Factors that Cause and Factors that Prevent Menstrual Blood Loss

Menstrual bleeding is controlled by factors that allow us to bleed and shed the lining, and factors that stop the bleeding. Like other areas of our body what is important is the “not too hot, not to cold, but just right” concept perpetuated by Goldilocks. And in our uterine lining, it’s no different. If there are too many factors causing the blood loss, menstrual bleeding is too heavy. If too much clot, then could be none at all…ok that sounds too good on the too hot side who wants to bleed anyway?! But you get my drift, balance is important. Women with heavy menstrual bleeding have increased plasminogen activators called “enzymatic ‘clot busters’ “ by Dr. David Grimes. In order to balance this off, plasminogen activator inhibitor (or antifibrinolytics) can be given to decrease bleeding. Ibuprofen, naproxen, mefenamic acid, or meclofenamate sodium, and we can even use birth control pills which change the whole physiology of our lining and make it so thin there is not much to bleed off. Ok, back up, too many big words, yep, you know my advice: talk to your gyno. When things are wrong we have the ABCs of how to approach it: Ask what is wrong, Be aware of alternatives, and then Carefully select a solution. Actually, that mnemonic is a bit off, just made it up. Many women select their type of birth control pill based on whether they will have periods or will not have periods. And a group of gynos from around the country publishing under NIH grant R03 TW007438 looked specifically at whether taking a long cycle pill, and skipping periods, would be better for controlling menstrual cramps, or dysmenorrhea. Actually for many in the first 6 months, the longer cycle pills were a bit better, but after that othe groups did well and did not have as many menstrual cramps. So for women who do want to still have light regular periods, be aware that you can achieve control of your menstrual pain this way too. Remember balance is important in all treatments, the side effects of the treatments must always be considered. And understanding the checks and balances in our body is a path to solutions.

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