A health condition in which a woman experiences bleeding between monthly periods, prolonged bleeding, or an extremely heavy period is called menometrorrhagia (abnormal uterine bleeding). It often occurs due to fibroids, cysts, hormonal changes, and cancer (rarely). Doctors often treat this condition with medicines or surgery.
In other words, menometrorrhagia occurs when a female experiences vaginal bleeding that is heavy, long, or irregular, and it does not follow a predictable pattern such as a typical menstrual period. Usually, a menstrual period lasts about 5 days and happens every 21 to 35 days. Thus, any bleeding that occurs outside of menstruation may indicate menometrorrhagia.
In general, the inability to predict bleeding can be frustrating, and it can affect your quality of life. In such cases, you may want to stay home or cancel plans you were looking forward to. However, if you have symptoms that resemble this condition, do not hesitate to visit a doctor, especially if it negatively affects your physical or emotional health. Sometimes, irregular bleeding may be a sign of health conditions that may cause infertility and other chronic (long-term) complications.
It is quite difficult to estimate how many people have menometrorrhagia because most people do not report their symptoms. Hence, approximately 10% to 35% of women may have abnormal uterine bleeding, according to some research. While it commonly occurs in perimenopause (several years before menopause), it may also affect people around 12 years old.
What is The Difference between Menorrhagia and Menometrorrhagia?
While both conditions cause similar symptoms, there are some differences between them. For instance, menorrhagia is a condition that causes heavy menstrual bleeding, but in people with menometrorrhagia, the bleeding happens unpredictably or irregularly. It means the bleeding may occur not only during menstruation.
Symptoms
In general, the symptoms vary among people because they depend on the cause. Usually, doctors consider abnormal bleeding to be anything other than bleeding for about 5 days every 21 to 35 days. Usually, people who do not know when they are going to bleed, how much they will bleed, and for how long have menometrorrhagia. Check some symptoms often noticed in people with this condition below:
- Heavy menstrual bleeding (also known as menorrhagia) – Signs of heavy bleeding include soaking through pads or tampons every hour or a few hours, or the need to double-up on pads or tampons.
- Abnormally long periods that last longer than 7 days
- Unpredictable or inconsistent menstrual cycles – Usually, people with menometrorrhagia may notice that their cycles occur fewer than 21 or more than 35 days apart.
- Lack of menstrual periods for more than 3 months in a row
- Bleeding after menopause
- Irregular spotting or bleeding
- Weakness or tiredness – These symptoms may indicate anemia. It is a condition that occurs when a person loses too much blood.
If any of the previous symptoms occur, do not hesitate to see a doctor for diagnosis and treatment.
Causes
In general, this condition may occur due to multiple reasons. For example, hormonal problems, noncancerous (benign) growths, cancer, infections, other health conditions, and certain medicines.
Hormonal Disorders
Usually, hormonal imbalances occur during periods, and they can cause abnormal uterine bleeding. In general, hormones are responsible for the menstrual cycle. That’s why any disruption to the hormonal balance negatively affects menstruation and may cause menometrorrhagia. Check below some conditions that may cause abnormal uterine bleeding:
- Thyroid disease (such as hypothyroidism, hyperthyroidism, and others)
- Anovulation
- Polycystic ovary syndrome (PCOS)
- Stress
- Obesity (excessive body weight)
Benign Growths
Sometimes, women develop noncancerous growths in the uterus that may cause blockages, or these growths may bleed. Check some examples below:
- Fibroids
- Polyps
- Adenomyosis
- Endometriosis
Precancer and Cancer
Usually, this is a rare cause of abnormal uterine bleeding. Check below some types of cancer that may cause menometrorrhagia:
- Uterine cancer
- Vaginal cancer
- Endometrial hyperplasia
- Ovarian cancer
- Cervical cancer
Infections
While some women may develop this condition due to sexually transmitted infections (STIs), it may also happen due to other infections that are not transmitted through sex. Check some examples below:
- Cervicitis
- Trichomoniasis
- Chlamydia
- Endometritis
- Pelvic inflammatory disease (PID)
- Vaginitis
- Gonorrhea
Other Diseases
The following health conditions can be contributing factors to menometrorrhagia. These include:
- Kidney or liver disease
- Von Willebrand disease
- Pregnancy
- Miscarriage
- Ectopic pregnancy
- Blood clotting disorders
- Trauma to the uterus
Medicines
Some medicines may also contribute to abnormal uterine bleeding. It is also recommended to inform your doctor if you have abnormal uterine bleeding symptoms while administering any of the following medications. Examples include:
- Hormone replacement therapy (HRT)
- Blood thinners (also called anticoagulants)
- Aspirin
- Tamoxifen (a medicine used to treat breast cancer)
- Intrauterine devices (IUDs) – If you forget to remove an IUD, it significantly increases the risk of menometrorrhagia and certain infections.
- Some types of birth control
Risk Factors
Usually, the medical term “abnormal uterine bleeding” is used to describe bleeding in nonpregnant women in their reproductive years. However, it does not mean irregular bleeding does not affect post-menopausal or pregnant women. It may affect anyone who has a uterus. Moreover, most cases of menometrorrhagia are not serious and improve with treatment. That’s why it is advised to visit a doctor if you experience bleeding and have transitioned to menopause or experience bleeding during pregnancy.
What Are The Potential Complications of Menometrorrhagia?
People who develop this condition and leave it untreated may experience some complications. Check some examples below:
- Iron deficiency anemia – This is a common complication of menometrorrhagia. It occurs due to excessive blood loss and may cause extreme tiredness, weakness, lightheadedness, and pallor.
- Dysmenorrhea (severe menstrual pain) – This is a serious complication that causes intense cramping and may interfere with your daily routine.
- Reduced quality of life – People who develop abnormal uterine bleeding often cannot participate in daily activities, social or work life, which often leads to emotional distress.
- Fertility problems – This complication occurs rarely, and it is often noticed in people with uterine fibroids, polyps, or adenomyosis.
- Acute hemodynamic instability – In more severe cases, fast or heavy blood loss may cause hypotension (low blood pressure), fainting, and an increased risk for cardiac failure.
- Underlying disease masking – Sometimes, abnormal uterine bleeding indicates other health problems (such as endometrial cancer).
The previous list does not contain a complete list of complications. However, your healthcare professional may help reduce the risk or even prevent them.
How to Prevent Menometrorrhagia?
It is not always possible to prevent this condition, but doctors may recommend some tips to reduce the risk. Check some examples below:
- Practice safe sex – It is recommended to use condoms or dental dams to prevent sexually transmitted infections (STIs), especially if you have multiple sexual partners.
- Physical activity – You should aim for 30 minutes of physical activity per day, at least 5 days a week, to maintain a healthy weight.
- Do not take any medicines without your doctor’s approval.
- Dietary changes – Doctors may recommend adding more fresh fruits and vegetables, whole grains, and iron-rich foods to your diet.
- Drink plenty of water to prevent dehydration
Diagnosis
Most of the time, the diagnosis of menometrorrhagia begins with a pelvic examination and a pap smear. Doctors may also ask some questions about your symptoms and medical history. However, to confirm or exclude this condition, they often perform the following tests. For example:
- Pregnancy test – In most cases, light bleeding is a common sign of a pregnancy in the early stages.
- Blood tests – Physicians usually perform a complete blood count (CBC) to check for blood clots.
- Hormone levels blood test – This test is used to check hormone levels in the body.
- Pelvic ultrasound – This is an imaging test that uses sound waves to make pictures of the inside of the pelvic area. It may help identify abnormal structures in the uterus, including polyps and fibroids.
- Endometrium biopsy – During this procedure, doctors will take a sample of tissue from the uterus to check for cancer or pre-cancer cells.
Treatment
People with menometrorrhagia often get different treatments because they depend on some factors. These include the exact cause of the condition, overall health, age, and preferences. In any case, doctors usually treat abnormal uterine bleeding with medicines or surgery. For example:
Medicines
- Birth control pills
- Progestin
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen
- Gonadotropin-releasing hormone (GnRH) agonists and antagonists – These medicines can temporarily stop or reduce bleeding because they help shrink the size of fibroids.
- Tranexamic acid – This medicine is frequently recommended by doctors for women who have heavy menstrual bleeding.
- Antibiotics – This group of medicines is used to treat bacterial infections.
- Iron supplements – These supplements are used to prevent iron deficiency anemia.
Surgery
The following treatments may be used along with medicines or when the previous medications do not work. Examples include:
- Hysteroscopy – During this procedure, doctors will remove atypical structures in the uterus (such as polyps, fibroids, and others).
- Uterine artery embolization – Doctors often recommend this treatment to stop blood flow to fibroids, which helps shrink them.
- Myomectomy – This is a surgery used to remove fibroids while keeping the uterus intact, which helps preserve the ability to have children in the future.
- Endometrial ablation – It is used to destroy the uterine lining using the following options. These include a laser, heat, electricity, microwave energy, or freezing. However, this procedure is not recommended for women who want to become pregnant in the future.
- Dilation and curettage (D&C) – This option is used to remove tissue from the uterus.
- Hysterectomy – This treatment is often recommended in severe cases. It involves the removal of the uterus, which affects the ability to become pregnant.
Frequently Asked Questions
How Common is Menometrorrhagia?
Generally, heavy menstrual bleeding is one of the most common problems that women report. It affects about 10 million people each year in the U.S.
Can stress cause menometrorrhagia?
Yes, persistent stress can make your menstruation heavier. In rare cases, it may also cause delayed periods. It occurs due to increased levels of Cortisol.
What is another name for menometrorrhagia?
This condition is also known as abnormal uterine bleeding, and it means any vaginal bleeding that is heavy, long, or irregular. Ask your healthcare provider if you have additional questions.
