Hypermenorrhea, also known as menorrhagia, is an excessively long or heavy menstrual cycle that is experienced on a regular basis. While about 30 percent of women have a heavy period, it's estimated that only about 10 percent of women suffer from hypermenorrhea. A typical menstrual cycle lasts an average of five days and has a total blood loss of less than 1/3 cup (80 ml). However, a woman with a menstrual cycle that lasts more than seven days, with a blood loss of more than 1/3 cup (80 ml) is considered to have hypermenorrhea.
Excessive bleeding from hypermenorrhea is caused by hormonal imbalances or various medical conditions. Uterine fibroids and endometrial cancer can cause thickening of the uterine wall, leading to heavy bleeding. Vaginal inflammation, uterine polyps, and thyroid conditions can also be contributing factors.
Common symptoms of hypermenorrhea include a heavy menstrual flow that requires changing pads or tampons every one to two hours, and large blood clots in menstrual blood. It is best to see a doctor as soon as possible if you suspect that you may be suffering from hypermenorrhea. Iron deficiency anemia can result if the condition is left untreated, as excessive bleeding can deplete iron levels in the blood. Experiencing symptoms of anemia, such as shortness of breath and fatigue, along with other symptoms of hypermenorrhea, may be an indication that the condition is present.
Some women are at higher risk of developing hypermenorrhea. Teenage girls are most prone to the condition in the 12-18 months after their first period, as they are not yet ovulating regularly. Women approaching menopause are also more likely to experience heavy bleeding, as hormonal imbalances are more common at this time. However, hypermenorrhea can affect women of all ages at any time during their reproductive lives.
Treatment of hypermenorrhea depends on your general health and the cause and severity of the problem. Drug therapy may be an option and includes iron supplements if anemia is present, nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce bleeding, oral contraceptives, and synthetic hormones such as progesterone. If drug treatment is unsuccessful, surgery may be necessary.
Surgical procedures for hypermenorrhea are varied and will depend on the severity of the case. Dilation and curettage, also known as "D and C," is done by dilating the cervix and scraping or aspirating excess tissue from the uterine walls to reduce menstrual bleeding. Endometrial ablation uses ultrasonic energy to destroy the uterine lining permanently, often resulting in normal menstrual flow thereafter. Endometrial resection uses an electrosurgical loop wire to remove the lining of the uterus, and is typically used when heavy bleeding is experienced, but there are no underlying uterine problems.