Karuna is a 31year old with no children and has never been pregnant though mothering is definitely on her life’s “to-do” list. She has heavy period bleeding for over a year and has been through tests and hormonal medication with no major relief. She feels it’s debilitating, humiliating, painful and uncontrollable – and it could all quite possibly end in removal of her uterus – and with it, her hopes of ever having her own children.
She is one amongst every 3 women worldwide who suffer from abnormal, heavy menstrual bleeding (HMB) at some point in their lives.
A normal period comes every 21 to 35 days and lasts for 3 to 7 days. The following signs can show that the periods are heavy- A need to change the sanitary towel frequently, large blood clots with pain, bleed that happens through to the clothes, normal activities such as going out or working are affected, the woman feeling excessively tired, depressed or becoming anaemic as a result of it.
There are many causes for prolonged bleeding – from something as simple as stress to serious conditions such as cancer. The hormones estrogen and progesterone control the uterus lining (endometrium) which is shed during a period. A hormonal imbalance causes it to build up so, when it is eventually shed, bleeding is heavier. Thyroid hormonal imbalance and pregnancy complications such as a miscarriage and ectopic pregnancy may also cause heavy bleeding.
In young girls, or in women approaching menopause, irregular periods are not unusual due to improper ovulation and changes in hormone levels. For others, HMB can be a result of polycystic ovary syndrome (PCOS), infections, endometriosis, adenomyosis, fibroids and polyps. However, the most common cause is Dysfunctional Uterine Bleeding (DUB) witnessed by women in midlife where a hormone imbalance leads to HMB. It is often impossible to predict how long this imbalance may last for. It could vary between few months to few years.
Diagnosis and Treatment :
Detailed history regarding possibility of bleeding disorders or cancers in the family, simple blood tests, ultrasonography and biopsy may be needed to arrive at a diagnosis.
Uterus removal is not needed in majority of women and they can be treated with hormonal pills or with a hormone containing intrauterine device (Mirena). For some women, a day-care procedure called endometrial ablation destroys the lining of the uterus using electric current or heated fluid to reduce or stop menstrual flow.
If uterus removal (Hysterectomy) is warranted, laparoscopic surgery is possible that facilitates quick recovery.
Helping yourself :
Having heavy periods can lead to low iron levels. Taking iron supplements and eating iron rich foods such as green leafy vegetables, meat, dry fruits like raisins, dates, apricots would replace the lost iron.
Exercise may be the last thing on your mind during periods but drinking plenty of water and regular exercise like walking or Yoga can reduce the pain and ward off depression. It’s always advisable to keep sanitary towels on you and use hot water bottle to help relieve abdominal pain and cramps.
You should not put up with the bleeding affecting your quality of life as many simple treatment options can help.