Menorrhagia
Menorrhagia means excessive blood loss during menstruation. While this is defined as being more than 80 millilitres per cycle, since most women don't measure their blood loss in millilitres a more practical definition is that which causes the woman difficulties with daily living. There are a number of different causes including infection, pregnancy, endometriosis, fibroids, and Cancer of the lining of the womb, together with generalised disorders such as failure of the thyroid gland, or problems with blood clotting. In the absence of any other pathology affecting the uterus, the cause is so-called dysfunctional uterine bleeding (which simply means that the uterus is bleeding more heavily than it should). In younger women, particularly in the early days of menstruation, it is often associated with menstrual cycles which have not produced an egg - called anovulatory. The ripening follicle does not rupture, but continues to secrete oestrogen so that the lining of the womb becomes very thick. Eventually it is shed, producing large amounts of bleeding. It can be helped by non-steroidal anti-inflammatory agents, drugs which increase the strength of capillary walls and drugs that stop the breaking down of blood clots (called anti-fibrinolytic agents) may help, as may using the combined oral contraceptive pill. In the older woman approaching the menopause the management may be different depending on the degree of blood loss, the persistence of symptoms and the possibility of other uterine problems. Surgical removal of the lining of the womb may solve the problem, but some women may opt for hysterectomy.
|
