Irregular Periods can Be the Sign of Other Medical Conditions

Heavy menstrual Bleeding

Menstrual Period Norms

The menstrual period's normal physiologic function to shed the lining and then prepare the lining for a pregnancy. Thus a sample of the lining under the microsope looks like it has glands within tissue.
It’s hard to know if this is a heavy period, or one that is really so heavy that you need treatment without really checking completely with your gyno! Experts have used a number of definitions to determine if the period you are having is too heavy. Your perception is important. The actual amount of blood lost is important, but that can be determined by collecting each pad and weighing them before and after blood collection. So gynos have struggled with how to determine the formal definition of heavy bleeding. A basic check up, and a basic blood count, is not going to really make your version of heavy periods fit the typical “FDA” approved definition because that is defined by the exact amount of blood lost, which is losing more than 80 ml of blood per day. In the US we also look specifically at whether you are becoming anemic. Passing clots is another determinant of heavy menstrual bleeding.

 Menstrual Periods can Disrupt Your Health and Your Life

Research studies show that Heavy Menstrual Bleeding (HMB to your doc) disrupts family life, work life, your moods, and your eating habits. In fact you can become so anemic you turn into a magpie, figuratively that is, as magpies eat virtually anything, so the Latin derivative for this condition, completely out of hand, is called pica eating. Chewing ice, the ends of your pens, your nails, (it can get worse and progress to clay and stuff that really sounded good in pregnancy, that's a whole different level of the problem of pica) sound like anyone you know? The moodiness, the tampon overuse, the big clots, the overuse of the cramp meds, all signs that you should consider treating your HMB.

Tracking Menstrual Periods

See the diagram for how we determine the heaviness of menstrual bleeding.

Uterine Fibroids, Uterine Polyps

Most causes of irregular bleeding are structural in nature, meaning a problem with the anatomy of the uterus itself. Uterine fibroids, uterine polyps, adenomyosis of the uterus.

Uterine Infections

It is not common for an STD to cause irregular bleeding, but if left untreated the lining can become infected and irregular bleeding can present. Usually there is also pelvic pain and discharge.

Bleeding Disorders. 

Most women with bleeding disorders have medical problems like bleeding too much from cuts and nose bleeds, as well as irregular periods. Bleeding disorders should be tested if you in fact are young and have very heavy periods.

Medical Conditions like Thyroid Disease

Most of the studies link thyroid disease to infertility, but it may have more to do with the health of the egg and implantation than actual irregular ovulation or irregular periods. None the less if you are bleeding irregularly you should consider thyroid disease.

Medical Conditions Like Cancer

Blood cancers have been known, rarely, to present with bleeding.  In a report in Obstetrics and Gynecology in August of 2016 they looked at blood cancers and the menstrual periods. Getting a basic blood count, also called a CBC is a guideline that is called for with all women with prolonged or heavy bleeding. It is not just anemia that can be found from this, but also abnormal levels of the red or white blood cells. It is also a test to detect the number of platelets. If the platelet count is abnormally low, not only can this cause irregular or heavy menstrual bleeding but other types of bleeding as well, like nose bleeds or gum bleeding, or bruising. Usually other tests, besides just the CBC, are necessary to determine whether a woman has cancer, but we do know that earlier diagnosis is critical to good outcomes.

Therapies Are Available From Medical To Surgical

We've discussed the results of a trial of a new medication called tranexamic acid in the post of May 7, 2009, and now Xanodyne Pharmaceuticals has won FDA approval for this drug and it will be called Lysteda.  One thing women will like to hear is that this same drug, but marketed under then drug name Cyklokapron, has been approved since 1986 as an injectable treatment for hemophiliacs to prevent bleeding during tooth extraction. Not only that but it has been widely used in other areas of medicine including cardiac surgery and orthopedic surgery as an antifibrinolytics. So this medicine is used to prevent a clot from being broken down. Thus, in order for some of the bleeding to stop, at the source, your uterus, some clotting has to occur, this drug then allows that process to happen naturally. If you are on the BC pills and you still have heavy bleeding, consult your gyno first , just adding in tranexamic acid tablets may put you at extra risk of blood clots, heart attacks or strokes. But for women who don't want bambinos any more OR the trouble of a menses consider getting your gyno to do an endometrial ablation. In the worst cases, at the end of child bearing women can also be offered hysterectomies. 

And PS, thank you again to all participants in our research trial. And if you would like to know more about Women's Health Practice research trials that are enrolling: Consider Joining a Study Now or Soon!


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