Pre-menopausal Heavy Bleeding

I took a couple of weeks off, but I can be silent no longer. Someone has to address the red elephant in the bathroom. It’s like we are in 7th grade again — everyone is dealing with it, but no one is talking about it. What is the story with debilitating periods in our forties? I think I was a suffragette in a previous life. The inequities between men and women continue to plague me, and I can’t stop talking about it. While, as you may know, “It is what it is” is my favorite, go-to saying, I just cannot apply it in this instance. Isn’t it bad enough my body is completely destroyed from my reproductive attempts? And now, that my role in populating the earth is over-done, I still have to be practically house-bound one day a month. Why all the punishment? Maybe Eve really did destroy Eden — it’s the only explanation.

1. Menorrhagia is the term used to describe abnormally long or heavy periods. It can happen at any time in life, but it is more common in the first few years of menses and in women in their 40s. There can be many causes, but most often, it results from a hormonal imbalance. At the beginning and at the end of your reproductive life, you are more likely to experience cycles in which an egg is not released. This results in a deficiency of progesterone, one of the hormones that helps regulate menses.

2. Symptoms of menorrhagia are self-explanatory, but if we are going to be technical:
– soaking through tampons or pads every hour
– waking up in the night needing to change your protection
– restriction of daily activites
– symptoms of anemia, including fatigue, pallor and shortness of breath

3. Complications – Other than the crippling effect to your social calendar and work schedule, who cares? We’re women. We deal. Actually, it’s not that simple. Heavy periods can lead to iron-deficiency anemia and often cause intense, unusual cramping and pain. In addition to the hormonal causes, other medical conditions and disease states can cause menorrhagia. It is worth bringing it up with your physician.

Treatment: Despite common, archaic thinking, you do not have to take this lying down.

4. Drug treatments: Anti-inflammatory medications and iron supplementation can help control the pain and the effects of blood loss. More useful, if you are a candidate, is hormonal therapy. Last year, I started taking a very low-dose birth control pill — which, for me, because of my family history, doubles as an ovarian cancer preventative agent. It has changed my life. I will literally cry on the day my doctor says I’m too old for it. No more planning my schedule around Mother Nature. I have several friends who have the Mirena IUD which releases a small amount of hormone to thin the lining of the uterus. This will either prevent or diminish severity of your period. 9 out of 10 of them rave about it.

5. Surgical treatments: These options are usually reserved for women who are confident they are done having children. D&Cs (dilation and curettage), which employ the scraping of the uterine lining, are the simplest surgical method. Hysterectomy is the most aggressive method. In between these, is a relatively new procedure called Endometrial Ablation. In this procedure, the lining of the uterus is essentially destroyed. The method of destruction depends on a variety of individual factors. It sounds painful and frankly, kind of barbaric, but I have spoken with women who have had it done, and they are very happy with the results. They assured me the procedure itself was not too bad, and they would definitely do it again.

Wow, I feel better getting it out there. I have had several women ask me to write about this topic.  I do hope it helps. At least you know you have options. Again, if you are concerned, I would address this with your doctor, as there can be more serious causes. My only other piece of advice is to be really good in this life, so you have a shot of coming back as a man in the next.


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