Heavy menstrual bleeding can have various causes, ranging in severity from 'worrying' to 'life-threatening'. Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.
Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms. In order to diagnose heavy menstrual bleeding, we could:
Cause | Probability | Status |
---|---|---|
Endometriosis | 92% | Confirm |
Vitamin A Need | 25% | Unlikely |
A Weight Problem | 24% | Unlikely |
Polycystic Ovary Syndrome | 2% | Ruled out |
Low Progesterone | 2% | Ruled out |
Fibroids | 1% | Ruled out |
Endometrial Hyperplasia | 0% | Ruled out |
Bleeding Tendency | 0% | Ruled out |
How would you rate your average menstrual bleeding?
Possible responses:
→ Don't know→ Light → Normal / average → Heavy → Very heavy |
Fibroids can lead to heavier bleeding during periods.
Prolonged and/or heavy periods are a sign of hypothyroidism.
In a normal menstrual cycle, estrogen and progesterone regulate the buildup of the endometrium (uterine lining of blood and tissue), which is shed each month during menstruation. Menorrhagia can occur because of an imbalance between estrogen and progesterone. As a result of the imbalance, the endometrium keeps building up resulting in heavy bleeding when it is eventually shed. Since hormone imbalances are often present in adolescents and in women approaching menopause, this type of menorrhagia (dysfunctional uterine bleeding) is fairly common in these groups.
One study found serum retinol levels (a measure of vitamin A levels) to be significantly lower in women with menorrhagia than in healthy controls. 92% of those with lower levels experienced either complete relief or significant improvement after 25,000 IU of vitamin A was taken twice per day for 15 days.
Chronic menorrhagia and PMS is usually the result of deficient progesterone secretion or constant adipose-released estradiol from obesity or recent substantial weight loss.