prescribed after the end of the discharge for a period of 3 to 6 months. Combined oral contraceptives with low doses of hormones (Marvelon, Mercilon or Logest) are selected, which are taken according to the contraceptive scheme. Also, women of reproductive age and girls undergo vitamin therapy according to the phases of the menstrual cycle. In the first phase, vitamins of group B are taken, in the second, vitamins A, E, C.

Intrauterine device

A good effect in the treatment of menorrhagia has an intrauterine device with levonorgestrel (Mirena). The gestagen released from the IUD inhibits the proliferation of the endometrium, reduces its blood supply and thickness. However, this method is not suitable for patients whose menorrhagia occurred while wearing an intrauterine contraceptive.

Surgery

In case of significant bleeding, lack of effect from therapeutic measures, severe anemia or physiological disorders of the genital organs, surgical treatment is performed. Hysteroscopy and curettage of the uterine cavity is performed for patients with:

• hyperplastic processes of the endometrium
• adenomyosis and polyps of the uterine mucosa
• women who experience recurrent menorrhagia.

As a result of these gynecological manipulations, the pathological endometrium and tumor-like formations are removed, and the resulting material is sent to histological examination. Then, depending on the results of histology, hormonal therapy is prescribed.

Hysterectomy () is resorted to only in extremely advanced cases of menorrhagia in young women or with heavy menstruation and concomitant tumor-like formations of the uterus in women of premenopausal age.

“Strong” periods, what to do if the bleeding is heavy, can it be stopped, and what diseases can be hidden behind such symptoms?

First, let's deal with what should be alarming and what is not. And when you need to see a doctor in an emergency.

This is bad:

• bleeding lasts more than 7 days;
• in the discharge there are clots larger than 2 cm in diameter, that is, large;
• there are unusually severe pain during menstruation (this may be a sign of an ectopic pregnancy, for example);
• in 1-2 hours you have to change at least one sanitary napkin, as this way it is completely saturated.

If you suddenly find yourself having heavy periods, what to do in this case? Sometimes menstruation begins quite intensely in the first 1-2 hours, and then sharply subsides. So call an ambulance or run to women's consultation if you have heavy menstruation within an hour - early. We need to keep an eye on the situation. Another will be the answer to the question of what to do with strong periods that began 10-14 days ahead of schedule. This is no longer menstruation, but real uterine bleeding. What caused it is the second question. The first is to stop him. How urgently you need to see a doctor depends on the intensity of bleeding. If you change pads every 1-3 hours, go immediately.

Of the gynecological diseases that caused acyclic bleeding, endometrial hyperplasia, including the formation of polyps, is most often diagnosed. The treatment of this pathology is surgical. A woman undergoes curettage of the uterus. The collected material is sent for histological examination. Actually, this is the answer to the question of what to do if menstruation goes very strongly much ahead of schedule. And to prevent a recurrence of the situation, if pregnancy is not planned, oral contraceptives are prescribed. When they are taken, there is no hyperplasia, cysts in the ovaries. Painful periods occur much less frequently. By the way, these same drugs are the prevention of endometriosis. This disease is also often the cause of very heavy menstruation. Oral contraceptives for Russian market There are a lot of different price ranges available. But as for the prevention of endometriosis, doctors often prescribe "Janine" or its cheaper analogue - "Silhouette".

If very “strong” periods with clots, what to do, what examinations to undergo? First of all, a gynecological examination and swabs for infections. They can provoke inflammation in the uterus - endometritis, and as a result, bleeding. It is necessary to do an ultrasound, and preferably in two phases of the cycle. You may need to consult a hematologist if bleeding disorders are found. With iron deficiency anemia, an iron preparation is prescribed. By the way, the treatment of anemia also helps to reduce blood loss.
Often, large blood loss provokes an intrauterine contraceptive. Here the only way out is to remove it.

If there is no cardinal solution to the problem, there is no treatment, then the woman needs to choose one of the options for reducing the abundance of menstruation:

• taking oral contraceptives, and in the case of pregnancy planning, a progesterone preparation in the second phase of the menstrual cycle, after ovulation;
• taking painkillers, anti-inflammatory drugs, it is advisable to start two days before the onset of bleeding;
• taking hemostatic agents, the most effective remedy from this group is considered to be Traneksam.

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Pain during menstruation, heavy bleeding is not normal. It is important to understand how serious everything is. Sometimes a healthy girl has similar manifestations at the very beginning of puberty. Women over 40 also often have to deal with this. Abundant and long periods can lead to anemia. Their cause must be known exactly in order to be treated in time, not to start the disease. Sometimes just rest and a change of scenery helps if the ailment is caused by stress and worries.

Content:

What periods are considered heavy

It is considered normal to have periods that occur after a period of 21-35 days, and for each particular woman they happen in approximately an equal number of days (for example, after 25-28). Their duration should not be less than 2 days and more than 1 week. And the volume of blood released for the entire menstruation is not less than 40 ml, not more than 150 ml (the normal average value is 80 ml).

Periods are considered heavy if more than 150 ml of blood is secreted. For convenience, women usually focus not on the amount of discharge, but on the number of pads per day. If everything is in order with menstruation, then about 4 pads per day are required.

When is menorrhagia not a problem?

Abundant periods (menorrhagia) are not a symptom of the disease in the following cases:

1. If there is a genetic predisposition in which menstruation is abundant throughout the reproductive period, there are no severe side symptoms, the woman is healthy.
2. Menorrhagia can occur in girls at the very beginning of puberty, when the cycle has not yet been established (during the first 2 years). The reason is fluctuations in the ratio of sex hormones produced in the ovaries.
3. The intensity of menstruation deviates from the norm during premenopause, and heavy menstruation alternates with meager ones.

Symptoms of abnormal heavy menstruation

Depending on the type of pathology, the blood may be bright scarlet in color or contain blood clots. It is required to change pads every 1-1.5 hours. Associated symptoms are:

• severe aching pain in the lower abdomen;
• weakness, headache, dizziness, sometimes a woman has bruises on her body, bleeding from the nose and gums, fainting;
• if heavy periods are associated with an inflammatory process in the uterus, then bleeding is accompanied by fever.

There are two types of menorrhagia: primary (at the first menstruation in adolescents) and secondary (occurring in adulthood).

Reasons for heavy periods

In addition to the natural causes mentioned above, there are also pathological ones associated with serious diseases.

Hormonal disbalance

Throughout life in a woman's body, the natural hormonal background changes many times. In adolescence, during puberty, during pregnancy, after childbirth, during menopause, all physiological processes are associated with sex hormones. The natural ratio is violated if a woman has endocrine diseases (deviations in the work of the pancreas and thyroid glands, adrenal glands, pituitary gland).

The cause of deviations from the norm may be the use of hormonal contraceptives or the treatment, for example, of certain pathologies in the mammary glands with the help of hormones. At the same time, the woman's menstrual cycle is disturbed, painful and heavy periods appear.

Diseases of the uterus and ovaries

uterine fibroids- benign outgrowths in the muscles of the uterus, both outside and inside it. They change the structure of the endometrium (internal mucosa). When it is rejected, causing the appearance of menstruation, a large number of vessels are injured, which is the reason for the increase in bleeding intensity.

Polyps. They can occur both in the uterine cavity and in the cervix. They grow from endometrial cells. They are a benign neoplasm in the form of a tubercle filled with blood. It is connected to the surface of the uterus by a thin stalk. Polyps reach several centimeters in diameter. They are easily injured and bleed. There may be several. Menstruation is accompanied by heavy bleeding. If such polyps are not removed, then they are able to degenerate into cancer. Abundant periods are in this case an important symptom that warns of the need for a serious examination.

Uterine adenomyosis. It happens that the mucous membrane grows into the wall of the uterus, which is under it. Sometimes this pathology is even congenital. It mostly occurs in women around the age of 30. The reason is the same hormonal imbalance or uterine injury during childbirth, abortion, curettage. If such a disease is associated with hormonal abnormalities, then, as a rule, when menopause occurs, it goes away on its own. Concomitant pathology is endometriosis, in which the epithelium of the uterus grows into tubes, ovaries, vagina, peritoneum. Detachment of the endometrium is painful, accompanied by profuse blood loss.

Ovarian dysfunction. This is a violation of the ovaries, insufficient production of sex hormones, estrogen and progesterone. The functioning of the ovaries depends on the state of the pituitary gland, where hormones such as prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH) are formed. If the production does not correspond to the norm (for example, with age-related changes during menopause or with a pituitary tumor), then the woman experiences various deviations in the menstrual cycle. Menstruation comes with a small, then with a long break. Discharges are scanty and frequent or copious and prolonged (lasting more than 10 days). At the same time, there are no ovulations, that is, a mature egg cannot leave the protective capsule (follicle), respectively, a woman cannot become pregnant, since fertilization of the egg is impossible.

With such a disease, the symptoms of premenstrual syndrome are usually exacerbated: headaches, tearful mood. Menstruation is accompanied by pain. Perhaps the appearance of bleeding in the intervals between them. In some cases, on the contrary, heavy periods come after a break of 6 months.

Addition: Timely diagnosis of ovarian dysfunction is of great importance, since this condition can be the cause of other diseases of the genital organs or a sign of an ectopic pregnancy. Violation of the ovaries sometimes leads to the occurrence of tumors of the mammary glands.

Malignant diseases cavity or cervix. With the appearance of unusual menstruation of great intensity, a visit to the doctor plays an important role in maintaining the health and life of a woman.

Video: Why uterine bleeding occurs

Non-hormonal diseases

Inflammatory and infectious diseases of the genitourinary system can also lead to the appearance of heavy periods. The anatomical connection provokes the rapid spread of inflammation to the uterus and ovaries, as a result of which their functioning may be impaired. Abundant periods occur with endometritis (inflammation of the mucosa in the uterine cavity). Inflammation of the fallopian tubes and ovaries (salpingoophoritis) leads to overgrowth of the tubes. This condition leads to an ectopic pregnancy. In this case, a rupture of the tube with dangerous profuse uterine bleeding can occur.

Abundant incessant menstruation may indicate blood diseases, a violation of its coagulability. The cause is often also diseases of the thyroid gland (hypothyroidism), pancreas ( diabetes) and other endocrine organs.

Note: An important reason for the appearance of heavy bleeding during menstruation is excessive physical exercise(for example, when playing sports or ballet), as well as emotional stress. The duration of menstruation in women is affected by a sharp change in climate.

Video: Abundant periods with endometriosis

Causes of heavy menstruation after childbirth

Sometimes the first menstruation after childbirth is very plentiful. The time of their onset depends on how long and often the woman breastfeeds the baby. The reason for intense menstruation is most often the restructuring of the body, the return of the hormonal composition to the usual norm. Hormones also affect the muscle tone of the uterus. In a healthy woman, if there were no complications during childbirth, the normal nature of the menstrual cycle, including the volume of menstrual blood, is restored after 2-3 months.

After a caesarean section, with complaints of heavy periods, the doctor specifies the reason why this method of delivery was used. If a caesarean section was done due to the presence of uterine fibroids removed during childbirth, then heavy menstruation may indicate a relapse of the disease.

If, along with menstruation, there are pains in the abdomen, back, the temperature rises, this may indicate an infection and the occurrence of postpartum inflammation. The same explanation can be given to the appearance of heavy periods after an abortion or a cleaning of the uterus.

Abundant periods are sometimes taken as lochia, or postpartum discharge, which accompanies recovery processes in the uterus for 6 weeks. Usually they are scarce and spotting, without an unpleasant odor, stop on their own until the end of breastfeeding. If they are abundant, bright red, accompanied by pain in the abdomen, this may indicate injury to the uterus during childbirth or incomplete removal of the placenta. In this case, there are clots in the blood.

Video: What is lochia

Treatment of menorrhagia

What to do with heavy periods? First of all, it is necessary to consult a doctor to make sure that the cause is not an injury, illness, or ectopic pregnancy. If the cause is physiological, then you can try to reduce bleeding by placing a cold heating pad on the uterine area, as well as drinking hemostatic home remedies such as chamomile or nettle infusion.

It is not recommended to take drugs to increase blood clotting on your own, as they can provoke the formation of blood clots in the vessels. From people's councils the following can be mentioned:

• drink a decoction of cherry leaves several times a day (1 tablespoon per 1 glass of water);
• infusion of acorns (grind and insist 1 tablespoon in 1 glass of boiling water);
• a decoction of a mixture of yarrow and chamomile (150 g each), horsetail (100 g), shepherd's purse and chestnut (50 g each). Boil the mixture in 1 glass of water, drink for 3 weeks, repeat after a 5-day break.

In diseases caused by hormonal disorders, hormone-containing tablets are prescribed or an intrauterine device is installed with a drug that reduces the thickness of the endometrium. In inflammatory diseases, antibiotics and physiotherapy are used. Vitamin C and iron supplements often help. If treatment does not help, surgery is performed.

Abundant periods are a real problem for a girl. Normally, menstruation lasts up to 7 days, and up to 150 milliliters of blood is lost. But for some the situation is different.

Abundant menstruation not only disrupts the usual rhythm of life, but also greatly depletes the body. To fix this, you must first understand the causes, and then proceed to treatment. However, this is what we are going to talk about now.

hypermenstrual syndrome

That is the name of the phenomenon we are talking about now. It is often characterized not by an increase in the volume and duration of menstruation, but by its constant presence. The periods just don't stop.

The reasons can be very different, here is just a short list of them:

• Inflammation in the appendages and in the uterus.
• genital infections.
• Pathologies of the endocrine nature.
• Malignant and benign tumors.
• Hematological diseases.
• Operational and traumatic injuries of the genital organs.
• Intoxication.
• Infectious and somatic diseases.
• Intrauterine contraception.

There are also certain risk factors, which include smoking, sudden climate change, adverse living conditions and depression.

If a woman loses more than 80 ml of blood during each menstruation, then she is immediately put at risk of developing a disease known as iron deficiency anemia.

In any case, to determine the exact cause of heavy bleeding, you need to go to the gynecologist. The doctor will perform a Pap smear, hysteroscopy, endometrial biopsy and ultrasound of the pelvic organs. After studying the results, the woman will be diagnosed and adequate treatment will be prescribed.

Hormonal disorders

This is one of the most common causes of heavy periods. They are usually caused by failures in the normal functioning of the hormonal system.

Most often, imbalance occurs in young girls during their first menstruation, and this is normal. Then the cycle is normalized, and the amount of blood released too.

This reason is also relevant for adult women. Their discharge may increase several years before menopause.

Also, an imbalance can provoke the intake of incorrectly selected birth control pills and hormonal drugs.

But why are there exactly abundant periods, and not meager ones? The fact is that the ovaries of a healthy female body produce estrogen and progesterone. Under their influence, the uterus becomes thicker and begins to put pressure on And during menstruation, its upper layer seems to be cleared. These fragments are excreted from the body along with the secretions.

And if a woman has a low level of testosterone and an increased amount of estrogen, it means that the process of ovulation is going wrong. In such cases, the uterine membrane becomes extremely thick, which provokes copious discharge.

Pathology of the uterus

This is the next common reason why many women have heavy periods. The most common pathology is myomatosis, in which the internal area of ​​the uterus increases and its shape changes. Because of this, it takes much longer to separate the endometrium, and therefore bleeding is characterized by profuseness.

Some women are also diagnosed with endometriosis. It manifests itself in the pathological growth of the endometrium into the muscular layer of the uterus. At the same time, the separation is also accompanied by unbearable pain, in addition to profuse blood loss. Often there are intermenstrual discharge.

Another reason for heavy periods may be It is characterized by the formation of intrauterine connective tissue adhesions. This disease not only entails endometritis and pain, but also makes it impossible to conceive. Because of these adhesions, there is no normal outflow of blood. It just lingers inside and curls up under the influence of temperature, and then comes out in the form of clots in a frighteningly large amount.

It is recommended to be wary of the appearance of very heavy periods after 45 years. Especially when they are with clots, and if the woman has already entered the menopause. Such anomalies usually indicate the presence of cancer.

postpartum sequelae

When a woman is pregnant, her body undergoes various changes and stresses for 9 months. After giving birth, he expects a long and difficult recovery. And it starts with heavy periods.

Such discharge cannot be called a standard menstruation. These are actually the consequences of a bleeding, unhealed uterus, from which the placenta was exfoliated during childbirth along with the fetus. But they are accompanied by the release of large clots, so that they can be confused with menstruation.

Abundant periods after childbirth last about 40 days. During this time, the structure of the uterus is restored and its functioning is normalized.

After the end of the discharge, menstruation is completely absent for a rather long period due to breastfeeding. But ovulation occurs despite this.

Then, when menstruation is restored, it will last about 5 days. Sometimes the period is from a week or more, but this is already a cause for concern. The reason for this duration is the uterus that has increased during pregnancy and the stretched endometrium.

Also, women who have experienced any of the following are prone to very heavy periods after childbirth:

• inflammatory processes in genitourinary system.
• C-section or difficult births.
• Change in the balance of prolactin, which is responsible for childbearing function and the normalization of the menstrual cycle.
• Iron deficiency anemia.
• Constant stress and tension during and after pregnancy.
• Advanced chronic diseases.

By the way, a separate cause may be particles of the placenta remaining inside or an ectopic pregnancy.

uterine fibroids

If a woman has very heavy periods, then it is likely that she has formed this benign hormone-dependent formation.

The exact cause of uterine fibroids is unknown to this day. Doctors are inclined to believe that this is due to a violation of the hormonal function of the ovaries, which produce estrogen in large quantities.

Also, risk factors include abortion, cyst, inflammatory diseases, difficult childbirth, obesity, endocrine and immune disorders, as well as a hereditary factor.

The main symptom indicating the presence of fibroids is long and heavy periods with clots, acyclic uterine bleeding and anemia that develops against their background. Accompanied by the growth of the formation of pain in the lower back and lower abdomen. If the fibroid grows slowly, then these sensations do not go away.

Also, since fibroids compress nearby organs, which include the rectum and bladder, a woman has problems with urination (it becomes either difficult or rapid) and suffers from constipation.

Advanced disease entails more serious consequences - heart problems, shortness of breath and abnormal pressure surges.

Hemostatic pills

So, what can be the cause of heavy periods and why they go in such quantity is clear. It is important to make a reservation just in case: everything is very individual here, and only a doctor can make an accurate diagnosis. He then prescribes treatment. As a rule, the following tablets are prescribed:

• "Vikasol". This medication is an artificial analogue of vitamin K. It makes up for its lack in female body, which helps to normalize blood clotting and stimulate the formation of prothrombins. There are contraindications. In the presence of allergies, a rash, hives, bronchospasm and itching may occur.
• "Dicinon"(uh tamzilat). If the girl is interested in how to stop heavy periods, then you should pay attention to this drug. These tablets can improve blood microcirculation and normalize vascular permeability. Etamzilat does not affect clotting, but it is incompatible with any other drugs.
• "Ascorutin". The composition of these medicines includes ascorbic acid. The drug reduces the permeability of blood vessels, makes them stronger and more elastic, and also has a hemostatic effect. With regular intake, menstruation becomes not only less abundant, but also shorter. This drug is indicated for women who have entered the period of menopause, as well as those who have undergone a caesarean section.

What exactly will be assigned to the girl depends on the reason why she has abundant periods. In the presence of a serious illness, the doctor may even prescribe a detailed course of therapy with the appointment of several drugs.

Hemostatic injections

The drugs prescribed for heavy menstruation were listed above. But also the girl can be prescribed injections. Injections have a faster therapeutic effect. Tablets begin to act after at least an hour, and injections - after 5-15 minutes.

One of three drugs is usually prescribed:

• "Tranexam". This is a hemostatic medication aimed at stopping heavy hemorrhages. Works almost instantly. It also has anti-inflammatory and anti-allergic effects.
• "Oxytocin". This tool reduces the uterus and helps stop blood loss. It is prescribed, as a rule, to women after childbirth. Introduced into a vein or muscle.

Depending on the specifics of the discharge, other medications may be prescribed.

Taking contraceptives

For most girls, gynecologists prescribe oral contraceptives to normalize their cycle. And this is one of the best and most versatile methods. Properly selected contraceptives have a lot of positive effects on the body:

• Normalize heavy periods, make them more scarce.
• Reduce the duration of menstruation. In some girls, after the start of taking oral contraceptives, it lasts three days.
• Correct dysmenorrhea (eliminate pain during menstruation).
• Treat posthemorrhagic anemia.
• Help to deal with inflammatory diseases pelvic organs.
• Correct hyperandrogenism (reduces androgen levels) and PMS.

In addition, contraceptives are one of the most effective means contraception. Their reliability reaches 98-99% (under conditions of use in accordance with the instructions). And for condoms, this figure is only 87%.

The most famous oral contraceptives include pills such as Yarina, Jess, Janine, Lindinet, Chloe, Silhouette and Regulon. There are other firms as well. In any case, the tablets are prescribed by the gynecologist on the basis of a survey of the patient and the results of her tests.

If you believe the reviews, heavy periods can be reduced without the use of drugs (although it is not recommended to postpone a visit to the doctor). For this you need:

• Reduce physical activity.
• Minimize the amount of alcohol and coffee consumed, and if possible, completely refuse.
• Stop taking vasodilators. But before that, you should consult with your doctor. If possible, find analogues.
• Diversify your diet with foods high in iron, vitamin C and folic acid. They contribute to the normalization of blood circulation.
• Every day, apply a cool heating pad to the lower abdomen (for a maximum of fifteen minutes).
• Do acupressure. It's simple: thirty finger pressure on the area of ​​\u200b\u200bthe hollow that connects upper lip and base of the nose.
• Do aromatherapy.

Of course, these methods will not give such an effect as injections or taking drugs, but they are quite suitable as a preventive measure.

Folk remedies

Sometimes it is not possible to immediately get to the gynecologist with heavy periods. What to do in this case, how to alleviate your condition at least for a while? You can also try folk remedies. Here are some simple recipes:

1. Take one tablespoon each of the following herbs: valerian root, knotweed, white mistletoe and shepherd's purse. Pour boiling water (0.5 l). Infuse for fifteen minutes, and then dilute with a liter of clean water. Boil and strain through cheesecloth. Drink half a cup twice a day.
2. Take twenty-five grams of erect cinquefoil root, yarrow and shepherd's purse, as well as ten grams of oak bark. Pour a liter of water and boil, then insist and strain. Drink twice a day for 1 tbsp.
3. 1 tbsp pour a glass of boiling water. Boil, strain. Divide into three parts. Drink each of them during the day before meals.
4. 1 tsp lilac seeds pour a glass of boiling water. Let it brew for fifteen minutes, stirring occasionally. Then put on a small fire for five minutes and cook. Drink in the amount of 2 tbsp. in the morning.
5. Pour twenty grams of dry dioecious grass with a glass of boiling water and boil for fifteen minutes. It is recommended to drink fifty milliliters (one glass) every three hours. Nettle will not only stop bleeding, but will also relieve inflammation and resist infections, if any.
6. Pour one hundred grams of crushed viburnum bark with a glass of water. Cook over low heat for an hour. Then drink 2 tbsp. every three hours.

It is worth noting that the listed funds are effective hemostatic during heavy periods, even if they are done at home.