Hypermenorrhea is a condition where menstrual bleeding occurs excessively or lasts longer than usual. The main cause is often related to gynecological problems in women during the reproductive period. Different from normal menstruation, hypermenorrhoea can cause very heavy bleeding so women have to change sanitary napkins frequently. 

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What is Hypermenorrhoea?

Hypermenorrhea is a medical condition in which a woman experiences menstruation with a larger blood volume than usual. Apart from that, menstruation also lasts longer than normal. In hypermenorrhea, excessive menstrual bleeding can cause physical discomfort for the sufferer. This often disrupts daily activities.

Apart from physical discomfort, hypermenorrhoea can also have an emotional impact on sufferers. Anxiety and stress often accompany this condition, given the excessive and prolonged bleeding. Therefore, it is important for people with hypermenorrhoea to get emotional support in addition to medical treatment.

The causes of hypermenorrhoea can vary, one of which is hormonal disorders. This disorder can cause an imbalance between the hormones estrogen and progesterone in a woman's body. This hormonal imbalance can affect the menstrual cycle and cause abnormal bleeding.

Apart from hormonal disorders, other factors such as certain medical conditions can also cause hypermenorrhoea. For example, the presence of polyps or fibroids in the uterus can worsen this condition. Therefore, it is important to know the exact cause of hypermenorrhoea so that appropriate treatment can be given.

Symptoms of hypermenorrhea usually include menstruation with very heavy blood flow. This excessive blood flow often requires changing pads or tampons more often than usual. Apart from that, menstruation that lasts more than 7 days is also a common symptom of hypermenorrhea.

To confirm the diagnosis of hypermenorrhoea, consultation with a doctor is required. The doctor will carry out a thorough physical examination to determine the general health condition. In addition, the doctor may perform several additional tests to confirm the diagnosis and determine the cause of hypermenorrhoea.

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Hypermenorrhea Symptoms

Symptoms of hypermenorrhoea can vary from woman to woman. Even so, hypermenorrhea generally causes several symptoms that can affect the sufferer's quality of life. The following are some of the symptoms that often appear in hypermenorrhea:

1. Heavy Menstrual Bleeding

Menstruation can last more than seven days or the bleeding can be very heavy. You may need to change your pad or tampon every hour in a row. This condition is certainly very disturbing and requires medical attention to avoid further complications.

2. Fast-Filling Bandages

There was so much blood that came out, the pad became full quickly in a short time. This can even take place in just one hour. This condition indicates that the bleeding is profuse and abnormal, so you need to see a doctor immediately.

3. Discharge of Large Blood Clots

The blood clots that come out are abnormal, namely large in size. The blood can be the size of a quarter or even larger. Large blood clots could be a sign of a serious problem with the reproductive system and requires immediate medical evaluation.

4. Severe Menstrual Cramps

Hypermenorrhea often appears along with severe menstrual cramps or intense pelvic pain. These severe cramps can really interfere with daily activities and require treatment to reduce the pain experienced.

5. Fatigue and weakness

Excessive blood loss can cause daily fatigue and weakness. If you don't get proper treatment, your daily activities can be disrupted. This fatigue can be very tiring and affect productivity and overall quality of life.

6. Anemia

Continuous or very large blood loss can cause the sufferer to experience anemia. This condition is characterized by symptoms such as fatigue, dizziness and shortness of breath. Anemia that is not treated properly can cause serious complications and requires appropriate treatment.

7. Disruption of daily activities

Hypermenorrhea is a condition that is very likely to interfere with daily activities. Because, sufferers need to change sanitary napkins in a short time, go to the toilet more often, or experience discomfort due to cramps and heavy bleeding. All of this can affect performance at work, school, or other social activities.

By understanding the symptoms of hypermenorrhoea, it is hoped that women will be more alert and immediately seek medical help if they experience one or more of these symptoms. Appropriate and fast treatment can help reduce the negative impacts of this condition and improve the sufferer's quality of life.

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Factors that cause hypermenorrhoea

There are various things that can cause this condition, namely:

1. Hormonal Imbalance

Estrogen levels that are too high or progesterone levels that are too low can cause hypermenorrhoea. This hormonal imbalance is often caused by a variety of factors, including natural changes in a woman's body, such as puberty or menopause. 

In addition, certain medical conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can also affect hormone levels in the body. For such conditions, treatment can usually be done with hormone therapy. This hormone therapy aims to restore hormonal balance in the body and reduce the symptoms of hypermenorrhea.

2. Ovulation Disorders

Polycystic ovary syndrome (PCOS) can trigger hormonal changes, causing heavy menstrual bleeding. PCOS is a condition in which the ovaries produce higher than normal amounts of androgens, which can disrupt the menstrual cycle. 

Apart from PCOS, other ovulation disorders such as anovulation (absence of ovulation) can also cause hypermenorrhea. In anovulatory conditions, the endometrial layer continues to thicken without ovulation, which then causes heavy bleeding during menstruation.

3. Use of Contraception

Intrauterine device (IUD) which contains hormones can be a factor causing hypermenorrhoea in some cases. Hormonal IUDs work by releasing progestin into the uterus, which can affect the menstrual cycle and cause heavier bleeding in some women. 

Apart from hormonal IUDs, the use of other contraceptives such as contraceptive pills or hormone injections can also affect the menstrual cycle and cause hypermenorrhoea.

4. Uterine Disorders

Problems with the uterus, such as uterine fibroids (myoma), uterine polyps, or endometrial hyperplasia, can cause this condition. Uterine fibroids are benign tumors that grow in or around the uterus and can cause heavy menstrual bleeding. 

Uterine polyps are tissue growths that attach to the uterine wall and can cause abnormal bleeding. Endometrial hyperplasia is a condition in which the endometrial lining thickens excessively, which can also cause heavy bleeding.

5. Blood Clotting Disorders

Hemophilia or von Willebrand's disease is an example of a blood clotting disorder that can cause heavy menstruation. Hemophilia is a genetic condition that makes it difficult for blood to clot, so bleeding lasts longer than usual. 

Illness von Willebrand is a blood clotting disorder caused by a deficiency or abnormality in von Willebrand factor, which can also cause heavy and prolonged menstrual bleeding.

6. Side Effects of Medicines

Some medications, such as anticoagulants or certain pain relievers, can cause side effects in the form of heavy menstrual bleeding. Anticoagulants are drugs used to prevent blood clots, but they can cause heavier bleeding during menstruation. Certain pain relievers, especially those containing aspirin or ibuprofen, can also affect blood clotting and cause heavier bleeding.

7. Cancer

Uterine cancer is another type of cancer that can affect the menstrual cycle. This condition occurs when cells in the uterus grow uncontrollably and form malignant tumors. Uterine cancer can cause abnormal bleeding, including heavy menstrual bleeding. Treatment options for uterine cancer can also affect hormone production and cause changes in menstruation. Therapies such as chemotherapy, radiation, or surgery can affect hormone function and cause changes in the menstrual cycle.

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How to Treat Hypermenorrhea

Knowing the causes of hypermenorrhoea is the main key in treating this condition. As a first step, you can do several things at home to help reduce symptoms. 

1. Drink Enough Water

One way to do this is to drink lots of water to keep your body hydrated. Adequate hydration is very important to maintain fluid balance in the body, especially when experiencing excessive menstrual bleeding.

2. Try Compressing with Warm Water

In addition, warm compresses can be used to reduce cramps or abdominal pain that often accompany hypermenorrhoea. Warm compresses work by widening blood vessels and increasing blood flow, so they can help relieve pain.

3. Meet your Nutritional Needs

Apart from maintaining hydration and reducing pain, it is also important to pay attention to nutritional intake. Eating foods high in iron, such as meat, green vegetables, and nuts, can help prevent anemia that may occur due to excessive bleeding. Iron is an important component in the formation of red blood cells that the body needs.

To help the body absorb iron better, you are also advised to consume fruit that contains vitamin C. Vitamin C increases the absorption of iron from food, so it can help overcome iron deficiencies that may occur.

If the signs of hypermenorrhoea persist despite treatment at home, you need to immediately see a doctor. The doctor will carry out an evaluation to determine the cause of excessive menstrual bleeding so that he can provide appropriate and effective treatment.

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Hypermenorrhea caused by fibroids or uterine polyps usually requires further treatment, such as surgery. However, for milder cases, treatment can generally be done through non-surgical treatment. One treatment option is the use of non-steroidal anti-inflammatory drugs (NSAIDs), such as paracetamol or ibuprofen, which can help reduce pain.

Contraceptive pills are also often prescribed to prevent prolonged menstruation and reduce the amount of excessive bleeding. In addition, progesterone hormone therapy can be used to improve hormone levels and reduce excessive menstrual bleeding.

Hormone-containing IUDs are another option that is effective in reducing bleeding. Tranexamic acid may also be prescribed to reduce heavy bleeding and is usually taken at the start of each month's menstrual period.

However, in cases of severe hypermenorrhoea that causes serious complications, all of the above treatments may not be enough. In situations like this, doctors generally recommend surgical removal of the uterus as a last resort. With this procedure, heavy and prolonged bleeding from the vagina can be stopped permanently.

If you experience symptoms of hypermenorrhea, such as excessive menstrual bleeding that causes anemia, it is highly recommended to immediately consult a doctor. This action is important to ensure you get appropriate and effective treatment.

References:

https://www.halodoc.com/kesehatan/hipermenorea#h-1 

https://www.alodokter.com/hipermenorea-kenali-penyebab-dan-cara-menanganinya