MENORRHAGIA

Menorrhagia is one of the most common forms of irregular periods.
It is the most common type of abnormal uterine bleeding characterized by heavy and prolonged menstrual bleeding. In some cases, bleeding may be so severe and relentless that daily activities become interrupted.
Any woman of childbearing age can develop menorrhagia. However, some women are likely to experience heavier menstrual bleeding than others. Risk factors include:

• •being a young adolescent or pre-menopausal woman
• •being overweight
• •using certain medications, such as blood thinners
• •having a hereditary bleeding disorder
  

Causes-

In some cases, the cause of heavy menstrual bleeding is unknown, but a number of conditions may cause menorrhagia. Common causes include:

• •Hormonal imbalance- In a normal menstrual cycle, a balance between the hormones estrogen and progesterone regulates the buildup of the lining of the uterus (endometrium), which is shed during menstruation. If a hormonal imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding.
• •Dysfunction of the ovaries- Lack of ovulation (anovulation) may cause hormonal imbalance and result in menorrhagia.
• •Uterine fibroids- These noncancerous (benign) tumors of the uterus appear during your childbearing years. Uterine fibroids may cause heavier than normal or prolonged menstrual bleeding.
• •Polyps- Small, benign growths on the lining of the uterine wall (uterine polyps) may cause heavy or prolonged menstrual bleeding. Polyps of the uterus most commonly occur in women of reproductive age as the result of high hormone levels.
• •Adenomyosis- This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and pain. Adenomyosis is most likely to develop if you're a middle-aged woman who has had many children.
• •Intrauterine device (IUD)- Menorrhagia is a well-known side effect of using a nonhormonal intrauterine device for birth control. When an IUD is the cause of excessive menstrual bleeding, you may need to remove it.
• •Pregnancy complications- A single, heavy, late period may be due to a miscarriage. If bleeding occurs at the usual time of menstruation, however, miscarriage is unlikely to be the cause. An ectopic pregnancy - implantation of a fertilized egg within the fallopian tube instead of the uterus - also may cause menorrhagia.
• •Cancer- Rarely, uterine cancer, ovarian cancer and cervical cancer can cause excessive menstrual bleeding.
• •Inherited bleeding disorders.-Some blood coagulation disorders - such as von Willebrand's disease, a condition in which an important blood-clotting factor is deficient or impaired - can cause abnormal menstrual bleeding.
• •Medications- Certain drugs, including anti-inflammatory medications and anticoagulants (to prevent blood clots), can contribute to heavy or prolonged menstrual bleeding. Improper use of hormone medications also can cause menorrhagia.
• •Other medical conditions- A number of other medical conditions, including pelvic inflammatory disease (PID), thyroid problems, endometriosis, and liver or kidney disease, may cause menorrhagia
  

Symptoms-

• •Spotting or bleeding between menstrual periods
• •Spotting or bleeding during pregnancy

Complications-

• •Iron deficiency anemia: In this common type of anemia, there is decrease in hemoglobin. Low hemoglobin may be the result of insufficient iron. Menorrhagia may deplete iron levels enough to increase the risk of iron deficiency anemia. Signs and symptoms include pallor, weakness and fatigue.

• •Severe pain: Heavy menstrual bleeding often is accompanied by menstrual cramps (dysmenorrhea). Sometimes the cramps associated with menorrhagia are severe enough to require prescription medication or a surgical procedure.
  

Differential Diagnosis-

• •Pregnancy complications:

• •Nonuterine bleeding:

• •Hypothyroidism
  

Investigations-

Treatment-

• •age, overall health, and medical history
• •extent of the condition
• •cause of the condition
• •tolerance for specific medications, procedures, or therapies
• •expectations for the course of the condition

Treatment for menorrhagia may include:

• •Iron supplementation (if the condition is coupled with anemia, a blood disorder caused by a deficiency of red blood cells or hemoglobin)
• •Prostaglandin inhibitors such as nonsteroidal anti-inflammatory medications (NSAIDs), such as aspirin or ibuprofen (to help reduce cramping and the amount of blood expelled)
• •Oral contraceptives (ovulation inhibitors)
• •Progesterone (hormone treatment)
• •Endometrial ablation - a procedure to destroy the lining of the uterus (endometrium).
• •Endometrial resection - a procedure to remove the lining of the uterus (endometrium).
• •Hysterectomy - surgical removal of the uterus.

Role of Homoeopathy-