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Menorrhagia: how do I know if I have a heavy period?
All women lose blood during their period. In reality, they are fragments of the endometrium, the mucous membrane that lines the uterine cavity, and which thickens with each menstrual cycle in preparation for a possible pregnancy. In the absence of fertilization and then implantation, the mucous membrane disintegrates: these are the rules.
In quantity, it is estimated that a “normal” period is equivalent to losing 35 to 40 ml of blood per menstrual cycle. We talk about heavy periods, very heavy or menorrhagia, when we lose more than 80 ml of blood per cycle. We also talk about heavy periods when they are spread over more than 7 days compared to 3 to 6 on average in the case of “normal” periods.
Concretely, since it is difficult to realize the quantity of blood that one loses during his period, it is better to base it on the use of periodic protection (tampons, pads or menstrual cup).
We can therefore consider it normal to change protection periodically up to six times a day and to put only one protection each time. On the other hand, having to double your protections because of your menstrual flow (a tampon plus a towel) and / or change it every hour or every two hours may be a sign of heavy, very heavy or even hemorrhagic periods.
In video: Everything about the cup or menstrual cup
The Higham score for assessing period abundance
To assess the abundance of your menstrual flow and whether or not you are suffering from menorrhagia, there is the Higham score. This involves completing a table where the number of pads or tampons used each day will be recorded in the box corresponding to the degree of impregnation of the tampon or napkin used. On the horizontal axis, we write the days of the rules (1st day, 2nd day, etc.) while on the vertical axis, we create different boxes such as “slightly soaked pad / towel; moderately soaked; completely soaked) to which we attribute respectively 1 point 5 points or 20 points. Thus, if the first day, we used moderately soaked towels (or tampons), that already makes 15 points on the counter (3 protections x 5 points).
Once the rules are over, we do the math. The total obtained corresponds to the Higham score. If you get a total of less than 100 points, it’s a safe bet that it is not a heavy or bleeding period. On the other hand, if the total score is greater than 100 points, this means that the volume of blood lost is greater than 80 ml and therefore that we are in the presence of excessive periods, or menorrhagia.
Note that the regles-abondantes.fr site offers a pre-filled table that calculates the Higham score in a few clicks.
What causes heavy or bleeding periods?
Several ailments and pathologies can cause heavy or bleeding periods. Here are the main ones:
- of the hormonal fluctuations, linked for example to puberty or menopause (an excess of estrogen can indeed lead to an endometrium that is too thick and therefore to a greater menstrual flow);
- uterine pathology such as the presence of a uterine fibroids or a polyp;
- a adenomyosis, that is to say a intrauterine endometriosis, when endometrial fragments are found in the uterine muscle, or myometrium;
- endometriosis;
- the presence of a copper IUD (or intrauterine device, IUD), which often causes heavier periods due to the local inflammation it induces.
In pregnancy, heavy bleeding may be due to miscarriage, molar pregnancy, ectopic pregnancy, or egg detachment. It is then necessary to consult very quickly.
Much more rarely, menorrhagia can be linked to:
- cancer of the cervix;
- a blood clotting abnormality (hemophilia, von Willebrand disease, etc.);
- taking anticoagulant drugs;
- leukemia (other symptoms are then present such as spontaneous hemorrhages in the nose or gums, fever, pallor, bruises, etc.).
When to consult for hypermenorrhea?
A priori, if you have always had fairly heavy periods and nothing has changed in terms of pain, frequency or quantity, there is no need to be alarmed. However, you can talk to your obstetrician-gynecologist or general practitioner during a routine visit.
On the other hand, any change in menstrual flow should lead to a consultation a gynecologist or a midwife. The same is true if the periods, in addition to suddenly becoming heavy, are associated with other unusual symptoms such as pelvic pain, pallor, extreme fatigue, shortness of breath on exertion, other hemorrhages, etc.
It is best to take note of all your symptoms, and to keep a rule book where we note everything that is important about his periods (duration, abundance, color of the discharge, presence or not of clots, associated symptoms…).
Pregnant with heavy bleeding, check out!
If you are pregnant or may be pregnant, it is best to consult very quickly. Indeed, pregnancy interrupts the menstrual cycle, there is no ovulation or thickening of the endometrium. In fact, there are therefore no rules, and any bleeding, even light, should prompt you to consult quickly. It can be quite benign as it can be the sign of a placental abruption, a miscarriage, a molar pregnancy or an ectopic pregnancy. Better to consult without delay.
Anemia: the main risk of heavy and long periods
The main complication of heavy periods is iron deficiency anemia, or iron deficiency anemia. Hemorrhagic bleeding reduces the body’s iron stores, even more so if the period is long. In the event of chronic fatigue and heavy periods, it is advisable to consult a doctor to detect a possible iron deficiency and to be prescribed iron supplementation.
Tips and advice for very or too heavy periods
Before embarking on the development of remedies for grandmothers not always effective or without danger, we make sure to find the cause (s) of his heavy periods.
Once we know what causes these heavy periods (endometriosis, copper IUD, fibroid or other), we can act, for example by taking a pill continuously to suppress menstruation (which are, of any way, artificial under oral contraception), a change of contraceptive. Your doctor may also prescribe an anti-fibrinolytic (such as tranexamic acid), a medicine used to treat bleeding.
On the side of alternative medicine, let us mention in particular three interesting plants against heavy periods:
- lady’s mantle, which has progestational action;
- raspberry leaves, which would regulate the cycle and tone the uterine muscle;
- the shepherd’s purse, an anti-hemorrhagic plant.
They will preferably be used in herbal teas or in the form of a mother tincture to be diluted in water, in the absence of pregnancy.
As for essential oils (EO), let us cite in particular EO of rosat geranium or EO of cistus ladanifère, to be diluted at the rate of one drop in a tablespoon of vegetable oil, and to swallow (Danièle Festy, “My Bible of essential oils”, Leducs Pratique editions).