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excessive menstruation

SYMPTOMS

What is menorrhagia?

Menorrhagia refers to a condition where a woman's menstrual cycle is regular and normal, but the duration of menstruation exceeds 7 days, or the total menstrual blood loss exceeds 80 mL.

In normal women, the menstrual cycle typically ranges from 21 to 35 days, averaging 28 days, with the menstrual period lasting 2 to 8 days (averaging 4 to 6 days) and a total blood loss of about 20 to 60 mL per cycle. Menstruation is regulated by the body's endocrine hormones. When various factors (such as uterine fibroids, adenomyosis, etc.) disrupt hormone levels, cause uterine or ovarian abnormalities, or affect blood clotting, it can lead to menorrhagia. Menorrhagia may persist until the underlying cause is resolved, after which normal menstruation gradually returns. Alternatively, it may occur sporadically without a discernible pattern[1,2].

Which vaginal bleeding symptoms can menorrhagia be easily confused with?

Some women with irregular periods may mistakenly attribute pregnancy to a delayed period. When early pregnancy complications occur, such as miscarriage or placental abruption, vaginal bleeding may be mistaken for menorrhagia.

TREATMENT

How to relieve heavy menstrual bleeding?

  1. Choose appropriate contraception: If heavy bleeding is caused by an intrauterine device (IUD), it should be removed promptly. Alternative contraceptive methods, such as condoms, can be used instead[3].
  2. Weight management: Those who are overweight should actively control their weight through exercise, such as walking or yoga, to promote healthy fat loss. Maintain a balanced diet by consuming more fruits and vegetables like cucumbers, celery, and apples, while avoiding greasy, high-calorie foods like fried chicken and螺蛳粉.
  3. Regular health check-ups: Detect and treat diseases early.
  4. Follow medical advice for medication: Discontinue unverified health supplements and avoid taking weight-loss drugs without guidance.

Note: If the above measures do not alleviate heavy menstrual bleeding or if the condition worsens, seek medical attention promptly to identify the underlying cause and receive targeted treatment.

What dietary precautions should patients with heavy menstrual bleeding take?

  1. Iron supplementation: Normally, women should absorb 0.7–2.0 mg of iron daily from their diet. Patients with heavy bleeding should consume more iron-rich foods, such as pork liver, green beans, egg yolks, and carrots[4].
  2. Maintain personal hygiene: Blood serves as an ideal medium for bacterial growth. During menstruation, patients should pay attention to hygiene and change sanitary pads frequently.

DIAGNOSIS

Under what circumstances should excessive menstrual bleeding prompt a hospital visit?

Patients should actively seek medical attention when experiencing the following conditions (including but not limited to):

  1. Excessive menstrual bleeding persisting over multiple menstrual cycles;
  2. Heavy bleeding (exceeding 80 mL, equivalent to soaking more than 10 regular sanitary pads during the entire menstrual period), accompanied by palpitations, shortness of breath, reduced urine output, pale complexion, and cold extremities;
  3. Intermenstrual bleeding (between two normal periods), postcoital bleeding, or sudden increase in menstrual flow (exceeding 60 mL);
  4. Abdominal pain or palpable abdominal masses;
  5. Pale complexion, skin bruising, dizziness, or tinnitus;
  6. Obesity, hirsutism, acne, or infertility;
  7. Loss of appetite, sluggishness, apathy, or constipation;
  8. Irregular menstrual cycles or delayed menstruation[2].

Which department should patients with excessive menstrual bleeding visit?

Gynecology.

POTENTIAL DISEASES

What are the possible causes of excessive menstrual bleeding?

  1. Endocrine disorders: Conditions such as dysfunctional uterine bleeding, polycystic ovary syndrome (PCOS), obesity, diabetes, and hypothyroidism can disrupt the hormones that regulate menstruation, leading to excessive menstrual bleeding.

  2. Ovarian dysfunction: Abnormalities in ovarian luteal function, for example.

  3. Benign uterine conditions: Uterine fibroids, endometrial polyps, and adenomyosis can all cause excessive menstrual bleeding.

  4. Malignant tumors of the reproductive system: Endometrial cancer, cervical cancer, and other malignancies may lead to abnormal uterine bleeding, which can be mistaken for excessive menstruation.

  5. Blood disorders: Conditions like immune thrombocytopenic purpura (ITP) and coagulation disorders can result in excessive menstrual bleeding.

  6. Intrauterine devices (IUDs): The insertion of an IUD may cause inflammatory reactions or endometrial damage, leading to excessive bleeding.

  7. Medications: Anti-inflammatory drugs (e.g., aspirin) and anticoagulants (e.g., warfarin) can contribute to heavy menstrual bleeding.

  8. Other diseases: Conditions like decompensated liver cirrhosis and renal failure[3].