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- Normal menstrual bleeding lasts for 5 days, and produces 2-8 tablespoons of blood per day.
- Menorrhagia describes menstrual bleeding that is heavier in amount or days of flow.
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- Paleness and fatigue if bleeding causes anemia or blood loss
- Heavy bleeding greater than 80 milliliters (normal 40-50 milliliters) or the presence of blood clots
- The bleeding lasts longer than 7 days
- A fever may arise if there is an infection present
- Pain may arise if tumors or infections are present. The pain could be in the abdominal region, or in the pelvic area (below abdomen).
- If the blood has thinned due to drugs or disease, generalized symptoms of hormonal abnormality as in Hypothyroidism may be seen.
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- Pelvic infections (i.e., infections of the uterus and the reproductive tract)
- Hormonal abnormalities:
- Pregnancy
- Taking estrogen without Progesterone
- Decreased thyroid hormones (Hypothyroidism)
- Tumors of the uterus, including fibroids
- Diseases of the endometrium (the lining of the uterus), such as abnormal growths or infections
- Ovarian tumors or cysts
- Stress: physical or mental
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- History of symptoms (i.e., how long has the cycle lasted, how much bleeding has occurred, characteristics of the pain or cramps, number of pads or tampons used, etc.) along with a general medical history is extremely useful.
- Physical and laboratory exam:
- General physical exam that covers the entire body
- Pelvic exam in which the vagina is examined externally and internally
- Pap smear may be done.
- Biopsy of the endometrium may be done.
- Pregnancy test of the urine or blood may be done.
- Blood may be checked for hormonal abnormality, anemia, and infection.
- Ultrasound (sound waves) or CAT scan may be done to locate tumors.
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- Obesity
- Approaching the age when menstruation stops (i.e., menopause)
- The insertion of an intrauterine device (IUD) to prevent pregnancy
- Drugs, herbs, medications, or foods (soy beans) that mimic female hormones or cause hormonal fluctuations.
- Drugs that thin the blood, such as aspirin or Warfarin
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- Hormonal therapy
- Removal of fibroid or cancers in the reproductive tract
- Treatment of infections
- Removal of the uterus (Hysterectomy) or endometrium
- Removal of IUD or foreign objects
- Treatment with iron if the patient becomes anemic
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This is a
common problem, and most cases are due to simple, treatable causes. Contact your physician if you notice any of the symptoms of Menorrhagia. The best time for examination is between menstrual cycles. If symptoms such as pain and fever or other symptoms occur, call your physician. In case of sudden and severe pain or bleeding, call 911.
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- Sudden abortion of a fetus
- Changing or playing with the way birth control pills or estrogen is taken
- Rectal or urinary bleeding may be confused with excess vaginal bleeding
- Vaginal Cancers, infections
- Insertion of foreign objects in vagina
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