Understanding Causes of Heavy Menstrual Bleeding

Women experiencing excessively heavy menstrual bleeding should seek to understand the underlying causes and address them effectively. One potential factor contributing to this condition is hormonal imbalance, particularly prevalent during the perimenopausal phase.

If sanitary products like tampons or pads need to be changed every one to two hours, this may indicate a condition known as hypermenorrhea. This condition is characterized by menstrual blood loss exceeding 80 milliliters per cycle and may involve the passage of blood clots. According to medical experts, while precise measurement of blood loss is often difficult outside of clinical studies, patient reports supplemented by the usage of hygiene products can provide a more objective assessment. Women suffering from hypermenorrhea may lose between 200 to 400 milliliters of blood monthly, potentially leading to subsequent health issues like iron deficiency.

Untreated, this condition can progress to iron deficiency anemia, which manifests through symptoms such as fatigue, weakness, pallor, concentration difficulties, and in severe cases, may lead to dizziness, shortness of breath, and heart palpitations, especially upon exertion. Additionally, the psychological impact due to ongoing concerns about hygiene and the fear of leakage can significantly affect quality of life.

Hypermenorrhea can stem from various organic causes such as uterine polyps, benign tumors in the uterine muscle layer (uterine fibroids), or adenomyosis, which involves benign growths in the uterine wall. However, it is often linked to functional causes, particularly hormonal imbalances that are frequently observed during the perimenopause. During this transitional phase, there is typically a decrease in progesterone levels, leading to estrogen-dominant phases that can intensify bleeding and cause irregular menstrual cycles.

Hormonal imbalances can also occur during puberty or following pregnancy. Certain organic issues become more common with advancing age. Research indicates that over 60% of women over 40 experience a condition known as uterine myomatosus, characterized by an enlarged uterus due to fibroids, and about half of these women report symptoms primarily associated with hypermenorrhea.