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Heavy periods in pre-menopause

Heavy menstrual bleeding affects women of any age, although it is more common at the ends of the reproductive age, that is, in adolescence and perimenopause (around menopause). This is explained by Dr. Rubén Betoret, head of Gynecology and Obstetrics at the Hospital Universitari del Vinalopó, the health center managed by the Ribera group in Elche. Therefore, this abundant bleeding that is so strange to women who have not had this symptomatology in their youth or in the reproductive stage is relatively common in these last years of the period, before the actual menopause begins.

The World Health Organization (WHO) estimates that heavy bleeding has a global prevalence of 8-27% of women at different stages of their lives.

Doctor Patricia Molina, gynecologist at the Dénia Hospital, also managed by the Ribera group, assures that it is one of the most common reasons for consultation or emergencies in women between the ages of 45-55, around menopause. What specialists now call “abnormal uterine bleeding”, previously better known as menorrhagia, refers not only to the amount of bleeding (more than 80 milliliters), but also to its duration (more than eight days), a if the cycle is less than 25 days recurrently or there are clots frequently. But how to measure these 80 milliliters? “It’s key to take a good medical history, talking to the woman,” explains Dr. Molina. In addition, analytical tests such as a blood count can be requested. “If the woman has anemia, for example, in addition to the symptoms you describe, there is abnormally heavy bleeding,” he adds.

Consequences of abundant rules

Dr. Betoret agrees on this point, assuring that the main side effect of heavy menstrual bleeding is anemia, “although in most women the perception of bleeding does not correlate well with the level of “anemia”. It also points out that “excessive loss of menstrual blood can interfere with a woman’s usual physical, emotional or social activity”.

In addition, the Vinalopó specialist assures that the amount of bleeding and pain or discomfort during menstruation are not necessarily related. “Although dysmenorrhoea is more common in women whose periods are prolonged and abundant, there can be heavy bleeding without dysmenorrhoea, that is, without pain,” he explains.

Causes of excessive bleeding

Dr. Molina explains that there are organic and dysfunctional causes that can justify this heavy bleeding: Polyps, adenomyosis (endometrial gland disorder), leiomyomas and malignant or premalignant lesions in the endometrium, in the case of organic causes; and dysfunctional, meaning that something is not working well, such as coagulopathy, ovulatory dysfunction, endometrial disorders, treatments that can affect bleeding and the unclassifiable. We recommend that you listen to the podcast included in this blog entry to hear from a Ribera professional the explanation of the causes of this abundant bleeding.

Podcast. How to reduce pain during the menstrual period and factors that influence heavy bleeding

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