Heavy menstrual bleeding affects women of any age, although it is more common at the extremes of the reproductive season, that is, in adolescence and perimenopause (around menopause). This is explained by Dr. Rubén Betoret, head of Gynecology and Obstetrics at the Vinalopó University Hospital, the health center managed by the Ribera group in Elche. Therefore, that abundant bleeding that is so strange to women who have not had this symptomatology in their youth or in the reproductive stage is relatively frequent in those last years of the period, before beginning the menopause itself.
The World Health Organization (WHO) estimates that heavy bleeding has a global prevalence between 8-27% of women at different stages of their lives.
Dr. Patricia Molina, a gynecologist at the Denia Hospital, also managed by the Ribera group, ensures that it is one of the most common reasons for consultation or emergencies in women between 45-55 years of age, around the menopause. What specialists now call “abnormal uterine bleeding”, formerly better known as menorrhagia, not only refers to the amount of bleeding (more than 80 milliliters), but also to its duration (more than eight days), to whether the cycle it is less than 25 days recurrently or there are frequent clots. But how to measure those 80 milliliters? “It is key to take a good clinical history, talking to the woman,” explains Dr. Molina. In addition, analytical tests such as a blood count may be requested. “If the woman has anemia, for example, added to the symptoms that she describes, it is that there is abnormally heavy bleeding,” she adds.
Consequences of Abundant Rules
Doctor Betoret agrees on this point, assuring that the main side effect of heavy menstrual bleeding is anemia, “although in most women the perception of bleeding does not correlate well with their level of anemia.” He also notes that “excessive menstrual blood loss can interfere with a woman’s usual physical, emotional, or social activity.”
In addition, the Vinalopó specialist ensures that the amount of bleeding and pain or discomfort during menstruation are not necessarily related. “Although dysmenorrhea is more common in women with long and heavy periods, there can be heavy bleeding without dysmenorrhea, that is, without pain,” he explains.
Causes of excessive bleeding
Dr. Molina explains that there are organic and dysfunctional causes that can justify this abundant bleeding: polyps, adenomyosis (endometrial gland disorder), leiomyomas, and malignant or premalignant lesions in the endometrium, in the case of organic causes; and dysfunctional, that is, they indicate that something is not working well, such as coagulopathies, ovulatory dysfunctions, endometrial disorders, treatments that can affect bleeding and unclassifiable. We recommend you listen to the podcast included in this blog entry to hear from a professional from Ribera the explanation of the causes of these profuse bleeding.
Podcast. How to reduce pain during the menstrual period and factors that influence heavy bleeding