Menstruation problems (severe and / or abnormal bleeding) mean something different for every woman. Some consider blood loss if it is more severe than they are accustomed, others call it violent because they need a lot of tampons or sanitary napkins, embarrassing, and very often need changing. A precise definition of severe blood loss is not there. Loss of blood clots (large chunks) and anemia is usually considered as characteristics of severe blood loss. Or severe blood loss is a reason for further examination and possible treatment depends on your symptoms. You are the one that indicates whether this is necessary. Severe blood loss is annoying, but is usually harmless. Only if there is anemia, the doctor often recommends treatment. Some women menstruate heavily from childhood on. They know little else, and often have learned to live with them. For many women, the complaint arises after their thirtieth or fortieth year, sometimes after stopping the pill. Severe blood loss has several causes, each requiring a different approach. It is estimated that ten to fifteen percent of women are afflicted and seeking medical attention.
Causes
The amount of menstrual blood is dependent on the thickness of the accumulated endometrium. Hormones made by the ovaries provide the structure of this membrane. A drop in hormone surge the uterus off the mucosa. The result is a bleeding: menstruation. As the transition nears, the ovaries make hormones irregular. This is sometimes a lot of mucous built up a strong repulsion that indicates hemorrhage. In pill remains the often thin mucous membrane, the blood loss is less than with a natural period. Hormones, and not only the structure of the mucous membrane will affect the loss of blood, including the uterus itself plays a role. The uterus, which is the shape and size of a pear has, consists of a muscular wall. On the inside, there is the uterine cavity. The muscle wall is lined with mucous membrane. The walls are coated with the mucous membrane against each other, so that there is essentially no question of a real cavity. Changes in the form of this "cavity" for example, by the presence of a polyp, or a myoompje (meat tree) tend to have excessive blood loss. Even with a uterus with many large fibroids can there be any severe blood loss, as in endometriosis and adenomyosis. These are abnormalities in which the mucous membrane lining the uterine cavity holds, also in the wall of the uterus or outside of the uterus is present. In endometriosis are painful menstrual periods in the foreground. A few times cause abnormalities in blood clotting or medications that affect blood clotting, severe blood loss. Also by a copper IUD can increase the blood loss. In 60% of women find a gynecologist no clear explanation for the severe blood loss.
What tests are available?
Gynecological examination
when viewing the gynecological examination by a gynecologist speculum (spreader) the cervix. If there are no recent smear or kweekje been made for this material will be removed. Then a vaginal examination (internal examination) performed. It assesses the doctor roughly the size and shape of the uterus. There are any abnormalities of the ovaries to feel. More information can be found under the first visit to the gynecologist .
Blood tests
Blood tests are possible to anemia, iron deficiency or abnormalities in blood clotting to detect. This research also takes place at your first visit.
Ultrasound examination
on your first visit will be also always tried to perform an ultrasound. Ultrasound is a study that uses high frequency sound waves. Information on ultrasound examination can be found under ultrasound . The research is conducted through the abdomen or the vagina (vagina). In a not too large uterus through the vagina ultrasound gives the best information about any abnormalities of the uterus or ovaries.
Liquid Contrast Ultrasound
To be able to see more details is suspected an abnormality in the uterus is often water or gel into the uterine cavity through a speculum (spreader) and a tube through the cervix. More information about this survey can be found under liquid ultrasound .
Hysteroscopic examination
A hysteroscopy is an examination in which the gynecologist with a thin viewing tube (hysteroscope) into the uterus looks. More information about this survey can be found at hysteroscopy, diagnostic . The gynecologist, a small polyp, if present at the examination Hysteroscopic removal. If there is any meat trees that protrude into the uterine cavity, it is recommended often greater hysteroscopic surgery.
