MENSTRUATION: TOO HEAVY
The average amount of menstrual loss is 40 milliliters per cycle. Up to 80 milliliters a cycle is still considered within normal limits. The term used for periods heavier than this is menorrhagia. Most women can judge the amount of loss they have by how many pads or tampons they change in a day. Again there can be variation, because some women change a pad when it is lightly soiled, others wait until it is soaked, so ‘four pads a day’ may mean different amounts of actual loss. On average, between four and eight moderately soaked pads or tampons a day is considered normal.
If you leave blood to sit for a while it will turn to a jelly-like consistency called a blood clot. Blood should form clots; it is the way our bodies avoid bleeding to death every time we cut ourselves, ft blood has a chance to sit for a while in the uterus or vagina before it comes out, it may form clots. If the bleeding is heavy, the tendency for blood to sit around is greater, so clots are more likely to form. Passing clots in a period is a regular occurrence for some women, and frightens the life out of others, especially if it has never happened before. It simply means that there is a moderately heavy flow. If a woman is passing a lot of dots, she probably has menorrhagia, and should be assessed regarding this.
Very rare causes of heavy bleeding, like blood-clotting problems and Weeding diseases usually show evidence of a generalised bleeding tendency, like bleeding gums and easy bruising. These tendencies may run in families, so there may he a history of a relative having a bleeding problem.
Not only is heavy bleeding inconvenient, but it can also be associated with the development of anaemia. The type of anaemia which happens as a result of blood loss is called iron deficiency anaemia. One of the important ingredients in blood ceils is haemoglobin. It is the stuff to which oxygen molecules attach themselves. Blood cells transport oxygen molecules from the lungs to the test of the body, drop the oxygen off at some point, for example at a muscle cell and collect the waste products, like carbon dioxide, and take that back to the lungs to get rid of it. It is like the milkman dropping off the fresh milk and picking up the empties (or how it was when milk was actually delivered).
Anyway, one of the important ingredients of haemoglobin is iron. To successfully transport oxygen around your body you need enough iron to make enough haemoglobin. Blood contains iron, and if you arc losing more iron (in periods) than you can eat ( in food) you may have to rely on your iron stores, which are stowed away for a rainy day (or a few heavy days, at least). If you
continue to lose iron at a relatively rapid rate, your iron stores will become low, and the iron content in your blood will become low. There will be less haemoglobin made, so the oxygen -carrying capacity of your blood will be less, so the cells around the body, which need oxygen to function, will start to suffer.
When someone is anaemic they may feel that they have less energy, because they are in fact missing, out on their usual dose of oxygen. Their blood is slightly paler, so the places which are usually dark pink, like inside the eyelids, and the tongue, may even look slightly paler. Even the fingernails may show changes with long terra anaemia, and the general condition of many systems may be impaired. If anaemia becomes more severe it can lead to breathlessness, and in people who have heart conditions can add further strain to the heart.
These changes take rime to develop in women who have very heavy periods. Most of us who have the occasional heavier period are able to make up for the loss with no problem, but persistent heavy periods, particularly in someone whose diet is low in iron, may result in that person becoming anaemic. The most common causes of heavy bleeding are hormonal, and physical. Heavier bleeding is more common at the beginning and end of the reproductive years (menarche and menopause), when anovulatory cycles arc more likely to occur, but may occur at any stage. It is also more common for a couple of cycles following a pregnancy of miscarriage or curette. Heavier bleeding may be due to a uterine polyp or fibroids which are usually diagnosed at either a curette or hysteroscopy.
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