Heavy, prolonged menstrual bleeding is the most common symptom for women with bleeding disorders.
Some women have heavy bleeding throughout the normal menstrual period. This is called menorrhagia.
Normally, all women lose a tiny amount of blood at mid-cycle of their period, the moment of ovulation, when the egg is ejected from the ovary. However, women with bleeding disorders can lose a large amount of blood at this time.
If women lose enough blood over a long period, they suffer from iron deficiency anemia.
Often, because a woman has always bled a lot during her menstrual cycle, and because many other women in the family also bleed a lot, she does not realize the menstrual flow is higher than normal. A blood flow assessment chart, in picture form, is available to help women and doctors measure the amount of bleeding.
Menstrual bleeding can be especially heavy at the time of a girl's first period. For this reason, when there is a family history of a bleeding disorder, she should be closely followed through puberty. The medical team should include:
- a gynecologist
- a hematologist with experience in treating bleeding disorders and
- a family physician or pediatrician.
Menorrhagia seriously affects women's quality of life. Here are some examples:
- Many women limit the amount of time they work.
- Many women change careers as a result of bleeding problems.
- Many women are unable to work normally during their menstrual periods.
- Many women lose faith in the medical profession after being told for years their problems are not real.
- Many women suffer constant fatigue from iron deficiency anemia.
- Some women suffer from depression as a result of the stress of their bleeding disorder.
- Many women suffer pain during their menstrual periods and times of ovulation.
- Many women have pain during sexual intercourse.
- Many girls and women must live with the embarrassment of staining due to heavy bleeding.
- Many women have had hysterectomies. Their bleeding symptoms were ignored. Doctors could not diagnose a bleeding disorder. This means they could not have any more children.
This problem is only now being recognized. Often, women themselves did not realize they were not normal. Their bleeding problem ran in the family. Therefore sisters, mothers, grandmothers, and aunts often had the same problem. Nobody saw it as special or, if they did, they said, “All the women in our family bleed a lot during their periods.”
Many women with bleeding disorders have pain during their menstrual period. This is called dysmenorrhea. They can also have pain at mid-cycle of their period, the moment of ovulation, if bleeding is heavy.
The cause of this pain is not known. It could be caused by the volume of blood and poorly formed clots in the uterus.
Some women can have a separate condition called endometriosis. With this condition endometrial tissue forms outside the uterus, for example, around the abdomen. When a woman menstruates, endometrial tissue - wherever it is in the body - bleeds. If these women also have a bleeding disorder, the bleeding may be heavy. The blood can irritate the abdominal wall, causing pain.