Menometrorrhagia

Menometrorrhagia is a condition marked by frequent instances of prolonged or increased uterine bleeding in women.

Menometrorrhagia is categorized into two types, i.e.,

• Metrorrhagia: In this, uterine bleeding occurs at unequal intervals and often between the likely dates of periods.
• Menorrhagia: In this, there are unusually heavy and prolonged periods or menstruation at equal intervals.

Symptoms

Some of the common signs and symptoms of menometrorrhagia are listed below:

• Abnormally heavy menstrual periods or uterine bleeding which can disrupt the daily routine of an affected woman
• Over 35 days or less than 21 days between periods
• Uterine bleeding between normal menstrual periods
• Continuous ache in and near the lower abdominal region during menstruation
• Periods tend to continue for over 7 days

Excessive loss of blood in patients with menometrorrhagia can cause anemia with the below listed symptoms:

• Weakness
• Breathlessness
• Lethargy or tiredness
• Depression
• Numbness often with tingling sensations in fingers and toes
• Headaches
• Lowering of body temperature
• Concentration problems

Causes of menometrorrhagia

In some women, menometrorrhagia may have no known causes. In most cases, the condition is caused due to the below listed factors:

• Hormonal imbalance: Abnormal levels of progesterone and estrogen hormones may trigger increased release of endometrium (the mucus membrane which lines the uterus), which then causes abnormal uterine bleeding.
• Polyps: They are tiny non-malignant outgrowths on the lining or wall of the uterus. They can trigger menometrorrhagia.
• Uterine fibroids: These are non-malignant tumors that form during the childbearing period. Uterine fibroids can cause abnormal menstrual bleeding.
• Complications of pregnancy: Miscarriage and other pregnancy complications can cause one, late and heavy menstrual period.
• Ovarian dysfunction: In some cases, lack of ovulation can hamper the release of progesterone hormone during periods, thereby causing hormonal imbalance and menometrorrhagia.
• IUDP/Intrauterine device: The menstrual disorders may also occur due to use of non-hormonal intrauterine devices as a method of birth control.
• Adenomyosis: In some cases the endometrium gets fixed into the muscles of the uterus. This can result in abnormal menstrual bleeding.
• Genetic bleeding disorders: Von Willebrand’s Disease and other blood coagulation illnesses can trigger abnormal menstrual bleeding.
• Cancer: Menometrorrhagia may also occur due to cancers like cervical cancer, ovarian cancer, endometrial cancer, uterine cancer, and primary fallopian tube cancer, etc.
• Drugs: The disorder may occur due to incurred use of different medications such as anticoagulants, hormone medicines, and anti-inflammatory drugs.
• Other causes: Menometrorrhagia may also occur due to:
  • Other underlying diseases like thyroid dysfunction, endometriosis, liver diseases, Pelvic Inflammatory Disease/PID, and kidney problems, etc.
  • STDs or Sexually Transmitted Diseases
  • Eating a diet which causes ketosis
  • Different illnesses triggered by stress
  • Endometrial hyperplasia
  • Dysfunctional uterine bleeding
  • Drug and alcohol abuse

Treatment of menometrorrhagia

Treatment options for menometrorrhagia are discussed below:

1. Medications

• Nonsteroidal anti-inflammatory drugs for alluvial of painful or dysmenorrheal menstrual cramping. They also help reduce the flow during periods
• Iron supplements to patients with low levels of iron or anemia
• Oral progesterone for improving hormonal imbalance.
• Oral contraceptives for decreasing menstrual bleeding, regulation of menstrual cycles, prevention of prolonged menstruation, and for managing different menstrual problems.
• Hormonal Intrauterine Device helps decrease excessive menstrual bleeding. It also releases a progestin type called levonorgestrel which aids in thinning the uterine wall lining, thus easing cramps.

2. Surgery

Severe cases of menometrorrhagia may be treated with surgery. Doctors opt for surgical procedures if drug therapy does not work. A few common surgical treatments for menometrorrhagia are:

• Dilation and Curettage: In this procedure, the cervix is dilated and the excessive tissues present on the uterine lining are scraped away. This helps decrease the flow of menstrual blood. Patients may undergo another session of dilation and curettage if menometrorrhagia recurs.
• Endometrial resection: In this surgical procedure, doctors use a tiny electrosurgical wire loop to remove the lining of the uterus. It is very helpful for women with abnormally heavy bleeding, but women undergoing the procedure may face problems in conceiving.
• Endometrial ablation: In this, different techniques are used by a surgeon to permanently destroy the complete lining of the uterus. After surgery, there is no or minor menstrual bleeding. Getting pregnant after surgery is very difficult.
• Operative hysteroscopy: In this, doctors use a hysteroscope to observe the cavity of the uterus and remove any polyp that causes heavy bleeding.
• Hysterectomy: This surgical procedure involves permanent removal of the cervix and the uterus. The result is no menstrual cycles and infertility. If the ovaries are also removed during a hysterectomy, then it will cause premature menopause.

3. Home Remedies

• Drinking rosehip tea increases the intake of vitamin C and flavonoids and thus decreases heavy bleeding.
• Eating a paste of a few rice grains and some pomegranate leaves, for about a month, can help manage menometrorrhagia.
• Boil fresh parsley leaves in water and drinking during first 3 days of period can help find relief
• Fenugreek water can alleviate menstrual cramps and reduce bleeding.