WHY DO WOMEN EXPERIENCE HEAVY MENSTRUAL BLEEDINGAT TIMES?
Heavy bleeding during menstrual periods used to be referred to as menorrhagia. This heavy bleeding can be heavy during the period or last for more than a few days. What is considered heavy? Soaking through sanitary pads or tampons every hour for hours in a row, bleeding for more than a week, passing blood clots and more. Cramping may accompany the heavy flow.
It is important to note that A menses, or a period, is a bleed that is preceded 14 days prior by ovulation. So not all blood that comes out of the vagina is a period, in fact there are many situations (normal and abnormal) which may result in heavy menstrual bleeding.
What causes these heavy periods? Dr Steven R. Goldstein, a NYC Gyn, gives certain reasons for these heavy bleeding periods.
Women with many children will see growth of the size of the uterus so that the surface area of the uterine lining is increased and bleeding may be heavy without there being any abnormality. In addition, an entity known as adenomyosis, which is benign, can also result in heavy menstrual bleeding at the appropriate time. Adenomyosis is due to the inner lining of the uterus protruding through the muscle wall of the uterus. The condition is sometimes misdiagnosed as a uterine fibroid.
This displaced tissue (the inner lining of the uterus) continues to act normally during each menstrual cycle by thickening, then breaking down and bleeding. This can cause an enlarged uterus and painful, heavy periods.
Hormonal balances between the hormones estrogen and progesterone can cause heavy periods. The uterine lining (endometrium) is shed during a menstrual period. This uterine lining can become too thick and shed itself by heavy menstrual bleeding, or, in some cases bleeding between periods.
Some women with fibroids will see growth of the uterine cavity such that there is more surface area and heavy menstrual bleeding at the proper time, or bleeding that goes on for longer
Finally, the presence of uterine polyps, only if they are in synchrony with the normal cycle, can result in heavy menstrual bleeding at the appropriate time.
Such heavy periods or vaginal bleeding must be distinguished from women who bleed at an irregular interval and irregular timing. Such irregular bleeding may herald more serious pathologies such as pre-cancers or cancers, although, more often, they are polyps that are not in synchrony with the menstrual cycle.
When it comes to diagnosis for this condition, Dr Goldstein warns NOT have a painful endometrial biopsy as your first choice to diagnose your condition. Instead opt for painless, non-invasive evaluation with office procedures such as Transvaginal ultrasound or sonohysterography.
Transvaginal ultrasounds and Sonohysterograms are a painless means of diagnosis. Skilled in both, Dr Goldstein is able to see the uterine lining, the uterus, the fallopian tubes, the ovaries, and cervix and generate clear, precise images. Armed with this diagnostic information he is able to advise on the reason for heavy periods.
Dr. Goldstein is a leading Gynecologist in NYC. He is a Professor of Obstetrics and Gynecology at New York University School of Medicine and a former Director of Gynecologic Ultrasound, NYU Langone Medical Center among many other positions. He is one of the most highly regarded individuals in the field of gynecologic ultrasound.