Menorrhagia: how to understand that you are losing a lot of blood during menstruation

Health Tips

During menstruation, the endometrium is removed from the uterus. This process is inevitably accompanied by rupture of small blood vessels, so the normal color of the discharge is bloody, that is, red or brownish. In addition to blood, clear mucus and other elements from the vagina and cervix also come out.

What is menorrhagia

How much blood does a woman normally lose during her period? Everything is individual. But on average – 40-60 ml per day. It’s about two tablespoons. In this case, only blood is meant. With a blood loss of 80 or more milliliters, it is worth talking about too heavy menstruation (menorrhagia).

The amount of blood coming out on the days of menstruation will impress the uninformed. Its volume is 250 ml (that is, a glass) in one cycle. For a lifetime – from menarche to the onset of menopause – menstrual blood comes out up to 90 liters. But don’t be afraid of these numbers. If blood loss is not higher than indicated, the body is able to restore them without harm to itself.

How to measure the volume of losses

It is technically difficult to measure the volume of your menstrual flow with the help of spoons and glasses. This can be done with hygiene products. What pads do you usually buy?

The number of allocations can be:

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  • Barely noticeable, in which two drops of blood are found on a single pad per day. This corresponds to 5-6 g per day.
  • Very light. It is enough to replace the hygiene product once or twice a day. Blood flows 6-9 g per day.
  • Easy. The pad or tampon is changed four times a day. This is 9-12.
  • Moderate. Tampons or pads of medium absorbency (normal) get wet every four hours. In this case, the blood comes out 12-15 g per day.
  • strong. Bulk (super) hygiene products leak in three to four hours. In this case, 15-18 g of blood per day follows.
  • very strong. Super absorbent tampons or pads get wet every one to two hours. Here, the volumes of excreted secretions cannot be accounted for, but this condition definitely requires medical attention.

The number of discharges for the entire period is important, and not per day. That is, if menstruation lasts four to five days, but only one of them is devoted to the constant replacement of pads (every two hours), and on the remaining days you balance in the “light” or “moderate” modes, this is normal – the total amount of blood released does not exceed 250 ml.

What causes menorrhagia

Often, women who have very heavy menstruation doubt that their blood loss is great. This delusion is especially typical for Russia. With a blood loss of more than 250 ml per cycle, the patient can shrug her shoulders and say: “Yes, I have my usual menstruation, like everyone else.”

Now, with universal literacy and Internet access, any woman understands that excessive blood loss leads to a decrease in hemoglobin levels. And it is this “extra knowledge” that makes many people postpone a visit to the doctor. It may seem to you that if hemoglobin is normal during very heavy periods, then there is no reason to panic.

But a decrease in hemoglobin is a belated diagnostic sign. It appears only with a complete disorder of iron metabolism in the body. A decrease in hemoglobin indicates already developed anemia. In the earlier stages preceding it, there is iron deficiency, but the body still maintains a normal concentration of hemoglobin Ў and it is much easier to return to normal.

With heavy and very heavy menstruation, it is necessary to be examined for the presence of a latent form of iron deficiency anemia, and then to determine the cause of too heavy menstruation.

What you habitually attribute to lack of sleep, excess work and household chores can actually be a sign of iron deficiency: fatigue and drowsiness, sentimentality or irritability, reduced immunity (susceptibility to infections), decreased mental activity and labor productivity.

How to react to blood clots

Almost everyone has seen blood clots on a sanitary napkin at least once. For some, this is the only occasion in life, for others, a regular occurrence. When asked why clots form, in each case, only the doctor gives the answer. The most common causes: a sedentary lifestyle, a congenital or acquired septum in the cervical region, hormonal imbalance, the body’s reaction to intrauterine devices, polyps in the uterus, uterine fibroids.

Do not postpone a visit to the doctor if there are quite a lot of blood clots during menstruation and they are not small in size, but the periods themselves have become more abundant and prolonged.

How is it treated

It all starts with a visit to a gynecologist or endocrinologist. The specifics of treatment will depend on the results of the examination: a functional disorder, gynecological disease, hormonal imbalance, iron deficiency anemia and other blood diseases. Treatment is more likely not to eliminate menorrhagia, but to neutralize the factors that caused it, and to restore the level of iron and hemoglobin in the blood.


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