Last week we discussed the causes of menorrhagia. We also defined what the terms meant.
This week, we shall look at the complications of menorrhagia as well as the investigations and the treatment that are available to deal with the disorder.
Complications
From the foregoing of the causes and how the disease presents itself and taking a cue from its very definition, it seems clear that the likely complications are not difficult to arrive at. Menorrhagia means heavy menstrual bleeding: A heavy blood loss in each occasion of menstrual period. Over time, this loss may accumulate and cause considerable complications.
Among the most feared complication is anaemia. A loss of blood over a long time will without doubt reduce the amount of blood that remains in the body, especially if the body is also not making enough nutrients to match what is being lost. The anaemia can be mild to very severe.
The second most worrying complication is heart failure. When the body contains less blood than the body needs and less blood that is available for the heart to pump around the body, then there will be less oxygen, less nutrients, water and other nutrients that the body needs. The result is undoubtedly a heart that is failing in its duty.
Thus, the victim of menorrhagia can experience, breathlessness due to water accumulation in the chest and abdominal swelling due to water storing in the abdomen. Legs may become heavy and swollen in what medical practitioners term oedema.
Ultimately, once the heart cannot cope with little blood remaining in the body and its failing, the sufferer will die.
Even on their own, most of the underlying causes of menorrahgia are in their own right, causes of anaemia. By virtue of these underlying causes and now the heavy menstrual period, it may be difficult for the woman sufferer to get pregnant. Therefore, infertility is a likely outcome in a woman who up till now may not have had a child of her own.
Menorrhagia can have serious economic consequences. One only needs to consider the cost of buying sanitary pads, the days off work not to mention the cost of seeking medical help. In the course of seeking solutions to the problem, many women had fallen into the hands of charlatans who peddle inactive or dangerous “cure-all” substances as solutions to the problem of menorrhagia.
Further, the psychological impact of knowing a heavy period may be approaching can be telling on the woman.
Investigations
In expert hands, menorrhagia will be thoroughly investigated. Such tests may include a detailed history of the illness and the doctor will also conduct his or her own examination of the patient. Laboratory tests that the doctor may order will include full blood count or the haemoglobin level in the blood. Liver and kidney function tests may be asked for.
Gynaecologists will surely want to do hormone profile which may also include thyroid function tests. The hormone profile may reveal a disorder of the cascade of hormones that control the menstrual period. Almost for certain, the doctor will do or ask for ultrasound of the pelvis.
In rare but in some important circumstances, the clinician may ask for MRI (Magnetic Resonance Imaging) if cancer is suspected.
Treatment
There are two stages to the treatment. The first one is to correct the complications which may actually be very urgent. This may involve blood transfusion in the case of anaemia. Correcting anaemia may also right the heart failure.
The second stage is to correct the underlying disease state. That is to say, in the medium term, fibroid may have to be removed if it is the cause. Under-functioning thyroid (Hypothyroidism) may call for a specialist in the area (Endocrinologist). Abnormalities of the blood such as Von Wilebrand’s disease should be referred to haematologists.
If menorrhagia has been due to IUCD form of contraception, alternative contraception should be substituted and there are many forms to choose from.
Endometriosis, adenomyosis and infection (PID) will surely require the attention of a gynaecologist. Cancers of the pelvic area will need to be dealt with by a cancer specialist.
Prevention: Menorrhagia can happen to any woman either she had previously had a child or not.
The important thing is to be vigilant by the woman, her partner or in unmarried individual by guardians and carers. Any suspicion of heavy bleeding should be taken seriously and same reported to the doctor who will undertake prompt action.
Except in diseases such as sickle cell disease and any situation where iron tablets should be taken with caution, women who are menstruating could support their body with regular iron tablet intake as well as ingesting balanced nutrition. In summary, heavy menstrual bleeding is a serious illness which requires our full and prompt attention.