[35F] Prolonged and heavy menstrual bleeding with increased pain

Patient Description

A 35-year-old female is experiencing a prolonged menstrual period, lasting 9 days instead of the usual 3 to 5 days, with heavy bleeding and increased pain. The pain, rated as moderate (5/10), is described as cramping and a sensation similar to a full bladder, localized in the uterus area. This pain began 3 days after the onset of menstruation. The patient reports feeling weak, and the bleeding intensity varies, being lighter at night and heavier during the day. There have been no recent injuries, weight changes, or prior irregularities in the menstrual cycle.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Menorrhagia: This is a condition characterized by heavy or prolonged menstrual bleeding. It can cause you to lose too much blood, leading to anemia, which could explain your feelings of weakness.

    • Treatment options for menorrhagia include medication, hormonal therapy, and in severe cases, surgery.
  • Dysmenorrhea: This is the medical term for painful periods. The pain is usually in the form of cramping in the lower abdomen.

    • Treatment options for dysmenorrhea include over-the-counter pain relievers, hormonal birth control, and lifestyle changes such as regular exercise and dietary changes.
  • Uterine fibroids: These are noncancerous growths of the uterus that often appear during childbearing years. They can cause prolonged menstrual bleeding and pelvic pain.

    • Treatment options for uterine fibroids include medication to regulate your menstrual cycle, noninvasive or minimally invasive procedures, and surgery.

Please note that these are just possibilities and not a definitive diagnosis. You should consult with a healthcare provider for an accurate diagnosis.

What you can do

  1. Schedule an appointment with your healthcare provider: It's important to discuss these symptoms with your healthcare provider, who can provide a definitive diagnosis and appropriate treatment options.

  2. Over-the-counter pain relievers: Non-prescription pain relievers such as ibuprofen can help reduce menstrual pain.

  3. Heat: Applying a heating pad to your lower abdomen can help reduce menstrual cramps.

  4. Rest: Make sure you're getting enough sleep and rest. Overexertion can worsen feelings of weakness and fatigue.

  5. Hydrate and maintain a balanced diet: This can help manage your symptoms and prevent anemia.

What you should look out for

Seek immediate medical attention if:

  • Your bleeding is so heavy that you're soaking through one or more tampons or pads every hour for several hours.
  • You're feeling dizzy or lightheaded.
  • Your menstrual cramps are severe and don't improve with over-the-counter medication.
  • You notice a sudden increase in the amount of bleeding or the duration of your periods.
  • You're experiencing severe pain that is not relieved by medication.

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6 mo ago


People Also Ask


What causes prolonged and heavy menstrual bleeding?

Prolonged and heavy menstrual bleeding, known as menorrhagia, can be caused by hormonal imbalances, uterine fibroids, polyps, or other underlying health conditions. It is important to consult a healthcare provider for an accurate diagnosis.


How can I manage menstrual cramps at home?

Menstrual cramps can be managed at home by using over-the-counter pain relievers like ibuprofen, applying heat to the lower abdomen, ensuring adequate rest, and staying hydrated. Regular exercise and a balanced diet may also help alleviate symptoms.


What are uterine fibroids and how do they affect menstruation?

Uterine fibroids are noncancerous growths in the uterus that can cause prolonged menstrual bleeding, pelvic pain, and pressure. They are common during childbearing years and can be managed with medication, minimally invasive procedures, or surgery, depending on their size and symptoms.


When should I seek medical attention for heavy menstrual bleeding?

You should seek medical attention if your menstrual bleeding is so heavy that you soak through one or more tampons or pads every hour for several hours, if you feel dizzy or lightheaded, if your cramps are severe and unresponsive to medication, or if there is a sudden increase in bleeding or pain.

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