Heavy bleeding could point to other medical conditions

Monday June 29 2020

You are advised to see a doctor if your period

You are advised to see a doctor if your period is so heavy and causes a lot of pain. PHOTO | SHUTTERSTOCK 

By Joan Salmon

Roselyn tried using normal sanitary towels but she always soiled her clothes no matter how careful she was. On other occasions, she would notice drops of blood on her house floor as she walked from one point to another. As such, she resorted to using cotton and gauze as pads.

Medically known as menorrhagia or simply Heavy Menstrual Bleeding (HMB), this is when a woman experiences either prolonged or abnormally heavy bleeding during their period.

However, Dr Junior Ndozire, an obstetrician and gynaecologist at MildMay Hospital, says it should be noted that while one may experience heavy bleeding, the blood loss might not be so severe to be referred to as menorrhagia.

“A daily loss of more than 80mls of menstrual blood or any blood loss that causes a change in the woman’s condition could be menorrhagia,” he clarifies.

Dr Paul Kato, an obstetrician and gynecologist at Span Medical Centre, says one should look out for heavy blood flow that soaks through a pad or more, within an hour.

However, this must be a repeated occurrence rather than a one-time thing. Also, unlike normal incidences where one has to wake up in the middle of the night say on their third day for a pad change because it is their heavy day, with this condition, they must change their pad every night.


Some women will experience bleeding that goes on for more than a week and will pass out somewhat large blood clots. As such, their daily activities will be restricted. With such heavy flow, one will most likely suffer fatigue, tiredness, shortness of breath, which are symptoms of anemia.

While at times the cause of this condition is unknown, Dr Ndozire says there are several reasons a woman would have it.

Anovulatory cycles
Ordinarily, an egg is released by a woman’s ovaries every month, a process called ovulation.
“When this does not happen, menstruation is likely not to occur and the endometrium (the layer that sheds during menses) will continue to grow until it will exceed its own blood supply causing excessive bleeding with clots and anaemia,” he shares.

These are said to be non-cancerous tumours of the uterus and will appear during a woman’s childbearing years. “Depending on their size and location within the uterus, they are likely to cause heavy menstrual bleeding, especially if they are within the endometrial cavity,” he mentions.

Contraception use
There are many types of contraception on the market, some are hormonal, others are not.
“Several hormonal contraceptives can cause heavy menstrual bleeding such as DMPA injections, implants and pills. While the Intra Uterine Device is non-hormonal, it can also cause heavy menstrual bleeding in the first three months of insertion but later normalises,” he says.

If this bleeding persists, the woman should check in with their gynacologist to have an alternative method.

With blood being lost in an excessive manner, Dr Kato says the woman may in the long run suffer complications including anaemia, iron deficiency anaemia and dysmenorrhea or cramps.
This is what Roselyn started suffering in that drugs such as diclofenac became part and parcel of her life.

Apart from the direct complications, Dr Ndozire points out that the social impact is also important. “There is loss of productivity at work places and these women will tend to isolate themselves from the public.”

Dr Paul Kato, an obstetrician and gynecologist at Span Medical Centre, says there is no one-size-fits-all treatment as it is based on several factors such as one’s health and medical history, their tolerance to certain drugs and therapies, their childbearing plans, among others.

“The diagnosis or cause of bleeding will mostly guide on the type of treatment options. Treatment can be divided into medical or surgical but still, the decision will be guided by a number of factors according to the assessment by the attending doctor,” he emphasises.