Heavy periods, hypermenorrhea or menorrhagia is a pathological condition that is characterized by prolonged regular bleeding from the uterus during the menstrual cycle in a volume exceeding the norm. It is worth talking about heavy periods only when menstruation lasts 7 days or more, and the amount of bleeding is more than 80 ml. However, before diagnosing hypermenorrhea (heavy periods), the individual characteristics of each woman’s menstruation should be taken into account.

Recent statistics show that approximately every third woman of reproductive age complains about the appearance of heavy menstruation. However, it is worth noting that these statistics take into account only those women who presented to medical institutions with a similar problem.

The duties of a gynecologist include not only determining the cause of heavy bleeding, but also clearly explaining to you what can and should be done if your periods are heavy. Therefore, even with minor menstrual irregularities, you should not delay visiting a specialist.

Why does hypermenorrhea occur?

In order to determine the exact reason why a girl or woman has heavy periods, as a rule, a comprehensive examination is carried out, including a variety of modern diagnostic techniques. Quite often there is no need to limit yourself to just a standard gynecological examination. Let's look at the most common causes of heavy periods:

• Hormonal imbalance. During a normal menstrual cycle, estrogen and progesterone regulate the growth of the uterine lining (endometrium), which is shed during menstruation. If an imbalance of these hormones occurs, then increased growth of the endometrium occurs, which leads to more heavy menstruation and the development of uterine bleeding. Most often, hormonal imbalance is observed in young girls during their first menstruation, when the menstrual cycle has not yet established, and in menopausal women.
• Functional failure of the ovaries. If there is no ovulation phase during the menstrual cycle, this leads to insufficient production of the hormone progesterone. Naturally, the resulting hormonal imbalance provokes menorrhagia and uterine bleeding.
• Uterine fibroids are a benign tumor that can develop in women of reproductive age. Often, uterine fibroids contribute to the appearance of heavy menstrual and uterine bleeding.
• Uterine polyps are benign growths of the mucous membrane (endometrium). Most often they occur in women aged 25-40 years, when there is high hormonal activity.
• Adenomyosis is internal endometriosis, in which there is a growth of the mucous membrane into the thickness of the muscular layer of the uterus. This pathological process often provokes severe painful uterine bleeding during menstruation and is typical for middle-aged women who already have children.
• Intrauterine device. Menorrhagia is considered a fairly common side effect when using this non-hormonal contraceptive. If it is determined that the intrauterine device is the cause of the development of heavy periods, then it is necessary to remove it as quickly as possible.
• Ectopic pregnancy. There are often cases when the cause of hypermenorrhea is the implantation (introduction) of a fertilized egg into the fallopian tube instead of the uterus.
• Malignant neoplasms of the internal genital organs. There is confirmed evidence that ovarian or uterine cancer can cause very heavy periods.
• Problems with blood clotting. For example, hereditary von Willebrand disease usually results in abnormal uterine bleeding during the menstrual cycle.
• Medications. It is reliably known that some medications, such as anti-inflammatory drugs and anticoagulants, can provoke heavy menstruation.
• Infectious and inflammatory diseases of the internal genital organs.
• Psychological stress, strong emotional reactions.
• Heavy physical activity, which can be associated with both professional sports and work.
• A strict diet that does not at all meet the needs of the female body.

If you do not determine the true reason why you have very heavy periods, then menstrual irregularities and uterine bleeding will recur, even after a course of medication.

Risk factors for hypermenorrhea

According to clinical statistics, the main responsibility for the development of menorrhagia or hypermenorrhea lies with hormonal imbalance. During a normal menstrual cycle, the release of a mature egg from the ovary stimulates the production of progesterone, one of the many functions of which is to maintain the regularity of menstruation.

If ovulation does not occur, then a lack of the hormone progesterone leads to heavy, prolonged menstruation. Most often, anovulatory cycles, which are not accompanied by the release of a mature egg from the ovary, occur among two age groups:

1. Teenage girls who have just recently started menstruating. Many young representatives of the fair half of humanity are very prone to anovulatory cycles during the first year after the first menstruation (menarche).
2. Mature women approaching menopause. Ladies aged 40 to 50 years, due to physiological characteristics, are especially at high risk of hormonal disorders.

If you do not know for sure how to shorten your periods (critical days), which are also very heavy, then first consult your gynecologist before taking any action.

When should you see a doctor?

Today, there is a tendency not to seek help from specialists once again, which is, at the very least, reckless and presumptuous. Many girls and women are confident that they know what to do if there is heavy uterine bleeding during menstruation. However, it is strongly recommended not to self-medicate and consult a specialist as soon as possible. Even if you manage to reduce your periods at home, without eliminating the cause of the menstrual irregularity, there is a high probability that everything will happen again.

No matter how hard you try, you cannot reduce heavy bleeding during menstruation, which means you should rush to see your gynecologist.

Why shouldn't you delay visiting a doctor?

If you do not consult a doctor in time for prolonged menorrhagia, you risk developing a number of quite serious complications that can further aggravate the current situation. If hypermenorrhea recurs and other pathological symptoms appear, this is a reason to sound the alarm. What can await you if you continue to neglect the help of specialists:

1. Iron-deficiency anemia. In most cases, mild to moderate anemia will be observed, which will manifest itself as pale skin, weakness, increased fatigue, headaches, dizziness, shortness of breath, rapid heartbeat, etc.
2. Severe pain in the lower abdomen. Along with heavy and prolonged periods, women may experience very painful sensations during menstrual periods (dysmenorrhea).

First aid for hypermenorrhea

What should you do if you have very heavy periods? First of all, you should calm down and stop being nervous, since pronounced psycho-emotional excitability only contributes to increased uterine bleeding. It is better to lie down on the bed so that your legs are in a more elevated position. It is recommended to apply cold (ice, chilled foods, etc.) to the area below the abdomen.

How can you shorten your periods if they have already started and are in full swing? Dicynon is considered one of the fastest and most effective hemostatic agents. Despite the fact that this drug is available in pharmacies without a prescription, it must be taken only with the approval of the attending physician, who determines the dosage and frequency of administration. It should be noted that Dicinon should be used only in case of heavy bleeding during the menstrual cycle.

Another popular hemostatic drug is Vikasol. However, it is worth noting that its action is more systemic and the effect of taking it does not occur as quickly as from Dicynon.

Folk remedies for hypermenorrhea

Quite often, many girls and women with heavy periods resort to traditional medicine recipes. Nevertheless, any use of folk remedies must be agreed with a doctor. What many healers recommend drinking during heavy periods:

• Cuff is a medicinal plant that can effectively reduce bleeding during menstruation by contracting the smooth muscles of the uterus. In addition, it has a diuretic and anti-inflammatory effect. As a rule, an infusion of mantle is used. Pour a tablespoon of crushed plant leaves into a glass of boiling water. Let it brew for about two hours. The resulting infusion is filtered. You should drink half a glass before meals three times a day.
• Shepherd's purse is a medicinal plant that has a pronounced hemostatic effect. Its effect is due to increased uterine tone and activation of the blood coagulation system. For various bleeding, including uterine bleeding during the menstrual cycle, an infusion of shepherd's purse is used. It is not difficult to prepare it. Pour a tablespoon of crushed dry plant into a glass of boiling water. Let it brew for half an hour. Strain and drink the resulting infusion one tablespoon three times a day. Contraindications to the use of shepherd's purse are all pathological conditions accompanied by increased blood clotting, the period of gestation and hemorrhoids.
• Comfrey. Due to the content of various beneficial substances, this medicinal plant has good anti-inflammatory, hemostatic, antispasmodic and antimicrobial effects. To prepare the tincture, take 2 tablespoons of comfrey root, which are infused in half a glass of alcohol for at least two weeks. Take 15 drops of tincture before meals, after diluting it in 100 ml of boiled water.
• A decoction of red raspberry leaves. To reduce heavy periods, a decoction is prepared at the rate of 2 teaspoons of crushed raspberry leaves per glass of boiling water. Drink half a glass of decoction three times a day. However, there are contraindications for women with kidney disease, liver disease, ulcers and gout.

You should never panic prematurely, even if you have heavy periods. Your doctor should explain to you what to do and how to behave.

Heavy periods– these are timely menstruation with pathological blood loss. Heavy periods are not an independent nosological entity, but serve only as a symptom of the underlying disease.

Throughout life, every adult woman is faced with incoming changes in menstrual function, including an increase in the intensity of menstruation. However, not every heavy period correlates with pathology; sometimes they appear for completely harmless, physiological reasons.

A distinctive feature of physiological strong periods is their episodic nature. For example, if, after excessively dosed physical activity, menstruation is severe, after a proper change in physical activity, menstrual function returns to normal. A similar situation occurs with hypothermia, stress, overwork and other temporary physiological changes.

If heavy periods tend to recur, and/or if the amount of blood loss increases from cycle to cycle, they are no longer considered a harmless abnormality and imply the presence of a serious pathology.

To talk about pathological menstruation, we must first define the very concept of “normal”. It is impossible to determine the exact boundaries of “normal” menstruation; it is different for each woman. Therefore, conditional criteria for the physiological norm of menstrual function have been defined, namely:

- Regularity. Your period should come regularly, at the same time. Fluctuations of 2-3 days are acceptable.

— Interval between menstruation. It should also be constant and is usually 28, but can vary between 25-35 days. The first day of menstruation is both the end of the previous and the beginning of the next cycle. Heavy periods after a delay may indicate an interruption or a serious hormonal imbalance.

- Duration of menstrual bleeding. In healthy women, it usually does not exceed a week. If your period lasts less than three days, it is no longer considered normal.

Some women incorrectly measure the menstrual interval by not including spotting days. Meanwhile, menstruation means the entire period of any (bright, dark, heavy, scanty) bleeding.

- Amount of blood lost. The most difficult indicator to measure. Normal menstrual blood loss ranges from 40 to 150 ml, but it is quite difficult for a woman to measure it on her own. Therefore, it is customary to measure it by the number of pads changed per day. Usually, with physiological blood loss, their number does not exceed four, provided that hygiene products are used correctly.

— Intensity of menstrual bleeding. Most healthy women bleed the most in the first 2-3 days, and then the blood loss decreases.

— The presence of accompanying subjective sensations. Menstruation should not be accompanied by severe pain. Minor unpleasant sensations such as “pulling”, “aching” and others are acceptable. Severely painful periods should not be ignored, as they indicate serious organic or functional diseases.

Heavy periods in adolescents, accompanied by intense pain, may indicate neurometabolic, psychoemotional and endocrine disorders.

— Absence of pathological impurities and clots. Heavy periods with blood clots often appear against the background of fibroids, polyps, or hormonal dysfunction.

It should be noted that in some women they exist initially and do not cause harm to health. An individual feature of the menstrual cycle is considered to be the situation when a woman constantly has heavy periods throughout her life, and no pathological causes have been identified during examination.

The clinical picture of heavy menstruation involves complaints of excessive menstrual bleeding, sometimes with clots and/or pain of varying intensity. If heavy periods continue for several cycles, patients may develop signs of anemia (general weakness, fatigue, etc.).

Since heavy periods are not an independent disease, their diagnosis and therapy involve searching for the underlying disease and its treatment.

Causes of heavy periods

Before talking about the causes of heavy periods, it is necessary to get a correct idea of ​​how the menstrual cycle is formed and why menstrual bleeding occurs in general.

The basis of any menstrual bleeding is the process of rejection of the functional (uppermost) layer of the endometrium, followed by exposure of the underlying blood vessels. The menstrual cycle is formed with the participation of not only the uterus and ovaries; cyclic changes affect many important organs and systems. The most important controlling link is the hypothalamus-pituitary gland system. It “controls” the hormonal function of the ovaries through the pituitary hormones - FSH (follicle-stimulating) and LH (luteinizing). FSH stimulates the development of the follicle and egg (first phase), and thanks to LH, the “corpus luteum” appears and functions (second phase).

In the ovaries, with the participation of pituitary hormones, estrogens and progesterone are produced, affecting structural changes in the endometrium. In the first half of the cycle, with the participation of estrogens, the endometrium increases in volume, sprouts new blood vessels, that is, it actually prepares the uterus for a potential pregnancy. If the egg dies without fertilization, all changes that have occurred in the endometrium begin to be eliminated with the participation of progesterone in the second phase, when the overgrown superficial mucous layer begins to gradually separate from the uterine wall. Completely shed endometrium is evacuated from the uterus during menstrual bleeding. Then, when the uterus is completely freed from fragments of mucous membrane and blood, everything repeats again.

Heavy periods accompany many gynecological and extragenital pathologies, but they are always based on a violation of the mechanisms of rejection and/or evacuation of the overgrown functional layer of the endometrium.

Among the physiological causes of heavy periods, the most common are:

— . The first heavy periods after childbirth are usually associated with natural causes. It takes time to restore the hormonal function of the ovaries and the previous prenatal tone of the uterine muscles, therefore, if the first menstruation after childbirth comes early (this happens in non-lactating women), it can be heavy. If subsequent menstruation continues to be heavy, you should think about other, pathological reasons.

— The period of formation of menstrual function. Heavy periods in adolescents are usually associated with imperfect hormonal regulation of the cycle.

- Psycho-emotional overload. Under the influence of stress, the pituitary-hypothalamus system malfunctions, and the nature of menstruation may change.

— Incorrect use of hormone-containing drugs, especially for the purpose of contraception. Unfortunately, women do not always consult a specialist when choosing a hormonal contraceptive. Meanwhile, a self-selected remedy may be chosen incorrectly and provoke menstrual dysfunction.

— Taking medications that affect blood clotting. Reducing the intensity of coagulation increases the duration of bleeding during menstruation and makes it more abundant.

Also, for natural reasons, periods sometimes come heavily after hypothermia, too intense physical activity, in the first months after the start of intimate life.

All pathological causes of heavy menstruation can be conditionally classified into hormonal and non-hormonal. Hormonal reasons are associated with when an excessive concentration of estrogen provokes too much growth of the endometrium.

Among the non-hormonal causes of heavy menstruation, the most common are fibroids, polyps, and adenomyosis. Formations in the uterine cavity prevent the free evacuation of menstrual blood and reduce uterine tone; they often provoke heavy periods with clots.

Heavy periods after a delay should never be ignored. They may indicate an early pregnancy that was interrupted.

The true cause of heavy periods can only be determined after examination and appropriate examination.

Symptoms and signs of heavy periods

The volume and duration of menstrual blood loss, accepted by a woman as normal, is always individual. Therefore, the concept of strong periods is, first of all, determined by the woman herself. As a rule, patients consult a doctor with complaints of atypical heavy menstrual bleeding and an increase in its duration (longer than a week). Since menstruation lasts longer, the menstrual cycle also changes - it becomes shorter.

If a lot of blood is released during menstruation, dark clots may be present in it. The presence of clots is associated with the inability of the uterus to quickly evacuate too much blood; it remains in the uterine cavity longer than usual and has time to clot. Severely painful periods with clots may also indicate the presence of fibroids or a polyp in the uterus, which deform the uterine cavity and create a mechanical obstacle to the flow of blood.

Heavy periods after childbirth with clots and moderate pain are sometimes associated with disruption of the processes of uterine involution.

The clinical manifestations of heavy menstruation depend on at what level (central or peripheral) of the formation of the menstrual cycle the failure occurred, and what events preceded it. As a rule, a correctly conducted survey of the patient often makes it possible to determine the situation that provokes heavy menstruation: severe stress, difficult childbirth or abortion, taking hormonal contraceptives, and so on.

After the conversation, the diagnostic search continues:

- Gynecological examination. Helps assess the condition of the genitals. If fibroids are present, an enlarged uterus is palpable, and if there is inflammation, it will be painful. Purulent ones will indicate an infectious process.

— Laboratory examination of the vaginal contents (smear, culture) for the presence of infection.

— Determination of the level of basic hormones at different periods of the cycle (estradiol, FSH, progesterone, LH and others).

— Determination of hemoglobin level using a general blood test.

— Ultrasound scanning. Allows you to diagnose the inflammatory process, ovarian pathology, fibroids, polyps and other pathologies.

- Hysteroscopy. It is carried out if it is necessary to visually examine the uterine cavity with subsequent collection of material (a piece of mucous membrane) for subsequent histological examination.

Very heavy periods

Menstruation can be very heavy, accompanied by pain or other alarming symptoms. More often, such periods have all the signs of menstrual bleeding, and since it initially coincides with the next menstruation, it is called cyclic.

Very heavy periods always last longer than usual and disrupt the patient’s usual lifestyle: she feels weak, gets tired quickly, and has to change pads very often. Often, along with blood, a large number of clots are separated from the uterine cavity.

Very heavy periods are often accompanied by pelvic pain, which can radiate to the lower back.

Very heavy periods always have a serious pathological reason, namely:

— , . Infectious inflammation of the uterine wall deforms its contractility, so the endometrium is rejected and evacuated unevenly and for a long time. Along with large blood loss, fever, weakness, deterioration of health and severe pelvic pain are noted.

— — pathology of the endometrium of hormonal origin. Sections of endometrial tissue begin to grow deep into the uterine wall and continue to function there according to their purpose - to grow and be rejected, in fact - to menstruate. Over time, muscle fibers are destroyed in the area of ​​pathological foci (heterotopias). The ability of the myometrium to contract changes, menstruation becomes strong and painful.

— . Sometimes the fibroid formed in the muscle layer begins to grow towards the uterine cavity. As a result, a submucosal (submucosal) myomatous node appears. It deforms the uterine cavity and prevents the uterus from contracting correctly. Submucous fibroids almost always provoke very strong periods with intense pain. The intensity of the pain is sometimes so severe that it resembles labor pains. Trying to get rid of the “foreign body” in its cavity, the uterus contracts so much that the “birth” of the submucosal node occurs, when it, like a fetus, leaves the uterus along with a very large amount of blood. This situation may coincide in time with the next menstruation.

— Incorrect use of hormonal drugs. Sometimes very heavy periods can begin due to untimely discontinuation of hormonal contraceptives.

— Intrauterine contraception. Sometimes the intrauterine device provokes excessive menstrual blood loss.

— Hormonal dysfunction. Excess estrogen leads to excessive growth of the endometrium (hyperplasia) and increases the risk of very heavy periods.

- Extragenital reasons. Menstrual function is influenced by the endocrine, metabolic and nervous systems. Therefore, the source of heavy periods can be pathologies of organs belonging to these systems: diseases of the liver and thyroid gland, cardiovascular diseases, disorders of the coagulation system, and others.

Very heavy periods cannot be treated on your own, even if you feel well. Pills chosen at random during heavy periods can temporarily eliminate some negative symptoms and reduce blood loss, but are not able to eliminate the cause of the bleeding.

Heavy periods - what to do

Menstruation can change for many reasons, so there is no universal advice for treating heavy periods. In order to choose the right treatment tactics, you need to find out why your periods are so heavy.

If there is a known harmless physiological reason behind the change in the nature of menstruation (climate change during travel, stress, physical overload, etc.), you can cope with excess blood loss on your own; in all other cases, you should consult a specialist.

Self-treatment of heavy periods is acceptable if:

- such periods came for the first time;

- they were not preceded by a delay;

- they do not make you feel worse;

— there are no large amounts of dark clots or pus in the menstrual blood;

- they are not accompanied by alarming symptoms: severe pain, fever, weakness, dizziness, nausea and the like;

— the intensity of bleeding does not increase;

— pregnancy is excluded;

- if there is no history of gynecological diseases: fibroids, adenomyosis, chronic inflammation.

If you are sure that your situation fits the framework described above, you can try to cope with heavy periods yourself. To begin with, pay attention to your life rhythm during the menstrual period and try to limit physical activity. Don't overwork yourself and rest often.

Don't refuse to eat, even if you have no appetite. Give preference to foods and drinks containing iron and vitamin C, and avoid strong coffee and alcohol. Large blood loss dehydrates the body, so the volume of fluid consumed should be increased.

To reduce the intensity of bleeding, you can put cold on your stomach, a heating pad with ice, a bottle of very cold water, or any frozen bag of food from the “freezer” will do. To prevent the cold from causing damage to the skin, first place any cotton cloth on your stomach. The cold will provoke vascular spasm, and the intensity of bleeding will decrease.

You should not immediately resort to medication. The large number of hemostatic drugs does not mean that they all work the same way. In order to choose the right remedy, you must first find out the exact cause of heavy periods and obtain a laboratory test report. Therefore, when doing independent treatment, it is better to try to reduce blood loss using folk remedies. Decoctions and infusions of herbs - nettle, shepherd's purse, peppermint, corn silk - successfully cope with "harmless" strong menstruation. You can also take tablets for heavy periods containing calcium gluconate, vitamins C and P (Ascorutin).

Self-therapy cannot be continued for long. If you see that your efforts lead to a positive result in the form of reduced blood loss (the number of pads to replace is reduced) and improved well-being, you can continue therapy for another two or three days. As a rule, during this period, heavy periods stop. However, you should remember that if subsequent periods are too strong again, you should contact a specialist, even if it seems to you that there is no reason for alarm.

You should not try to stop heavy periods on your own after childbirth or abortion, since the mask of periods is often hidden due to serious complications.

Sometimes in a woman’s life the problem of heavy periods with clots arises, which makes it impossible to lead a full life. What kind of disease this is and how to deal with it can be understood by considering the problem from all sides.

Significant blood loss during menstruation can be either a separate disease or a symptom of a disorder in women's health. Heavy periods with clots, or dysfunctional uterine bleeding, is a disease that is characterized by the presence of abnormal bleeding from the uterine cavity, which is not caused by the presence of pathology of the pelvic organs, systemic diseases or disruption of pregnancy.

ICD-10 code

N92 Heavy, frequent and irregular menstruation

Epidemiology

Heavy periods with clots can occur at any time in a woman’s life, regardless of her age, place of residence and race. During the hot season, the risk of bleeding increases significantly due to the increased load on the cardiovascular system. There is also an influence of changes in atmospheric pressure on the development of menstrual irregularities.

Causes of heavy periods with clots

The etiological factors for the occurrence of heavy menstruation are:

• Stress, severe psycho-emotional shock;
• Eating disorders such as obesity, hypo- and avitaminosis, starvation;
• Chronic diseases of the liver, cardiovascular system, etc.;
• Hormonal imbalance;
• Previous gynecological operations;
• Infectious diseases of the pelvic organs;
• Radiation exposure;
• Congenital anomalies of the development of the genital organs.

Risk factors

A variety of unfavorable factors affect the female body during different periods of development, formation, formation and decline of reproductive function. Most often during periods of greatest vulnerability - puberty and menopause. The main risk factors for the development of uterine bleeding are:

During puberty:

• Excessive physical activity;
• Malnutrition, hypovitaminosis;
• Mental stress and stress;
• Acute and chronic diseases of infectious origin.

During reproductive age:

• History of abortion;
• Complicated childbirth;
• Inflammatory diseases of the pelvic organs;
• Neuroendocrine diseases;
• Hormonal imbalance;
• Occupational hazards;
• Mental and emotional stress.

During menopause:

• Acute and chronic infectious diseases;
• Education of the pelvic organs;
• Stress;
• Presence of pelvic organ prolapse;
• Diseases of the cardiovascular system and endocrine glands.

Pathogenesis

Normally, menstruation is regular, cyclical, painless uterine bleeding, which occurs when the functional layer of the endometrium is rejected due to a decrease in the level of progesterone and estrogen and does not exceed 80 ml of total blood loss during menstruation.

The following concepts are used in medicine:

• Hyperpolymenorrhea is a disorder of menstrual function, which is manifested by regular heavy bleeding exceeding the total blood loss of 80 ml per menstruation.
• Acute menorrhagia is unexpected heavy uterine bleeding not associated with the cycle.
• Metrorrhagia is heavy, prolonged, irregular bleeding between menstruation.

Heavy menstruation may indicate such disorders of women's health as: the presence of uterine fibroids, cervical tumors, pathological menopause, pregnancy complications, etc.

The main pathogenetic aspect of the development of uterine bleeding is an imbalance of the main hormones against the background of changes in the function of the most important parts of the hypothalamic-pituitary and ovarian systems.

The female reproductive system is built according to a hierarchical type, the main links of which are: the cerebral cortex, hypothalamus, pituitary gland, ovaries, uterus and other target organs (breasts, thyroid gland). So in the cerebral cortex, the main regulators of the menstrual cycle are dopamine and norepinephrine, which control the hypothalamic gonadotropin-releasing hormone (GnRH), and serotonin, which controls luteinizing hormone (LH). The hypothalamus is one of the main structural formations of the brain, which produces releasing hormones that release pituitary hormones and statins that suppress their release. GnRH is the main hypothalamic hormone involved in the menstrual cycle. It is released into the bloodstream once every 60 minutes and the maximum frequency of its release is recorded in the preovulatory period, and the lowest in the second phase of the cycle. Directly involved in the regulation of the menstrual cycle are gonadotropins - pituitary hormones such as: prolactin (PRL) - the lactation hormone, follitropin (FSH) - the hormone of growth and maturation of follicles, and lutropin (LH) - the hormone of the corpus luteum. The ovaries synthesize estrogens, gestagens and androgens - hormones that have a vegetative (development and vital activity of the genital organs) and generative (hormonal background) effect on the female body. Thus, if at least one of the links - the cycle regulators - falls out or is disrupted, the hormonal levels will fail and the proliferation of the endometrium of the uterus will change. Excessive stimulation of the uterus by estrogen will lead to an increase in the thickness and hypoxia of the endometrium, which, due to increased contractility of the uterus, will be rejected continuously and non-simultaneously, one area after another, which in turn is accompanied by heavy uterine bleeding with long-term clots.

Symptoms of heavy periods with clots

Depending on the cause of bleeding from the genital tract, a woman may experience various symptoms, ranging from pain to dizziness and loss of consciousness. In more detail regarding the cause of occurrence, a detailed description of the symptoms, first signs and complaints is presented below.

Heavy periods with clots after a delay

Sometimes, after a delay in menstruation, a woman experiences heavy bleeding with clots from the genital tract, and there may be aching pain in the lower abdomen with radiation to the anus. The cause of this symptom complex may be a disrupted pregnancy or the use of an oral contraceptive. Determining the level of human chorionic gonadotropin in the blood will help determine the cause. Even with complete spontaneous abortion, its numbers, for some time, remain at a high level. This occurs due to the fact that the non-viable embryo is rejected by the prepared endometrium and is accompanied by a large amount of blood loss. In this case, the woman experiences weakness, dizziness, nausea, and sometimes vomiting. If you have such symptoms, you must immediately call an ambulance for hospitalization in a specialized medical facility.

Heavy periods with clots during pregnancy

The appearance of bleeding from the genital tract in a pregnant woman usually indicates a spontaneous abortion. In this case, the first symptom is a nagging pain in the lower abdomen, which radiates to the rectum; in the second half of pregnancy, the pain can be cramping. Bloody discharge, however, in significant quantities with clots of varying intensity. Depending on the stage of pregnancy, vacuum aspiration of the uterine contents is performed in the first trimester; after the sixteenth week of pregnancy, the fertilization product is evacuated under adequate anesthesia and hemodynamic control. In the absence of contraindications, it is permissible to prescribe uterotonics to accelerate the expulsion of uterine contents.

In later pregnancy, vaginal bleeding may indicate placenta previa. In this case, bleeding varies in intensity and is absolutely painless. If a woman is more than 20 weeks pregnant, this condition occurs, she should immediately call an ambulance.

Heavy periods with clots after childbirth

Usually, immediately after childbirth, a woman experiences physiological bleeding - lochia. It can be of varying intensity and will continue until the postpartum uterus is completely reduced to normal size. After this, if the woman in labor breastfeeds her newborn, she does not have menstruation. This phenomenon is called lactational amenorrhea and, as a rule, it continues until complementary foods are introduced into the infant’s diet. And so, after 6-12 months, the woman’s menstrual cycle is restored. Due to physiological changes that have occurred in a woman’s body, such as shortening of the cervix, dilation of the cervical canal, an increase in the size of the uterus, an increase in the volume of the endometrium, menstrual flow becomes more intense and abundant.

Immediately 2-4 weeks after birth, heavy bleeding with clots may occur due to the presence of placental remnants in the uterine cavity. In this case, bloody discharge is bright scarlet in color with an unpleasant odor and is accompanied by pain in the lower abdomen radiating to the lower back. In this case, it is necessary to seek qualified medical help, since infection of the remnants of the placenta and the development of endometritis - inflammation of the uterus - are possible.

Heavy periods with clots after cesarean section

Often, heavy bleeding with clots is observed after a cesarean section. This is due to the presence of a scar on the uterus, reduced contractility of the uterus and an unchanged cervical canal and cervix, which is an obstacle to the free discharge of lochia, as after normal childbirth. As a result, bleeding becomes longer with more clots. Over time, the menstrual cycle will improve and the amount of menstrual blood released will become more normal.

Heavy periods with clots after curettage of the uterine cavity

Heavy periods with clots after curettage of the uterine cavity may be the result of an instrumental abortion. In this case, curettage of the uterine cavity is carried out with a curette, removing the endometrium with the fertilized egg layer by layer. If during such a procedure the surgeon missed any part of the cavity, bleeding with scarlet clots may develop on days 2-4, accompanied by aching pain in the lower abdomen. In this case, you need to contact the medical institution where the termination of pregnancy was performed.

If bleeding occurs 7-10 days after curettage of the uterus, it is also necessary to seek medical help, since this condition may be caused by the presence of a placental polyp, which occurs at the site of the remains of the fertilization product. In this case, a woman may experience bleeding of varying intensity, pain in the lower abdomen, low-grade fever and nausea. To eliminate this symptom complex, in the inpatient gynecological department, against the background of adequate antibiotic therapy, repeated curettage of the uterine cavity is performed, with further prescription of oral contraceptives.

Heavy periods with clots after hysteroscopy

Hysteroscopy is a gynecological procedure using an optical device, with which the doctor is able not only to visualize the inside of the uterus, but also to take material without traumatizing the entire uterine cavity, as with curettage. Hysteroscopy is performed for both diagnostic and therapeutic purposes. However, in the case of diagnostic hysteroscopy, there are no changes in the menstrual cycle. As for surgical hysteroscopy, here the cycle lengthens, and often periods become heavier than usual. But sometimes bloody discharge changes the smell, clots appear in it and their color changes, which may indicate an infection. If heavy bleeding turns black against the background of severe pain, this may be a symptom of the disease – endometriosis. Endometriosis is a complex hormone-dependent disease in which endometrial tissue is located not only in the uterine cavity, but also outside it. In this case, the woman is bothered by severe pain in the first days of menstruation. The doctor will make an accurate diagnosis after additional diagnostic examinations.

Heavy periods with clots due to fibroids

Uterine fibroids are a benign formation that consists of connective tissue or muscle elements. If muscle fibers predominate in the structure of the formation, we are talking about fibroids, if connective tissue predominates, we are talking about fibroids. One of the first symptoms of uterine fibroids is heavy menstruation. The nature of the discharge depends on the location of the myomatous node in the uterus. So, when it is located in the submucosal layer from the very beginning of its formation, the woman is bothered by heavy, prolonged menstruation with clots, which is also associated with impaired uterine tone.

Sometimes the growth of a submucosal myomatous node in the uterine cavity is directed towards the cervical canal, which over time leads to its exit from the uterine cavity. This process is accompanied by profuse uterine bleeding, cramping pain in the lower abdomen, general weakness, a drop in blood pressure and loss of consciousness. In this condition, assistance can only be provided in a medical facility. The main goal of treatment in this case is to stop uterine bleeding, pain relief and surgical removal of the nascent myomatous node, followed by curettage of the uterine cavity.

Heavy periods with clots after 45-50 years

During premenopause, women often experience heavy uterine bleeding. This is due to the aging of the hypothalamus, in which hormonal levels are disrupted towards hyperestrogenism against the background of reduced levels of progesterone, which leads to excessive growth of the endometrium and disruption of its transformation and is manifested by long, heavy periods with clots. In this case, the cyclicity is disrupted, and the time interval between menstruation lengthens. Treatment of this category of patients is mainly surgical and is presented in the form of curettage of the uterine cavity and cervical canal. In the future, hormonal therapy is prescribed to suppress menstrual function.

Heavy periods with clots during menopause

The appearance of bleeding in postmenopause may be a symptom of a malignant tumor of the pelvic organs. Therefore, if you have such a symptom, you must immediately contact a gynecologist to carry out the necessary examinations. Such bleeding occurs for no reason and can be of varying intensity and duration.

Another cause of bleeding during menopause may be senile colpitis, which occurs due to a decrease in the level of estrogen in the blood, which leads to thinning of the vaginal mucosa and increased vulnerability. Such bleeding occurs after physical activity, heavy lifting, or sexual intercourse. In any case, if bloody discharge from the genital tract appears, you should seek medical help from a gynecologist.

Heavy, prolonged periods with clots

Menorrhagia, or prolonged heavy periods, can occur in the presence of pathology of the uterus, endometriosis, endometrial hyperplasia, diseases of endocrine origin and blood clotting disorders. Also, the cause of this symptom may be an intrauterine contraceptive or an incorrectly selected oral contraceptive. The disease can occur at any age and is not cyclical. This condition is dangerous because, against the background of prolonged heavy bleeding, anemia usually develops, which is difficult to correct due to the presence of a genital cause of bleeding. If recurring episodes of prolonged periods occur, you should contact a gynecologist who will prescribe the necessary diagnostic procedures and treatment.

Heavy, painful periods with clots

Algodysmenorrhea is a disease that plagues a large number of women and is manifested by painful, heavy cyclic menstruation. There are many reasons for this disease. Painful periods can bother women with uterine fibroids, endometriosis, intrauterine contraceptives, abnormal development of the genital organs, as well as inflammatory diseases of the pelvic organs and diseases of the endocrine and nervous systems. Pain, as a rule, occurs a couple of years after the onset of menarche and begins on the first day of the menstrual cycle or the day before it. Pain of a cramping, spastic nature, radiating to the rectum, lower back, and ovarian region. Sometimes, with severe pain and bleeding, a woman experiences nausea, vomiting, and dizziness. This symptom complex leads to temporary disability and requires drug treatment.

Complications and consequences

The main complication that occurs as a result of heavy periods with clots is anemia. Due to the significant amount of blood loss, the reserves of hematopoietic cells are depleted, erythropoiesis is disrupted, which leads to persistent anemia with all the ensuing symptoms: weakness, dizziness, nausea, loss of appetite. In addition, this condition reduces the effectiveness of hemostatic therapy. With profuse bleeding, hemorrhagic shock often develops, which requires immediate administration of blood products.

In the absence of anti-relapse treatment, heavy periods with clots may resume, with the exception of conditions after hysterectomy.

Diagnosis of heavy periods with clots

Heavy periods with clots is a disease that requires immediate medical and sometimes surgical treatment. But in order to begin its treatment, it is necessary to conduct a diagnosis and establish an accurate clinical diagnosis.

Diagnosis of this disease is carried out by an obstetrician-gynecologist, upon initial contact with complaints of heavy periods with clots. First of all, the doctor collects a detailed somatic anamnesis (history): the presence of diseases of the liver, cardiovascular and endocrine systems, trauma and surgery on the female genital organs. Then the menstrual and gynecological history: age at which menarche began, cycle quality, onset of sexual life, sexual activity, gynecological diseases and contraceptive methods. It is also important to take medications such as estrogens, antidepressants, anticoagulants, corticosteroids, digoxin and propranolol, which could cause heavy bleeding from the genital tract.

After a detailed interview, the doctor conducts functional diagnostic tests, such as: basal temperature control, hormonal colpocytology, estrogen saturation tests, which make it possible to determine hormonal levels.

Laboratory examination

A pregnancy test or determination of human chorionic gonadotropin is carried out to exclude pregnancy pathology, or trophoblastic disease, or ectopic pregnancy.

A general blood test, biochemical blood test, and coagulogram are carried out to determine the degree of anemia in the body for further correction of anemia.

Hormonal examination over time is recommended for all women suffering from heavy periods to determine their hormonal status. To do this, the levels of FSH, prolactin, LH, testosterone, progesterone and estradiol in the blood serum are determined over time. It is important to examine thyroid and adrenal hormones.

Instrumental diagnostics

Ultrasound examination of the pelvic organs and hysteroscopy are reliable and accessible methods for diagnosing pathologies of the female reproductive organs. Sometimes hysterosonography is performed (filling the uterine cavity with saline solution under the control of an ultrasound machine), which makes it possible to identify submucosal myomatous nodes of the uterus, endometrial polyps, etc.

Diagnostic curettage of the cervical canal and uterine cavity is performed on all menopausal women who have complaints of bleeding from the genital tract. In other cases, it is performed in the presence of ultrasound signs of endometrial pathology.

It is also possible to perform MRI, computed tomography, laparoscopy, hysterosalpingography and other diagnostic methods if there are indications for them.

Differential diagnosis

Differential diagnosis of heavy periods with clots is carried out in accordance with the woman’s age, since each period of a woman’s life is characterized by the occurrence of certain diseases.

Thus, in the puberty period, a differential diagnosis is made with diseases of the hematopoietic system, accompanied by blood clotting disorders and bleeding; dysfunction of the liver and gastrointestinal tract, abnormal development of the genital organs, diseases of the endocrine system (adrenal glands, thyroid gland), foreign bodies of the genital tract and vaginal neoplasms.

Differential diagnosis in reproductive age is carried out with ectopic pregnancy, uterine fibroids, adenocarcinoma, endometrial hyperplasia, endometrial injury from an intrauterine contraceptive.

In the menopausal period, differential diagnosis is carried out with endometrial adenocarcinoma, adenomyosis and hormone-producing ovarian tumors.

Treatment of heavy periods with clots

The method of treating heavy periods with clots is prescribed by the doctor in accordance with the patient’s age, the cause of occurrence, the amount of blood lost and the duration of bleeding. But, in any case, the first stage is hemostasis - stopping bleeding, which can be done surgically or medically.

How to stop heavy periods?

The first thing to do is to calm down, since with excitement the blood vessels dilate and the bleeding may increase. If bleeding occurs in a pregnant woman, you need to take a horizontal position with the foot end of the bed raised, relax, and call an ambulance. It is allowed to take the tablet form of ethamsylate “Ditsinon” 1-2 tablets with water.

For other reasons for heavy periods with clots, pre-medical measures should be as follows:

• Call an ambulance.
• Take a horizontal position with the foot end of the bed raised.
• Place a heating pad, bottle or any other vessel with cold water on the lower abdomen, which helps to constrict blood vessels and reduce bleeding.
• Drink plenty of fluids to replace blood loss.
• Taking medications that stop bleeding, such as: Dicinone 1-2 tablets, maximum 4 tablets per day, 0.25 mg each, Tincture of water pepper, 25 drops 3 times a day, Shepherd’s purse extract, 25 drops 3 times a day., Calcium gluconate 1-2 tablets 3 times a day.

Further treatment will be prescribed by the gynecologist in accordance with the indications.

1. Hemostatic therapy is aimed at stopping bleeding, for which fibrinolysis inhibitors are used - Aminocaproic acid and Tranexam.

Aminocaproic acid is an effective antihemorrhagic agent, the action of which is aimed at inhibiting fibrinolysis, which provides a hemostatic effect. The effect of the drug occurs 15 minutes after intravenous administration. The drug is prescribed intravenously in a drip of 100 ml of a 5% solution of no more than 8 g per day or orally 30 ml 4 times a day. Contraindications for use are coagulopathies, a tendency to thrombus formation, a history of cerebrovascular accidents, and coronary heart disease. The drug should be prescribed with caution with estrogen-containing contraceptives, which increases the risk of thromboembolism.

Tranexam is an antifibrinolytic drug with local and systemic hemostatic effects. The effect of the drug occurs 3 hours after oral administration and lasts up to 17 hours. Take 1 tablet 4 times a day for 4 days. Tranexam is administered intravenously at a dose of 15 mg/kg every 6 hours no faster than 1 ml/min. Contraindications for use are subarachnoid bleeding and renal failure. Prescribed with caution for deep vein thrombophlebitis and thromboembolic syndrome. Side effects occur when the recommended doses are increased or with individual hypersensitivity to the active substance of the drug, and can manifest as nausea, vomiting, dizziness, the development of thrombosis, tachycardia, skin rash, itching, and urticaria.

1. Hormone therapy indicated for use based on age and examination results.

During puberty, hormones are prescribed if there is no effect from hemostatic therapy. Preference is given to combined oral contraceptives: Microgynon, Lindinet 20, Yarina, 2-3 tablets per day with a gradual reduction in the dose to 1 tablet over 21 days.

It is possible to prescribe gestagens: Duphaston, Norkolut, Utrozhestan, 2 tablets per day, followed by a dose reduction.

In reproductive age, it is performed only on nulliparous women if the M-echo of the endometrium does not exceed 8 mm on ultrasound. The drugs of choice are: 17OPK 12.5% ​​2 ml IM 1 time per day for 7 days, Duphaston 1 tablet 3-5 times per day, Norkolut 1 tablet 3-5 times per day, followed by a gradual reduction to 1 tablet per day .

17 OPC (oxyprogesterone capronate) is a synthetic progesterone of gestagenic origin in high doses that inhibits the secretion of gonadotropins, which helps reduce bleeding and has a prolonged gestagenic effect. The drug is administered intramuscularly with 2.0 ml of a 12.5% ​​solution every day until bleeding stops and 0.5-1.0 ml on day 21 to prevent the development of recurrent bleeding. After intramuscular administration, the effect of the drug begins after 5 hours and lasts up to 14 days. Contraindications to the administration of 17OPK are liver dysfunction, a tendency to thrombosis, and malignant tumors of the pelvic organs and mammary glands.

During menopause, women over 45 years of age are not recommended to undergo hormonal hemostasis. It is acceptable to prescribe gestagens, such as: 17OPK 250 mg on days 14 and 21 of the menstrual cycle, Depo-Provera 200 mg on days 14 and 21.

In case of bleeding associated with impaired ovarian function, intramuscular administration of progesterone is prescribed at a dose of 5-15 mg/day for 7 days, followed by a dose reduction if the dynamics are positive.

Gonadotropin-releasing hormone agonists, such as Goserelin and Diferelin, are not used so often to stop heavy menstruation with clots, but have proven themselves well in further treatment regimens for uterine bleeding. The fact is that with constant administration of drugs, LH synthesis decreases and the concentration of estradiol in the blood decreases. This helps reduce the growth and proliferation of the endometrium, which leads to minimizing the risk of bleeding until the development of menopause. Goserelin is injected subcutaneously into the anterior abdominal wall once every 28 days, which ensures that the effective concentration of the drug is maintained in the body. The drug is contraindicated in pregnant women, lactating women and children. The drug was well tolerated. In rare cases, headaches, mood swings, dryness of the vaginal mucosa, cessation of menstruation, and demineralization of bone tissue may occur.

1. Vitamin therapy. Prolonged, heavy uterine bleeding, as a rule, leads to depletion of the body's resources of vitamins and microelements. First of all, iron deficiency occurs and, as a result, iron deficiency anemia develops. To eliminate it and replenish iron, the following is prescribed:

• Vitamin B12 200 mcg/day.
• Folic acid 0.001 g 2-3 times a day.
• Totema 1-5 ampoules per day orally.
• Globiron 1 tablet once a day.
• Sorbifer Durules 1 tablet 1 time per day.
• Maltofer 1 tablet 1 time per day.
• Venofer intravenous drip.

The duration of taking iron supplements depends on the degree of anemia and is carried out under the control of blood counts.

Among vitamin preparations, it is justified to prescribe vitamins B6 and B1 alternating for intramuscular administration. It is also recommended to prescribe vitamin E 200 mg per day and routine 200 mg 3 times a day.

1. Medicinal drugs have found wide application in the treatment of heavy periods with clots. herbs and traditional medicine.

• Dry nettle leaves pour half a liter of water and boil for 10 minutes, leave for 30 minutes. Take 1 tbsp internally. spoon 5 times a day.
• Shepherd's purse grass 50g, knotweed grass 50g, mistletoe grass 50g. Pour the mixture of herbs into 200 ml of water, boil for 5 minutes, cool. Drink 1 glass 2 times a day from the 3rd day of menstruation.
• Oak bark 30g, wild strawberry leaves 20g, raspberry leaves 20g, yarrow herb 30g. Brew in 200 ml of water and drink 200 ml. morning and evening from the 1st day of menstruation.
• Buckthorn bark 30g and raspberry bark 30g. Pour boiling water over the collection, leave and drink 1 glass morning and evening.

In folk medicine, to treat heavy periods with clots, not only herbal infusions are used, but also other components for the preparation of medicinal potions.

• A decoction of orange peels has good hemostatic properties. Boil the peels of 5 oranges in 1 liter of water for 1 hour over low heat. Add a little sugar and drink 1 tablespoon three times a day.
• Mix fresh rowan berries and mint leaves 1:1 and brew as tea. Drink this tea 3 times a day until your period ends.
• Brew 30g of dried and finely chopped herbs and parsley roots with boiling water in 400 ml of water and boil for 15 minutes, then strain. Take half a glass three times a day 15 minutes before meals.

1. Physiotherapy.

The following types of physiotherapeutic treatment are widely used in treatment regimens for heavy uterine bleeding with clots:

• Electrophoresis with copper sulfate provides a vasoconstrictor effect
• Cervicofacial galvanization increases the contractile function of the uterine myometrium
• Endonasal electrophoresis with vitamin B1 increases uterine muscle tone
• Vibration massage of the paravertebral zones has a complex effect on the vessels of the uterus and muscle tone, which helps reduce blood loss.

1. Homeopathy.

If the cause of heavy periods with clots is functional disorders, the following drugs are used for treatment:

• Ovarium compositum. It is a complex homeopathic remedy that regulates hormonal levels. It has metabolic, sedative and anti-inflammatory functions. Prescribed 2.2 ml intramuscularly 2 times a week, from the third week 1 time every 5 days. The course of treatment is 10 injections. Contraindications – hypersensitivity to the components of the drug, children under 12 years of age. Prescribed with caution to pregnant and lactating women. Among the side effects, increased salivation was noted, in which case it is recommended to reduce the dose of the drug or discontinue it.
• Mulimen is a complex homeopathic drug, the action of which is aimed at regulating the balance of gonadotropic and steroid hormones, normalizing the autonomic nervous system and stabilizing the mental state of a woman. It has hormone-regulating, antispasmodic, sedative and drainage pharmacological properties. Indicated for use in menstrual disorders, mastopathy, treatment of side effects of hormonal contraception, premenstrual and menopausal syndrome. Prescribed 10-12 drops 2 times a day during the intermenstrual period and on menstrual days 10-15 drops 3-5 times a day, depending on the degree of bleeding. Take 15-20 minutes before meals, holding briefly in the mouth. Contraindicated in children under 12 years of age and in case of hypersensitivity to the components of the drug. Prescribed with caution to pregnant and lactating women. The drug is usually well tolerated; allergic reactions may occasionally occur.

With the development of heavy periods with clots against the background of an inflammatory process of the pelvic organs, the following are additionally prescribed:

• Gynekoheel is a basic anti-inflammatory agent with vasotonic, anti-edematous and analgesic pharmacological properties. Promotes completion of the inflammatory process, restoration of microcirculation and the formation of new tissue at the site of inflammation. Reduces the risk of complications. Has a regulating effect on the menstrual cycle. Prescribed 10 drops 3 times a day every day, except for menstrual days. Course of treatment 3 cycles. The drug is contraindicated for persons who are allergic to the venom of bees, wasps and bumblebees. No side effects were identified.
• Traumeel S is the first choice drug for any damage to body tissue. It has anti-inflammatory, anti-exudative, regenerating and analgesic pharmacological properties. The drug is contraindicated for use in persons with hypersensitivity to the components of the drug, those suffering from tuberculosis, leukemia, or AIDS. Prescribed 1 tablet 3 times a day. Adverse reactions in the form of redness and rash on the skin are possible.

1. Surgical treatment.

Surgical intervention for heavy periods with clots, regardless of the cause, is carried out for hemostatic purposes to stop bleeding.

Therapeutic and diagnostic curettage of the walls of the uterine cavity is carried out under general anesthesia, followed by sending the resulting scraping for pathohistological examination, which makes it possible to determine the cause of bleeding in 80% of cases. After the operation, the patient is prescribed hemostatic and antibacterial therapy.

Endometrial ablation is a surgical method for treating uterine bleeding, which is carried out using a laser or electrode under the control of a hysteroscope and involves removing the entire layer of the endometrium.

Hysterectomy is a radical surgical procedure that involves removing the uterus. It is the last stage of treatment for uterine bleeding, when the condition cannot be treated with other methods.

Every woman has probably had heavy periods. But such a symptom, which constantly arises, indicates a disorder, most often in the hormonal sphere.

Why heavy periods might appear and what to do about them

Menstruation is not the most pleasant period of the month. For many women, it is accompanied by abdominal pain and weakness. But if, in addition, very heavy periods begin, this creates additional discomfort, and may also be a signal of pathological changes in the body. This fact is not only worth paying attention to, but it is necessary to consult a specialist.

Of course, everyone's periods are different: the cycle, the amount of discharge and well-being can vary significantly. On average, a woman loses 50-80 ml of blood during menstruation. Usually in the first days there is a strong discharge, and already on the 3-4th day it becomes much weaker.

With a normal amount of blood per day, a woman needs 1-2 pads. There are also those who, from a young age, have very heavy periods, in which case this is just a feature of the body. But if they become abundant beyond the norm every month, and this has not been observed before, you need to urgently consult a doctor.

You can understand that not ordinary, but very heavy menstruation has begun, by the following signs:

• critical days last longer than a week;
• more than 150 ml of discharge appeared;
• presence of clots in the blood.

If you have to deal with these symptoms, it is better not to postpone a visit to the doctor.

Causes of very heavy periods

Among the main reasons why discharge is abundant, doctors name:

• hormonal imbalance;
• uterine fibroids;
• endometrial hyperplasia;
• endometrial polyps;
• ovarian cysts,
• malignant tumors of the endometrium or cervix;
• bleeding disorders.

Hormonal imbalance is most common in teenage girls who do not yet have a stable menstrual cycle, as well as in women close to menopause. The balance between hormones (estrogen and progesterone) during these periods is unstable, which leads to bleeding.

- benign neoplasm. Often occurs in adulthood. If it is present, menstruation can last up to 10 days.

Endometrial polyps are a kind of growth that appears on the walls of the uterus for various reasons: infection, interrupted pregnancy, infection.

Malignant tumors of the endometrium or cervix - women encounter these diseases much more often than it seems; cervical cancer ranks first among malignant tumors found in women.

Blood clotting disorders. The cause of this pathology may be von Willebrand disease, excessive growth of the endometrium.

Endometrial hyperplasia. A growth in the uterine cavity exceeding 16 mm.

If a woman has recently had a caesarean section, her first postpartum menstruation is often quite heavy. After a few months, the discharge should return to normal.

If all diseases have been excluded, the woman did not give birth and did not take contraceptives, very often the cause of such a disruption in menstruation is an incorrect lifestyle, stress, physical and psychological stress. Lack of vitamins and fresh air similarly leave their mark on a woman’s body.

Clinical picture

When blood is released very abundantly, it is no longer just a symptom, but an independent threat to the body. Massive blood loss causes anemia and can lead to death.

They last more than one day, the woman’s general condition worsens, and the following accompanying symptoms appear:

• pain in the lower abdomen;
• weakness;
• headaches and dizziness;
• pallor;
• states close to fainting;
• fast fatiguability.

This condition should not be ignored; it can lead to complete loss of consciousness and the need for urgent hospitalization.

It is also worth noting that the reason that initially caused heavy menstruation may develop into another disease (for example, endometriosis appears due to hormonal imbalance).

What to do

To determine, you need to see a doctor. If a woman feels very bad, there is a lot of blood loss, it is better not to wait until a visit to the hospital, but to immediately call an ambulance. An indicator of such a need is the hygiene product becoming unusable within an hour.

Trying to stop bleeding on your own using your grandmother’s recipes is not recommended, and even more so, because of their use, delaying calling real doctors. It's not worth risking your own health. Consult a gynecologist for advice.

When examining a patient with the above symptoms, most often a set of studies is performed to determine the root cause of the bleeding. It is not uncommon for your period to start coming heavily for several reasons at once.

Patients with complaints of heavy menstruation are prescribed such examinations.

1. Ultrasound of the uterus and ovaries (performed intravaginally). Detects malignant and benign tumors, cysts, hyperplasia.
2. Hysteroscopy is a modern way of thoroughly examining the endometrium, thanks to which it is also possible to take a sample for biopsy (insertion of a thin probe).
3. Complete blood count + tests for hormone levels.
4. Hemostasiogram - determination of the level of blood clotting.

Before examinations, it is almost always necessary to perform a curettage: dead endometrial particles and blood clots are removed from the uterus. This procedure will help not only improve the quality of the examination, but also help improve your well-being.

Treatment for very heavy periods

Only a doctor, after a thorough examination and tests, can say what is suitable for treatment. If a woman regularly begins to menstruate in larger quantities than usual, and examinations have not found any serious reasons, it is most likely necessary to address her general health. You will need:

• to refuse from bad habits;
• consume as much vitamin C as possible;
• reduce physical activity;
• take hemostatic drugs.

It is better to consult a doctor about the correct prescription of the latter.

If we are talking about bleeding, it is stopped by using such means.

1. Aminocaproic acid, Vikasol, Calcium gluconate are antihemorrhagic, hemostatic drugs.
2. Oxytocin, Methylergometrine are stimulants of the uterine muscles.

To get rid of anemia, the use of folic acid, B 12 is prescribed. Problems with hormones are solved with the help of hormone therapy. For this, in most cases, oral contraceptives are prescribed, which suppress the production of the hormone estrogen. This treatment helps reduce discharge and prevents the development of endometriosis.

Polyps are removed surgically, but treatment of fibroids depends on its size and location. Physiotherapy is considered an effective method to relieve inflammation.

With the development of malignant tumors, iron deficiency anemia and the failure of drug treatment, surgical intervention may be required.

Conclusion

If earlier the discharge during menstruation was not profuse, but at some point it began to flow very heavily, this process cannot be ignored. In this way, the female body warns about a malfunction that has occurred in it. This can be either a consequence of fatigue or age-related changes in hormonal balance, or a message about the development of a serious disease (or even several). In case of severe bleeding, it is better to call an ambulance without delay. If the condition is not so critical, you should go to the doctor for examination as soon as possible.

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Women's menstrual flow varies in nature. Menstruation comes at different intervals, causing pain for some. The amount of blood leaving the body also differs. When there is an excess of it, heavy periods occur.

The amount of blood released during menstruation depends on a number of factors. Heredity, body characteristics, and physical condition matter. The volume of menstruation may increase sharply. Having seen heavy discharge, women do not know how to behave and whether to go to the doctor.

How to determine?

To separate the concept of menstruation from, the following criteria should be taken into account:

• duration of menstruation (normally no more than 7 days);
• volume of discharge (should not be more than 150 ml per day);
• profuseness (a large volume of discharge should normally occur in the first two or three days, no more);
• duration of the menstrual cycle (at least 21 days between bleeding);
• sensation of pain (normal – moderate pain);
• discharge between periods (there should not be any).

Heavy periods

Very intense periods are called “menorrhagia” in medical parlance. The concept defines a violation of menstrual function, as a result of which the amount of discharge is significantly increased during the normal duration of the cycle.

Symptoms

This condition cannot always be attributed to a disease. The cause can be not only gynecological pathologies, but also certain conditions of the body.

We can talk about menorrhagia when there is a significant increase in the volume of bloody discharge, when you have to change a pad or tampon every hour.

Causes of menorrhagia

There are a number of reasons why a woman experiences heavy bleeding:

• Hormonal imbalances. If there is a malfunction of the body's hormonal system, heavy periods are likely on the first day, as well as on subsequent days. Such problems most often occur at a young age or in adolescents, while the menstrual cycle is just becoming established. Women may experience problems when taking hormonal contraceptives. There may be an increase in the volume of menstrual flow in premenopausal women.
• Uterine fibroids. Myoma or fibroids are benign formations. Causes excessive discharge and bleeding. The cause of the disease is inflammatory processes or infections that affect the organs of the reproductive system.
• Cervical polyp. This is a formation in the endometrium. Appears due to injury, curettage, hormonal disorders, inflammation of the cervix.
• Endometrial cancer or cervical cancer. A malignant tumor can cause large amounts of menstrual blood.
• Problems with blood clotting. If there is such a disease, a woman has heavy periods, only a doctor can tell. Going to the clinic is mandatory, since large blood loss will negatively affect the general condition and cause anemia.
• Use of the IUD. The intrauterine device can cause heavy discharge during menstruation. This means the body is incompatible with this contraceptive, so it must be removed.
• Heredity. If the mother had problems with the amount of menstruation, most likely the daughter will suffer the same.
can cause heavy menstruation.
• Stress, climate change, flights- all this can provoke a problem.

To find out the cause in each specific case, you need to consult a gynecologist. After the examination, the woman will be prescribed treatment.

Uterine fibroids can cause a woman's heavy periods

After childbirth and cesarean

After childbirth, the functioning of a woman’s body changes, which also affects the nature of her periods. Most often they become more abundant and last longer. The reason is the uterus, the cervix of which becomes anatomically wider after the birth of the baby. As a result, the amount of menstrual flow increases. The size of the uterus also becomes larger, so its surface area, and therefore the endometrium, becomes larger. This leads to a significant increase in the volume of menstruation.

If a cesarean section was performed during childbirth, a suture remains on the uterus, and subsequently a scar. The scarred tissue is connective and cannot contract, causing menstrual flow to become more abundant.

After scraping

Artificial termination of pregnancy or abortion has a strong negative impact on the functioning of a woman’s body. There is a complete restructuring of the functioning of the hormonal system.

Discharge that begins immediately after curettage is not menstruation, as many women think. They last up to one week and are moderate in quantity. If the blood loss after surgery is large, you should immediately consult a doctor.

A danger to health and life is indicated by copious discharge accompanied by:

• unpleasant odor;
• high temperature;

The cause of menorrhagia in this case may be an inflammatory process of the uterus.

With clots

With heavy menstruation, you should pay attention not only to the volume, but also to the nature of the discharge. Sometimes a woman observes large dark blood clots. This suggests that the blood is coagulating directly in the uterine cavity.

The reasons for heavy periods with clots are as follows:

• hormonal imbalance;
• the presence of a barrier to the exit of blood, for example, polyps, fibroids, etc.;
• problems with uterine contractions as a result of the presence of fibroids or endometriosis.

First menstruation in adolescence

Teenage girls often experience heavy discharge when their menstrual cycle begins. The reason is the instability of the hormonal system.

Problems in girls can be triggered by negative emotions, excess body weight or its deficiency, excessive physical activity, as well as problems with the endocrine system.

• moderate exercise;
• swimming in the pool;
• proper nutrition;
• the required amount of vitamins.

Before menopause

In women aged 40-45 years, the perimenopause period begins. This is a condition when the body is rebuilt and becomes unable to conceive.

Due to the restructuring of the hormonal system, the volume of menstruation in women becomes significantly larger. It is also possible to increase their duration. But the cause of menorrhagia can be not only natural processes, but also pathologies, for example, diseases such as endometrial polyp or uterine fibroids.

How to reduce discharge?

How to help yourself with heavy menstruation? You need to go to the doctor.

• avoid heavy physical activity or reduce it;
• stop drinking alcohol and coffee;
• take multivitamin medications;
• for abdominal pain, you can use a heating pad with cold, but not more than a quarter of an hour;
• avoid stress;
• drink shepherd's purse and horsetail, which can reduce the amount of blood loss during menstruation.

Is treatment required?

After the examination, the doctor will choose the necessary treatment tactics and prescribe medications.

Diagnostics

At an appointment with a specialist, you need to tell him about the number of pregnancies and abortions, complications that arose after childbirth, and the use of medications. The doctor will conduct an examination. Pregnancy, especially ectopic pregnancy, uterine fibroids or other pathologies must be excluded.

May be prescribed for diagnostic purposes:

• ultrasonography;
• biopsy;
• smear;
• general blood analysis.

For women who have problems with menstrual flow, doctors recommend keeping a special calendar. It is necessary to note the duration of the cycle and days of menstruation, as well as the volume of discharge.

Purpose of therapy

Treatment of menorrhagia can be conservative and surgical. The first is prescribed to girls and adolescents, as well as women who have not yet given birth.

What to drink during heavy menstruation in this case? As therapy for heavy periods, medications with, for example, or Vikasol are prescribed. The complex prescribes non-steroidal anti-inflammatory drugs - Indomethacin, Ibuprofen, as well as vitamin therapy.

It is possible that the doctor will prescribe hormonal medications and indicate the dosage regimen. The Mirena IUD, which contains levonorgestrel, is effective in treating heavy menstruation.

Surgical treatment is indicated in the presence of diseases such as:

• endometriosis;
• adenomyosis;
• polyps.

Hysterectomy or hysterectomy is indicated in the most severe cases, such as when heavy periods are caused by a tumor in premenopausal women.

Will traditional medicine help?

In some cases, treatment can be combined with traditional medicine, after consulting with your doctor.

For heavy periods, the following remedies are effective:

• Infusion from shepherd's purse. Preparation: pour two or three tablespoons of herbs into a glass of boiling water.
• A decoction of a mixture of yarrow and burnet herbs. A tablespoon of raw material should be brewed with a glass of boiling water. Next, the decoction is kept in a water bath for at least 15 minutes and taken for 14 days, starting around the middle of the menstrual cycle.

How to prevent it?

Preventive measures to avoid heavy periods include:

• healthy lifestyle;
• moderate physical activity;
• food that includes all the necessary vitamins and iron.

Heavy periods are something you shouldn’t turn a blind eye to. It is necessary to consult a doctor, find out the cause of the pathology and begin a course of treatment after the examination.

Video about heavy discharge