Unraveling Menstrual Heavy Bleeding
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Unraveling Menstrual Heavy Bleeding

Introduction

Menstrual heavy bleeding is a common concern experienced by many menstruating individuals. It is a menstrual blood loss that is perceived by women as excessive and can have a negative impact on their physical, emotional, social, and material quality of life. In this article, we will explore the causes of menstrual heavy bleeding and delve into the intricate relationship between this symptom and hormone balance.

What Causes Menstrual Heavy Bleeding?

The mechanisms controlling menstrual bleeding are poorly understood. However, scientists have demonstrated that menstrual heavy bleeding can be caused by various factors, ranging from hormonal imbalances to underlying medical conditions. Understanding these causes is essential for effective management and treatment. There are many causes of heavy menstrual bleeding, including:

  • Hormonal imbalances: In the past decade, studies have shown increased endometrial fibrinolysis and an alteration in prostaglandin balance as local uterine abnormalities present in dysfunctional uterine bleeding. Besides, hormones play a crucial role in regulating the menstrual cycle, and an imbalance can lead to heavy bleeding. Estrogen and progesterone, the primary hormones involved in menstruation, need to be in proper balance for a healthy menstrual flow.
  • Uterine fibroids: These are noncancerous growths that can develop in the uterus. Uterine fibroids are noncancerous growths that develop in the uterus. These benign tumors can cause heavy bleeding, as they disrupt the normal structure of the uterine lining and interfere with its ability to contract effectively during menstruation. Researchers have demonstrated that uterine fibroids are hormone-responsive neoplasms that are associated with heavy menstrual bleeding.
  • Uterine polyps: These are small, benign growths that can develop in the lining of the uterus. Polyps can cause heavy bleeding by interfering with the normal shedding of the uterine lining. Endometrial polyps are growths that occur in the lining of the uterus. Studies have also shown that larger polyps are more likely to persist and are associated with the development of abnormal menstrual bleeding. 
  • Adenomyosis: Adenomyosis is a common disorder that is characterized by the presence of endometrial glands and stroma within the myometrium, usually surrounded by hypertrophied myometrial smooth muscle. Adenomyosis occurs when endometrial tissue grows into the muscle layer of the uterus. Adenomyosis can cause heavy bleeding by making the uterus more sensitive to hormones and by increasing the surface area of the uterus that is shedding.
  • Pelvic inflammatory disease (PID): This infection can damage the fallopian tubes and uterus, which can lead to heavy bleeding.
  • Endometrial cancer (EC): EC is a hormonally driven disease, and the continuous, unopposed effect of estrogen is thought to be the primary promoter in at least 80% of endometrial cancers. This type of cancer can cause heavy bleeding, especially if it is advanced.

Conclusion

Menstrual heavy bleeding can significantly impact an individual's physical and emotional well-being. Understanding the causes behind this symptom, particularly its connection to hormone balance, is crucial for effective management and treatment. By seeking for medical guidance and exploring appropriate interventions, individuals can find relief from heavy menstrual bleeding and improve their overall quality of life. Hormone balance plays a pivotal role in regulating menstrual flow, and addressing any hormonal imbalances can lead to better menstrual health.

References
  • Bonnar, John, and Brian L. Sheppard. "Treatment of menorrhagia during menstruation: randomised controlled trial of ethamsylate, mefenamic acid, and tranexamic acid." Bmj 313.7057 (1996): 579-582.
  • Hapangama, Dharani K., and Judith N. Bulmer. "Pathophysiology of heavy menstrual bleeding." Women’s Health 12.1 (2016): 3-13.
  • Lethaby, Anne, et al. "Progesterone or progestogen‐releasing intrauterine systems for heavy menstrual bleeding." Cochrane Database of Systematic Reviews 4 (2015). 
  • Schlaff, William D., et al. "Elagolix for heavy menstrual bleeding in women with uterine fibroids." New England Journal of Medicine 382.4 (2020): 328-340.
  • DeWaay, Deborah J., et al. "Natural history of uterine polyps and leiomyomata." Obstetrics & Gynecology 100.1 (2002): 3-7.
  • Peric, H., and I. S. Fraser. "The symptomatology of adenomyosis." Best practice & research Clinical obstetrics & gynaecology 20.4 (2006): 547-555.
  • FRASER, IAN S., et al. "Measured menstrual blood loss in women with menorrhagia associated with pelvic disease or coagulation disorder." Obstetrics & Gynecology 68.5 (1986): 630-633.
  • “Heavy Menstrual Bleeding”, Centers for Disease Control and Prevention, https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html.
IN THIS ARTICLE
1.Introduction
2.What Causes Menstrual Heavy Bleeding?
3.Conclusion