What causes menorrhagia

　　If you are careful, you pay close attention to your menstrual cycle, but have you paid attention to the flow of menstrual blood? If the originally regular menstruation suddenly becomes a flooded ocean, it often means healthy Something went wrong……

　　First of all, we need to clarify a question - how much menstruation is too much? Doctors believe that normal menstrual bleeding should be 20 to 60 ml, and more than 80 ml is considered excessive. Menorrhagia . Based on the approximate usage of sanitary napkins, normal usage is to replace them four or five times a day on average, with no more than two packs per cycle (10 pieces per pack). If using 3 packs of sanitary napkins is not enough and almost every sanitary napkin is soaked, it is considered as excessive menstrual flow.

　　of different ages and physiological stages female , the causes of menorrhagia are also different. Taking women aged 25 to 40 as an example, abnormally increased vaginal bleeding is mainly related to the following seven factors——

　　Assumption 1: Improper contraceptive method

　　Sometimes, abnormal vaginal bleeding is related to the type of birth control you are using. The most common "trouble" is Uterus Ringed. In our country, this is the most common contraceptive method used by women after childbirth. The most prominent problems it brings are shortened menstrual cycles, prolonged menstrual periods, significantly increased menstrual volume, and postmenstrual bleeding. In particular, the new generation of active uterine rings with copper ions not only improves the contraceptive efficacy, but also increases the amount of menstrual bleeding. In addition, short-acting oral contraceptives can often make your menstrual periods more regular, less heavy, and Dysmenorrhea alleviate. However, incorrect use can also cause hormone regulation disorders, resulting in abnormally increased menstruation. For example, failure to take it according to the prescribed information, missing or taking the wrong dose, etc. can lead to disorders of reproductive hormone levels in the body, affecting the development of the endometrium and causing abnormal bleeding. There are also women who use long-acting injections or subcutaneous implants for contraception. What they most often experience is not a large amount of vaginal bleeding, but continuous, spot-like bleeding. Sometimes the amount of bleeding accumulates to a large amount due to prolongation of time. This situation is mostly due to the unbalanced effects of external reproductive hormones in your body.

　　Countermeasures: Solutions to excessive menstruation after placing a uterine ring include: using oral medications instead of other contraceptive methods, or switching to a uterine ring containing progesterone that can reduce menstrual flow. Although oral contraceptive pills are readily available at regular pharmacies, it’s important to know that they are prescription drugs. If you want to use this method of contraception, it is not enough to read the prescription information of the drug in detail. Before purchasing, you must consult a professional doctor to learn more about its indications and contraindications, the correct method of taking it, and the remedial measures in case of missed doses. Although you have been informed that a similar situation will occur when you choose long-acting injections or subcutaneous implant technology for contraception, if it does not gradually improve over time, or becomes more serious, you should go to a follow-up consultation in time and ask your doctor to re-evaluate whether you are suitable for this method of contraception.

　　Hypothesis 2: Infection

　　Inflammation of the reproductive organs is another common cause of abnormal vaginal bleeding. We all know that the female reproductive organ is not completely sealed. The semi-open passage between it and the outside world gives it the opportunity to be invaded by various pathogenic factors from the outside world. When you are in situations such as anxiety, tension, fatigue, etc. that reduce your own defense function, various pathogenic factors may take advantage of the situation, leading to the occurrence of the above-mentioned inflammations, making local blood vessels fragile, and bleeding during menstruation is not easy to stop, often causing increased menstrual flow and prolonged menstrual periods. If you are in overall poor condition recently, have heavy vaginal bleeding accompanied by lower abdominal or waist pain, increased vaginal discharge, abnormal color or smell, fever, and frequent and painful urination, you should consider a genital infection.

　　Countermeasures: The universal prescription for dealing with various infections is to get enough rest, drink enough water and eat a light diet. Such mild infections can get better on their own; otherwise, you need to see a doctor in time to choose effective antibiotics for treatment.

　　Hypothesis 3: Miscarriage or abnormal pregnancy

　　Abnormal vaginal bleeding in mature women is sometimes related to pregnancy complications. If your menstruation is usually very on time, but it is late for more than a week or more than ten days for no reason, then it will flow like a floodgate, mixed with more blood clots or tissue than usual, and it will last longer than usual. So, this is most likely a small miscarriage. Similar events occur more often in induced abortions (either surgical or medical abortion ), especially after medical abortion, there is a 5% to 10% chance of abortion failure or incomplete abortion. In addition, if accompanied by increased vaginal bleeding, palpitation, dizziness, cold sweats, abdominal pain or even syncope occur, it may be Ectopic pregnancy signs.

　　Countermeasures: The simplest self-test method is to take a pregnancy test: you can get a rough estimate of the situation by checking your morning urine. However, this method is not completely reliable. Sometimes, hormone levels have dropped before a miscarriage occurs, resulting in a negative result. If your vaginal bleeding increases too much or too quickly in a short period of time, or if your bleeding lasts for too long, or if you have other uncomfortable symptoms at the same time, you should contact your doctor immediately.

　　Hypothesis 4: Endometriosis

　　Related terms: ovarian endometriosis, adenomyosis. To put it simply, endometriosis is when the tissue that should originally grow in the lining of the uterine wall appears in other locations. These "ectopic" endometrium interfere with various normal functions of the reproductive organs and are often accompanied by various Menstrual disorders ——Prolonged menstruation, excessive menstrual bleeding, premenstrual spotting, secondary dysmenorrhea, etc. If your menstrual flow gradually increases and is accompanied by increasingly severe dysmenorrhea; if you feel severe discomfort or even pain when being intimate with your lover; if you find that your efforts to get pregnant have repeatedly failed... pay attention, you may have suffered from endometriosis.

　　Countermeasures: The first thing is to make a clear diagnosis. Although experienced gynecologists can detect some typical manifestations of endometriosis through a simple pelvic examination or ultrasound scan, laparoscopy is required to confirm the disease. Corresponding treatments include oral hormone-modulating drugs or surgery. If you happen to have a childbirth plan, patients with mild symptoms can also ease the progression of the disease through pregnancy and delivery.

　　Hypothesis 5: Tumor

　　The most common genital tumor among women of childbearing age is uterine fibroids. The incidence of uterine fibroids is very high, reaching 20% ​​to 25%, but please don’t be afraid, because 99.5% of them are benign. Only two types of uterine fibroids, intermuscular and submucosal, are the most common causes of menorrhagia. Endometrial polyps are actually a chronic inflammatory lesion. In recent years, the incidence of cervical cancer has become higher and higher, and there is a trend of getting younger. The first symptom of cervical cancer is bleeding after sexual intercourse, which is especially prominent before and after menstruation, and sometimes may even cause fatal heavy bleeding. If you have progressively more menstrual periods, or are combined with other menstrual abnormalities such as shortened menstrual cycles, prolonged menstrual periods, irregular bleeding, or bleeding after sexual intercourse... please ask a gynecologist for a timely examination.

　　Countermeasures: An annual standard gynecological examination, including a pelvic examination, Pap smear and, if necessary, a pelvic ultrasound scan, laparoscopy or hysteroscopy, can help you detect and treat the above abnormalities early.

　　Hypothesis 6: Blood disease

　　Increased menstruation may not be a problem with the reproductive organs themselves, but a sign of a blood disease. Menstruation, like other bleeding phenomena in the human body, is regulated by its own coagulation system. If there is an abnormality in the coagulation system, such as a hemophilia patient who is congenitally deficient in a certain coagulation factor, the blood will not clot easily, resulting in heavy menstrual flow and long bleeding time. Menorrhagia is sometimes the only symptom of female hemophilia patients! Other common blood diseases such as thrombocytopenic purpura, leukemia, aplastic anemia, etc. can also easily affect the coagulation system and increase menstrual flow. If you are prone to various infections, have frequent fevers (especially high fever), in addition to frequent menstruation, you may also experience skin ecchymosis, nosebleeds, gum bleeding, etc... These abnormal bleeding are more likely to be problems with the coagulation system - that is, blood diseases.

　　Countermeasures: Especially young women, if you have long-term problems with menorrhagia and no cause can be found after examination by an obstetrician and gynecologist, you should consider receiving a detailed blood test to see if you have a blood disease.

　　Assumption 7: Functional anomalies

　　If none of the above is your problem, it’s time to consider the possibility of dysfunction. This is the case with endocrine disorders that many people often mention. But everyone’s situation will be different. For example, a professional doctor can distinguish the type of hormone level imbalance and its possible causes based on your different menstrual phases, basal body temperature measurement, measurement of reproductive hormones in the blood, combined with diagnostic dilation and curettage, ultrasound scan, MRI and other auxiliary examinations, and then carry out targeted treatment. If you often have symptoms such as irregular menstruation, frequent or intermittent menstruation, irregular menstrual periods, premenstrual spotting, etc., and no other obvious reasons can be found, then it is likely that abnormal function is at play.

　　Countermeasures: You often cannot determine the cause of the above situation through your own judgment. It is recommended that you let an experienced doctor verify the cause of the disease. The diagnosis can only be made after first excluding all other "organic" causes mentioned above.