CHENNAI: It’s universal. It’s monthly. Most of the time, it makes you feel like you may puke your guts out and on rare occasions, it calls for a truce. But unlike the white flag of truce, this visitor is blood red — quite literally. That time of the month, Code Red, menstruation, or simply, a period.
While the age-old rulebook deems up to seven days as the ‘normal’ duration of Aunty Red’s visit — with a flow that decreases by the day — there are some cases where the volume increases on a continuum. Has this ever happened to you, ladies? Well, you may have menorrhagia.
What is menorrhagia?
“Simply put, menorrhagia is heavy menstrual flow, usually above 80 ml, lasting for over seven days. The condition can occur at any point between puberty and menopause. For example, if you used to change your pad twice a day during menstruation, the heavy flow caused by menorrhagia requires you to change it every two hours. It is important for you to observe your cycles closely in this regard,” explains Dr Padmavathi Kapila, chief consultant obstetrician and gynecologist at Renova Hospitals, Hyderabad.
While small blood clots are released along with your period blood, menorrhagia causes the release of noticeably bigger blood clots. The gynaecologist adds, “When you lose so much blood over a couple of menstruations, your haemoglobin levels drop and the iron in your body depletes. This can cause anaemia. Symptoms include feeling breathless while walking, discomfort in the chest, palpitations, excessive tiredness, and inability to do daily activities.”
It is important to note that if you are diagnosed with menorrhagia, you may or may not have painful menstrual cramps.
What causes this condition?
“Hormonal disturbances due to PCOS and PCOD, hypothyroidism, and stress can cause menorrhagia. When you are stressed, cortisol, the stress hormone, is released and disrupts the balance of estrogen and progesterone,” shares Dr Padmavathi.
Fibroids — non-cancerous growths in the uterus — also cause menorrhagia. The obstetrician underscores, “Fibroids are caused by genetics, environmental factors, lifestyle, and higher estrogen levels, which are present in obese individuals.”
Another condition which causes menorrhagia is adenomyosis, where the tissue from the lining of your uterus grows into your uterine wall. “This causes the uterus to become bulky and leads to menorrhagia,” says the doctor, adding that while there are a slew of causes, all of them essentially make the endometrium — the innermost lining layer of the uterus — thicken. And when this happens, the endometrium sheds as it always does that time of the month. But the flow is heavy and prolonged due to menorrhagia.
What are the treatments?
“Once we identify that a patient has menorrhagia, we decipher the causes by conducting some basic diagnostic tests and a pelvic ultrasound, which, among other uses, can help us understand the types of fibroids, if any. It can also help determine if the uterus is adenomyotic or there is any inflammation,” explains Dr Padmavathi, further elaborating that a complete blood picture is done to show haemoglobin levels.
“If the levels are low, we work towards increasing them. In cases of hypothyroidism, we may also do a thyroid profile and administer the necessary treatments,” she adds.
The gynaecologist points out how women with PCOS and PCOD can manage their conditions to a good extent by maintaining a good diet, getting ample sleep, and regularly exercising.
“Ladies, do not be afraid — if you notice symptoms, immediately consult your gynecologist, who will diagnose accordingly and help you,” advises Dr Padmavathi.
Tackling taboos
with Dr Smita Balakrishnan, counselling psychologist at the Hyderabad Academy of Psychology
During Covid-19, I was diagnosed with menorrhagia. Many women who notice symptoms often browse, self-diagnose, and get scared. This causes anxiety and mental stress, which affects your personal and professional life. Others hold back, ignore, and put it on the back burner, prioritising everyone around them. Ladies, this New Year, put yourselves first and
head to the doctor if you notice symptoms. Early intervention is key.