Loss of a lot of blood causes pain

Heavy menstruation

Some women continue to feel tired, uncomfortable, and in pain during their periods. Often a very heavy menstrual period is the reason. Such bleeding can be relieved with medication and surgery.

At a glance

  • About 9 to 14 out of 100 women have an excessive menstrual period (hypermenorrhea).
  • Very heavy bleeding can be relieved with medication or surgery.
  • If a woman loses too much blood during her menstruation, it can lead to iron deficiency. Anemia may develop.
  • The most common cause of excessive menstrual bleeding is that the uterus cannot contract properly.

Note: The information in this article cannot and should not be used as a substitute for a doctor's visit and should not be used for self-diagnosis or treatment.

When do you speak of an excessive menstrual period?

Many women experience pain, cramping, irregular or very heavy bleeding during their period. If you need to change sanitary napkins or tampons more often than every few hours, your menstrual period is likely to be heavier than normal. If the bleeding interferes with everyday life and weakens the body, it is clearly too strong.

About 9 to 14 out of 100 women have a heavy menstrual period (hypermenorrhea). Menstrual bleeding that lasts longer than 5 to 7 days is prolonged bleeding (menorrhagia). Often both occur together because the cause is the same.

Some women find good ways to deal with their heavy bleeding. However, if the bleeding leads to an iron deficiency or is too bothersome, it can be alleviated with medication. Surgery is also possible in these cases.

Which symptoms indicate an excessive menstrual period?

Typically, women lose a total of around 60 ml of blood during their menstrual period. That corresponds to around one and a half shot glasses. It takes about four hours to fill a full-size pad or tampon with this amount. However, these are average values. In fact, the bleeding may be heavier on some days and less on others. The amount of blood that drains during menstruation can therefore feel larger at times.

If a woman loses more than 80 milliliters of blood during her period, gynecologists assume that the menstrual period is too heavy.

The following signs can indicate an excessive menstrual period:

  • A pad or tampon change is regularly required after one to two hours.
  • The affected person quickly feels weak, tired, and listless during their period.
  • Menstrual blood contains many thick blood clots.

What are the causes of heavy menstrual bleeding?

Some girls have very heavy menstrual periods right from the start. Most of the time, however, the bleeding doesn't get worse until later. Hormonal changes, such as those that occur during menopause, can also increase the menstrual period.

The most common reason for an excessive menstrual period is that the uterus cannot contract properly. Usually, the contraction helps loosen the lining of the uterus. It can then be flushed out with a little blood. The contraction also ensures that the bleeding does not last too long.

Larger benign tumors such as fibroids and mucosal polyps can prevent the uterine muscles from contracting.

Fibroids form in the muscle layer of the uterus, polyps in the lining of the uterus. The uterine muscles can also be obstructed by an IUD.

Adhesions on the uterus and inflammation of the uterus or fallopian tubes often cause profuse bleeding. In some cases, however, the cause cannot be clearly clarified.

What are the consequences of heavy menstrual bleeding?

If a woman loses too much blood during her menstruation, it can lead to iron deficiency. Iron is very important for building red blood cells. If there is a lack of iron, not enough red blood cells can be produced. Anemia may develop.

Red blood cells carry oxygen to the organs. If there are too few red blood cells, the organs are poorly supplied with oxygen. Those affected then feel weak and exhausted.

Paleness and cold hands are also signs of anemia. If there is severe anemia, symptoms such as shortness of breath and palpitations can occur, especially after physical exertion.

How is excessive menstrual bleeding diagnosed?

To make a diagnosis, it is first important to know the severity of blood loss during the period. The amount of blood cannot be precisely determined, but it can be estimated.

The number of sanitary napkins or tampons you will need during your period on different days can provide an indication of strength. Therefore, it can be useful to write down these numbers over a period of 1 or 2 months.

Usually the uterus is examined first to determine the cause of heavy menstrual bleeding. To do this, the doctor feels the uterus and does an ultrasound scan. In some cases, a hysteroscopy is also advisable. To do this, a small camera is inserted into the uterus.

A blood test can be used to check whether the heavy menstrual period has caused anemia. The laboratory then measures the amount of hormones in the blood that affect the lining of the uterus and the menstrual cycle.

The personal situation and the type of complaint can also provide important information about the causes. Anyone who has heavy menstrual periods should therefore speak to their doctor about existing illnesses, illnesses in the family, the use of medication, weight problems or psychological stress.

How is heavy menstrual bleeding treated?

How a very heavy menstrual period is treated depends on the cause. Fibroids, polyps, or other benign growths of tissue in the uterus can be removed by surgery. However, many women first try to reduce the bleeding tendency with medication. Certain pain relievers can also reduce the bleeding a little.

Hormonal contraceptives such as birth control pills or a hormone IUD can also counteract excessive bleeding. Because these contraceptives weaken the menstrual period by inhibiting the growth of the uterine lining.

If you experience severe symptoms and you no longer want to have children, it is also possible to remove or obliterate the uterine lining (endometrial resection or ablation). A major procedure is removal of the uterus (hysterectomy). This step is only possible with very severe and stressful complaints.

Important to know:If a heavy menstrual period does not lead to anemia, the affected women can forego treatment.

Women considering treatment should first find out about the pros and cons of any medication or surgical procedure.

The choice of treatment also depends on whether the affected woman has a desire to have children. Because the most effective treatments have an impact on it. At times, contraceptives like the pill hardly make this possible. If the uterus is removed, it is no longer possible to become pregnant permanently.

You can find more detailed information on the treatment of severe menstrual pain at Gesundheitsinformation.de.

What is everyday life like with a heavy menstrual period?

Many women with heavy menstrual periods feel weak and tired during and shortly after their periods.

If these complaints become very severe, they can find it difficult to cope with everyday life - be it at home or at work. Even social activities and hobbies that are otherwise fun can be a burden.

If pads or tampons have to be changed frequently at night, sleep is impaired. Abdominal pain can also occur with heavy menstrual bleeding.

Heavy bleeding can not only be physically stressful: Many women are embarrassed. They can also be perceived as annoying, for example during sex, and can sometimes inspire fear.

Important to know:Sometimes the people around affected women do not take menstrual cramps seriously - not even some doctors. Heavy menstruation and the associated symptoms do not have to be endured. Women who are affected by this should allow themselves sufficient rest, seek medical advice or look for suitable treatment - even and especially when they do not feel taken seriously and find it difficult to do so.

Menstruation is part of a woman's life, but if heavy menstrual bleeding affects her well-being, there are ways to alleviate the symptoms and deal with them better.

In cooperation with the Institute for Quality and Efficiency in Health Care (IQWiG). Was standing: