According to the WHO, about 40% of women of reproductive age (menstruating) suffer from iron deficiency anemia or latent iron deficiency. All due to heavy menstrual losses. But what periods should be considered abundant, how to calculate how much blood flows approximately and how to check for iron deficiency? Let's talk about it.
Method for visual assessment of menstrual blood loss
Menstrual bleeding, their intensity and how many grams of blood a woman loses during menstruation is an important sign by which one can judge the state of women's health.
Each woman knows the length of her critical days, assesses the abundance of discharge by day, but to calculate even the approximate blood loss in grams is not an easy task. Fortunately, there is a method for visual assessment of menstrual blood loss and a table attached to it to help you cope with this task.
Print it and use on health.
With the help of such a table, each woman will be able to quite accurately determine her blood loss during menstruation. Pay attention to the construction of the table. Cells with numbers indicate the day of menstruation. The first wide column on the left indicates the type of hygiene product used - a pad or tampon. On the tampon, as well as on the gasket, it is quite clearly indicated how strongly he (she) is saturated with secretions. As can be seen from the table - even the selection of clots is taken into account, if any.
For greater clarity, we consider a specific example: monthly lasts four days, while using pads as a hygiene product.
For example, on the first day of menstruation, the abundance of discharge was minimal, approximately, as shown on the uppermost strip, and during the day three of them were used. As can be seen from the table, next to the gasket there is a multiplication sign and the digit “1” - this means that we multiply the units used on the first day of the gasket by this unit, the number goes 3that we write to the table on the first day of menstruation.
Next, the second day. Suppose that on this day the allocations are most intense and three gaskets with medium occupancy were used (3x5 = 15, where "5" is the number near the gasket in the table) and two gaskets were filled out completely (2x20 = 40 - where, "20" near the most painted strip). Total for the second day of menstruation is 15 + 40 =55we write this number in the table on the second day of the month.
Day three - four pads, half-filled (4x5 =20).
Fourth day - three pads of minimum fullness (3x1 =3).
If during the critical days the release of, for example, two clots was noticed, it is necessary to add them too. In the table, next to the word “clot” there is a unit, which means that we multiply the number of clots that came out of it (2x1 =2).
Now it only remains to add the obtained figures for all the days of menstruation: 3 + 55 + 20 + 3 + 2 (clots) =83.
And this is how the filled table looks like.
By such simple calculations it turns out that blood loss during menstruation was approximately 83 ml, and this is already a sign of menorrhagia (heavy menstruation). If less than 100 grams or 100 points - this is easy blood loss, and if more than 150 ml, it is very large. Blood loss of more than 80-100 ml can lead to iron deficiency anemia. A woman needs to consult a gynecologist to find out the cause of the pathological menstruation and to undergo treatment.
We also recommend that you remember these criteria for heavy menstrual bleeding. According to the symptoms and characteristics of the diagnosis is made by doctors.
Women and blood donation
If a woman has decided to become a donor, then she needs to approach this even more seriously than a man. Here you should consider some of the nuances. For example, after pregnancy and childbirth, before a woman can become a donor, the body should be given a period of recovery of at least one year, after breastfeeding - three months, after the end of menstruation - five days.
When you donate a standard dose of blood (450-500 ml), 200-300 mg of iron is lost from the body, which is almost half the amount of iron in the body of a menstruating woman! For comparison, this proportion of iron in the body of a man is only 5-10% of its reserves. This is due to the fact that approximately 500-1000 ml (one or two donor doses) of a woman’s blood annually lose during menstruation.
Of course, the more abundant menstruation a woman has, the less often she is recommended to donate blood or red blood mass.
Symptoms of iron deficiency
Iron - one of the most important trace elements for the body, because it is part of various hormones and enzymes, is involved in the process of blood formation and immune protection, in the transport of oxygen. One of the illustrative methods for detecting abnormalities in health is a complete blood count for hemoglobin. Iron deficiency is a phenomenon that carries a completely diverse range of symptoms. Consider signs of iron deficiency anemia depending on the stage of the disease.
The first stage is prelarent. Here asthenic syndrome makes itself felt. At the same time, a person feels weakness, depression, fast fatigue, headaches in the morning, a noticeable loss of strength. In terms of the mental state, heightened nervousness and fearfulness, irritability and even depression are noted. For the first stage, heart palpitations are characteristic, even after a minor load, disability, daytime sleepiness. Patients may experience a distortion of taste preferences: aversion to one product (usually meat) and, conversely, an inexplicable craving for others. Familiar to many women during pregnancy, the desire to eat chalk may indicate the initial stage of iron deficiency anemia.
Second stage - latent iron deficiency. During this period, the condition is aggravated, the indicators of pressure and body temperature fall. Concerned about dermatological manifestations:
- herpetic eruptions
- buns in the corners of the mouth,
- bacterial vaginosis or thrush,
- the skin becomes pale, bluish tint,
- chilliness of the hands
- dry skin
- fragility and hair loss,
- itchy skin.
And finally, the third stage - stage of severe iron deficiency. At this stage, there are violations of the digestive processes (difficulty in swallowing solid foods, unstable stools, atrophic gastritis, reduced gastric secretion). Dermatological manifestations are exacerbated - the nails become brittle and blackened, the skin of the hands and feet becomes covered with cracks. There is a decrease in muscle tone and muscle weakness, uncontrolled urge to urinate, urinary incontinence. This condition carries a direct threat to the life of the patient.
Diagnosis and treatment of iron deficiency
Diagnosis of iron deficiency anemia (IDA) occurs in two stages. At the first stage, a series of laboratory tests is carried out aimed at confirming the lack of hemoglobin in the body. The most accurate method for diagnosing iron deficiency anemia is to determine the concentration of ferritin in the blood.
The content of this substance in the blood below 40 ng / mg confirms iron deficiency, and blood tests should be carried out in the complete absence of various inflammatory diseases, colds (with a normal level of ESR in the blood). By the way, if the content of ferritin exceeds 100 ng / mg, it should, on the contrary, be reduced. The second step in the diagnosis of IDA becomes the search for the causes of this deficiency.
It is important to consider that the absorption of iron from the gastrointestinal tract is directly affected by the content of ascorbic acid (vitamin C) in the body. In this regard, smoking donors or donors taking oral contraceptives, as well as those whose diet is poor in vitamin C, are encouraged to take ascorbic acid with iron supplements (the calculation is simple: 4-5 mg of vitamin C for every 1 mg of iron) .
What is menorrhagia
How much blood does a woman lose during menstruation in normal conditions? All individually. But on average - 40-60 ml per day. This is about two tablespoons. In this case only blood is meant. With blood loss of 80 or more milliliters, it is worth talking about too heavy menstruation (menorrhagia).
The amount of blood coming out on menstruation days will impress the uninformed. Its volume is 250 ml (that is, a glass) in one cycle. For all his life - from menarche to menopause - menstrual blood goes up to 90 liters. But do not be afraid of these numbers. If the blood loss does not exceed the above, the body is able to restore them without harm to themselves.
How to measure loss
Technically measuring the volume of your menstrual flow with the help of spoons and glasses is quite difficult. This can be done with hygiene products. What kind of gaskets do you usually buy?
The amount of discharge may be:
- Barely noticeablein which two drops of blood are found on a single ply per day. This corresponds to 5-6 g per day.
- Very easy. Hygiene is enough to replace one or two times a day. Blood flows 6-9 g per day.
- Easy Pad or tampon is changed four times a day. It is 9-12 y.
- Moderate. Medium absorbency tampons or pads (normal) get wet every four hours. In this case, the blood goes 12-15 g per day.
- Strong. Volumetric (super) hygiene products flow in three to four hours. In this case, 15-18 grams of blood per day.
- Very strong. Super absorbent swabs or pads get wet every one to two hours. Here, the volumes of excreted excretions are incalculable, but this condition definitely requires medical assistance.
It is important to the amount of discharge for the entire period, and not for the day. That is, if the monthly period lasts four to five days, but only one of them is devoted to the constant replacement of gaskets (every two hours), and on other days you balance in the “light” or “moderate” modes, this is normal - the total amount of blood secreted does not exceed 250 ml.
What causes the menorrhagia
Often, women who have very heavy menstruation doubt that their blood loss is high. This error is especially characteristic of Russia. With blood loss of more than 250 ml per cycle, the patient may shrug and say: "Yes, I have a normal menstruation, like everyone else."
Now, with universal literacy and Internet access, every woman understands that excessive blood loss leads to a decrease in hemoglobin levels. And it is this “extra knowledge” that makes many postpone a visit to the doctor. It may seem to you that if hemoglobin is normal with very heavy menstruation, then there is no reason for panic.
But a decrease in hemoglobin is a late diagnostic sign. It appears only with a complete breakdown of iron metabolism in the body. A decrease in hemoglobin indicates an already developed anemia. At its earlier stages, iron deficiency is present, but the body still maintains a normal concentration of hemoglobin Ў and it is much easier to return to normal.
With abundant and very abundant menstruation, it is necessary to be examined for the presence of a latent form of iron deficiency anemia, and then determine the cause of too abundant menstruation.
What you usually write off for lack of sleep, excess work and household chores can actually be a sign of iron deficiency: fast fatigue and drowsiness, sentimentality or irritability, reduced immunity (susceptibility to infections), decrease in mental activity and productivity.
How to respond to blood clots
Practically everyone has ever seen blood clots on a sanitary pad. For some, this is the only case in life, for others it is a regular occurrence. On the question of why clots are formed, in each case only the doctor will give an answer. The most common causes are a sedentary lifestyle, a septum of a congenital or acquired nature in the cervix, hormonal disturbance, the body's response to intrauterine devices, polyps in the uterus, uterine fibroids.
Do not postpone a visit to the doctor if there are quite a lot of blood clots during menstruation and they are not small in size, and the menstruation themselves have become more abundant and long lasting.
How is it treated
It all starts with a visit to a gynecologist or an endocrinologist. The specificity of treatment will depend on the results of the examination: functional disorders, gynecological diseases, hormonal imbalances, iron deficiency anemia and other blood diseases. The treatment is aimed rather not at eliminating menorrhagia, but at neutralizing the factors that caused it, and at restoring the level of iron and hemoglobin in the blood.
Where does it come from
When a girl reaches fertile age, one of the eggs inside the follicle grows, approaches the edge of the ovary, the follicle bursts and the egg goes into the fallopian tube. This process is called ovulation and occurs regularly every 21-32 days. By this time, the woman's body is as ready as possible for planning conception. The thickness of the endometrium increases, reaching 10 or more millimeters, and creates ideal conditions for implantation of a fertilized egg.
Physiology of the menstrual cycle
When an ovum is fertilized by a sperm cell, the resulting zygote normally attaches to the uterine wall, and the uterine pregnancy begins to develop. However, without fertilization, the egg is simply rejected by the body along with an increased in size endometrium, which was prepared by the body for pregnancy.
Menstrual bleeding in a girl indicates the absence of pregnancy and in fact is the cause of a slight injury to the inner layer of the uterus, from which blood is taken during menstruation. Inclusions of mucous tissue that can be detected in the blood during menstruation are nothing but pieces of exfoliated endometrium. They should not frighten a woman. After 5-7 days, menstruation stops.
This process cyclically manifests itself every 21-32 days and lasts until menopause (a period of complete cessation of the influence of sex hormones in a woman’s body and the associated cessation of menstruation). The exception is the woman’s pregnancy and lactation period, when menstruation is absent for physiological reasons.
How much blood is out of cycle
Reasoning how much blood comes out with menstruation, it may seem that the bleeding is too heavy for some damage to the endometrium. This can be explained by the fact that the inner layer of the uterus has a massive abundant blood supply. In menstruation, not only the part of the endometrium is rejected, where the fertilized egg could implant, but the entire layer is completely.
The amount of blood in a woman that came out during her menstrual bleeding varies considerably not only in two different women, but also in the same cycle during the same cycle. This correlates with some aspects of the body's work (features of the development of the uterus itself, the abundance of its blood supply, the type of nervous system, hormonal balance, genetic predisposition). In some women, menstruation is scanty, in some - extremely abundant.
It is believed that physiological blood loss during menstruation is 50-60 ml of pure blood. Usually women tend to think that this amount is much larger. But menstruation is not only blood, but mucous blood discharge, which makes up the bulk. The main amount of blood during menstruation comes out in the first two days of bleeding. In most cases, menstrual bleeding lasts from 3 to 7 days, most often its duration is 4-5 days.
Why a lot or a little blood
When the nature of menstruation changes in a girl (too abundant or, on the contrary, insignificant), it is necessary to consult a specialist to exclude a number of pathological conditions. It is the doctor who is able to clarify why with menstruation there may be too much or not enough blood.
Poor discharge of blood during menstruation can also be a reason for seeking advice from a gynecologist. For girls with an unspecified ovulatory cycle, scanty menstruation should not cause any particular concerns. Imperfection of hormonal processes in a young organism can lead to such states.
If menstrual bleeding is scarce in the established fertile period, it is usually the result of a lack of estrogen formation in the ovaries. This is possible in the period before the approaching menopause, in other cases of hypoestrogenia - a reason to contact a specialist.
Small girl's menstrual bleeding can be triggered by chronic fatigue syndrome, stress, overwork, fasting. It is worth remembering that to a greater extent, they should be alerted in terms of deviations from the norm, not only abundant or judicial judgments, but, to a greater degree, a change in their character.
Determine exactly how much blood goes during the month most likely will not succeed. It is more correct and productive to periodically visit your gynecologist even in the absence of pathology on the part of the pelvic organs for prophylactic purposes.
After all, women's health is a guarantee of motherhood and a healthy, full-fledged generation.
How much blood comes out during menstruation
Человек – существо, способное размножаться круглогодично. This makes it different from most other animal species on the planet. But for the possibility of year-round reproduction, a mechanism is needed to get rid of the unfertilized in time egg, ready to receive the embryo tissue that lines the uterus.
This tissue is called the endometrium and exfoliates during menstruation. Since the endometrium is connected to the walls of the uterus by a multitude of capillaries, the purpose of which is to deliver nutrients to the fetus, the capillaries rupture when detached. Naturally, the torn capillary blood. When he is alone, we usually do not even notice such bleeding. But in the endometrium there is a dense network of capillaries. As a result, blood flows quite a lot.
Blood loss during menstruation varies even in the body of one woman. Bleeding may be more abundant in one month, less so in another. But in general, the amount of blood lost by women ranges from 50 to 250 ml. According to other sources, not more than 150 ml.
Monthly can be:
They differ not only in the amount of blood lost, but also in duration.
Amount of blood, ml
The most profuse bleeding occurs on the first and second day. Since it is at this time the endometrium is separated. Further, the uterus wall heal, and the amount of oozing blood decreases.
Blood rate at monthly about 150 ml. Often, girls rejoice in their poor monthly periods, not suspecting that this is one of the types of pathology.
A type of scanty menstruation, when the amount of blood lost is less than 50 ml. In this case, the monthly look like a smearing dark brown or light color. Such a state does not cause any inconvenience and does not pay attention to it, considering such monthly variations as the norm.
Hypomenorrhea can actually be the norm in the first 2 years after the onset of puberty, or upon the onset of menopause, when the reproductive function of the body fades away.
The reasons for the hypomenorrhea can be:
- tough diet. Leads to a lack of nutrients that are necessary for the functioning of the reproductive system,
- anorexia. The consequence of a rigid diet, in which there is a shift in the psyche and a person considers himself fat even at very low weight,
- the effect of hormonal contraceptive drugs,
- miscarriage. In fact, "monthly" duration of less than 2 days may not be monthly, but miscarriage at a very early gestational age,
- some infectious diseases of the brain,
- small amount of estrogen in the body. In women with a male type of appearance, menstrual periods can go less than 4 days,
- ovarian disease affects the regularity of the monthly cycle and the amount of blood lost,
- climate change,
- genetic predisposition.
In women of mature age, hypomenorrhea, with a high degree of probability, is a sign of hormonal imbalance or other problems of the reproductive organs. The worst option of hypomenorrhea is amenorrhea, that is, the complete cessation of menstruation.
If this is not a consequence of the disease, it means that the body lacks nutrients. And, paradoxically, but nowadays amenorrhea can occur because of the desire for a healthy lifestyle. If by this HLS mean raw foods and veganism.
For normal functioning, the female body needs animal protein. Even if it is a protein of insect larvae. Supporters of the theory of return, to the style of feeding of their ancestors, would do well to remember that gathering meant not only eating fallen fruits, but also collecting eggs of ants, larvae of beetles and flies.
Today, few women can be forced to eat a delicious living larva of the May beetle, and raw plant food to the body is not enough for normal functioning. Therefore, with raw food, menstruation gradually stops altogether. But adherents of syroedeniya, and for some reason of a male sex, are sure: the absence of monthly bleeding is evidence of cleaning the body of toxins.
And not only in the human. With an active lifestyle, all nutrients either turn into energy or go to the construction of new cells. If a fan of syroedenia wants to get pregnant, she will have to resume the consumption of animal protein. At least at the level of eating dairy products. The resumption of monthly bleeding - a prerequisite for the onset of pregnancy.
If the daily blood loss exceeds 80 ml, you can talk about another pathology: too heavy periods. It is difficult to determine how many milliliters of blood is lost daily at home. Moreover, it is necessary to measure only pure blood, and not a mixture of blood with other natural secretions. But you can estimate approximately.
If during menstruation a woman needs to change the superabsorbent pads every 2 hours or more often, it is better to consult a doctor. This takes into account the total amount of blood for the entire month. On the first day with the most heavy bleeding, you may need to change the pads every hour or two. But on other days, the amount of excreted blood can decrease dramatically. This phenomenon is considered a variant of the norm. But if you often change the gaskets have a few days in a row, it means that a visit to the doctor has matured.
Causes of menorrhagia are:
- low blood clotting
- intrauterine device,
- hormonal drugs
- genetic predisposition
- climate change.
The last two points are true and with scanty monthly bleeding.
This is actually coagulated blood. Blood clots may appear:
- sedentary lifestyle
- after sleep, when blood stagnates in the vagina or even already outside between the labia,
- at the bend of the uterus,
- if there is a septum in the cervix,
- with polyps in the uterus,
- with uterine myoma,
- in case of hormonal disorders,
- as a reaction to the presence of a helix.
Single blood clots are normal, especially 2-3 days after sleep. If you have multiple blood clots, in combination with more heavy monthly bleeding, you need to visit a doctor.
In fact, it is not necessary to "clean" the body. It is necessary to pass a full examination.
How many pads you need
Manufacturers today produce gaskets for any kind of bleeding. The number of pads depends on the volume of blood that they can absorb. When calculating the amount of necessary hygiene products should be guided by average values. When calculating the daily rate of gaskets for the standard, you need to take a tool with a normal absorbency:
"Normal" pads with scanty bleeding theoretically need less. The change is needed not so much because of overflow with blood, but for hygienic reasons.
Such a common on the globe phenomenon as menstruation is still surrounded by a mass of myths. It seems that we know more about the structure of the Universe than about our own organism.
The most common myths are:
- during menstruation, the body is cleaned. The body does not need any cleaning, and with monthly uterus just gets rid of waste endometrium,
- can not have sex. Strictly speaking, it is possible. If you do not take into account the lengthening of the bleeding time. There is also an increased risk of contracting sexually transmitted diseases. And not the last role is played by the partner’s disgust,
- increased physical exertion and coups are contraindicated. In general, no. But at this time often do not want to move,
- long and painful periods disappear after childbirth. The birth of a child does not play any role. A similar situation with menstruation may be a sign of the disease, and the doctor who advises to have a baby needs to be changed,
- can not swim. Before the appearance of tampons, this ban made sense. When bathing in an open pond, you can get an infection on the "open wound." Yes, and in a sterile pool, it would be inconvenient to get out of the water during bleeding,
- the normal cycle time is 28 days. When taking hormonal drugs, yes. Without contraceptives, the duration of the cycle varies from 21 to 35 days.
The roots of these myths lie in the XIX century, when they thought that all the problems of a woman from the fact that she gave birth to little, and physical activity for her then was unthinkable. At the same time work on the farm and in the field for such activity was not considered.
Monthly for all girls are different. In many ways, this affects the physiology of women. The amount and nature of discharge differs even in one woman depending on:
- Cycle day - on the second and third day the volume of menstrual discharge for all girls is maximum. At this time, the uterus "gets rid" of the greatest amount of discharge.
- Medication. Against the background of the use of oral contraceptives, the amount of menstrual flow is significantly reduced in most women with proper selection of medication. And drugs that reduce blood coagulation (aspirin, warfarin, and others) can lead to some increase in secretions.
- Intrauterine contraception. Using the IUD as an effective method of contraception in most cases leads to increased bleeding, menstruation becomes more painful, prolonged.
In addition, the nature of the discharge during menstruation is influenced by the following factors:
- Constitution. In girls with "lush" menstruation often more abundant. This is due to an excess of estrogens in high body weight, since they undergo transformation in adipose tissue. In lean, the number of menstrual flow is often smaller, although this criterion is not always met.
- Heredity. In this group, rather. You can include diseases that are not identified and were present in women along the family line. For example, endometriosis, pathology of blood coagulation and others.
- Climate. For those living closer to the equator, menstruation occurs earlier and is somewhat more abundant and the same age as in more northern countries.
- Nervous System Stability. Brain functions are closely interrelated with the work of the genitals. When psychoemotional instability often occurs various violations of the cycle, including bleeding.
- Age. In adolescence and closer to menopause, menstruation is often more abundant.
Also, the nature and amount of menstrual flow depends on the health of the woman. Diseases of the genital organs, the endocrine system strongly influence these processes.
And here more about how to distinguish between menstruation and uterine bleeding.
Composition and number of monthly
Menstrual flow is not only blood. They include the following components:
- rejected endometrium - the upper layer of the inner lining of the uterus, which is formed monthly in case of implantation of the ovum, but if the pregnancy does not occur - it is not needed,
- blood - when the endometrium is rejected, blood vessels are exposed, which causes the release of blood that mixes with other elements,
- bacteria - the entire microbial landscape, which is contained in the vagina and, possibly, in the uterus, partially enters the menstrual flow, therefore, in the presence of an active inflammatory process, they acquire an unpleasant and even putrid odor,
- mucus - it fills the cervical canal and with the passage of secretions from the uterus, they mechanically push it.
Blood rate in discharge
Allowed such monthly, which do not lead to a deterioration in the general well-being of women. Normally, this is not more than 150 ml for the entire period of menstruation - five to seven days. On average, these are two tablespoons per day, the maximum is four.
An interesting fact is that in a lifetime, each woman loses approximately 70-90 liters of blood.
If the amount of menstrual flow is greater, the woman should consult a doctor to clarify the situation. The first thing she will notice when exceeding the volume of discharge is weakness, lethargy, dizziness on critical days, and blood tests will reveal a decrease in hemoglobin level.
To determine the amount of blood lost during menstruation can be on the following benchmarks:
- 10 ml g - scanty discharge, enough daily pads for hygiene,
- 15 ml - 1-2 pads are enough for 2 drops per day,
- 20 ml - the average gasket or tampon is filled every 3-4 hours,
- 30-40 ml - pads or tampons from the “maxi” group should be changed every 3-4 hours,
- More than 60 ml - the maximum absorption means must be changed every two hours and more often, in this case it is necessary to think about visiting the gynecologist and detailed examination.
Causes of poor monthly
In medicine, the term is used to describe this phenomenon - hypomenorrhea (insignificant in volume) or oligomenorrhea (a small number of days). Causes may be hidden in the following states:
- After childbirth. Pregnancy and childbirth is a "revolution" in a woman's state of health. Especially if they proceeded with complications. So, if the process of curettage of the uterus, manual separation was done, there was a tight attachment of the placenta, then it is likely that the functional layer of the endometrium will not fully recover, which will be clinically manifested by scant menses.
- After manipulations in the uterus. Any type of curettage - as a result of an abortion, miscarriage, a non-developing or simply diagnostic procedure (HFA), hysteroscopy, with careful removal of the surface layer of the endometrium, removal of its basal layer can occur. Without it, the normal growth of the endometrium is impossible, which leads to its “thin state” and scanty monthly periods.
- Ovarian dysfunction. Hormonal changes that lead to a violation of the production of estrogen or progestin, lead to delays, scanty or heavy menstruation.
- Inflammatory processes. Any infectious process in the area of appendages provokes a disturbance in the blood supply to the tissues of the ovaries, as a result they change their main function - the synthesis of hormones. Premature aging occurs.
- Ovarian depletion. Observed during the perimenopause. An earlier depletion of the ovaries is typical for women who have undergone surgery on the ovaries, multiple stimulations (for example, in IVF protocols), chemo- and radiation therapy. In these cases, exhaustion can occur at any age - even at age 25 and earlier.
Why go very abundant
Abundant periods - the lot of women of premenopausal age, but can occur in all age groups. On the eve of menopause, the causes of significant discharge are hormonal disorders, the formation of functional cysts, and endometrial pathology. Sometimes the actual cause is difficult to establish, and a woman after several cycles of bleeding smoothly into menopause - menstruation comes less often, then disappears altogether. Also, the reasons may be the following:
- Endometrial pathology. This is the most common cause of heavy menstruation. Endometrial pathology includes polyps and hyperplasia. In any case, this anomalous proliferation of endometrial tissue leads to the fact that more tissue is rejected each month than usual, the contractile function of the uterus is disturbed and all this leads to abundant menstruation.
- Malignant tumors. In the early stages of a tumor of the genital organs, the woman is practically not disturbed. Abundant menstruation occurs at the advanced stages - 3 and 4. At the same time, the tissues where the tumor is localized are so tiny that they literally “fall off into pieces”, and the abundant discharge is accompanied by an unpleasant, putrid odor.
- Adenomyosis. This is an endometrioid lesion of the uterine wall. On the histological specimen, the endometrium looks like a honeycomb - the whole is “devoured” by canals. Monthly while very abundant, painful, on the eve of critical days and after them appears a long black or dark brown daub.
- Abnormal structure of the genitals. Congenital pathologies of development of the uterus can lead to its atypical reduction during menstruation and, as a result, abundant menstruation. This two-horned uterus, saddle, with a partition, double and other options.
Anomalies in the structure of the genitals
- Ovarian cysts. The first to play the role of functional formations - follicular and luteal cysts. They are the result of hormonal disorders, accompanied by delays, during which the endometrium continues to grow. This increases the likelihood of the development of polyps, hyperplasia. With the rejection of such a "thick" endometrium monthly become more abundant.
- Uterine myoma. Fibromyomas, located submucosically (under the endometrium) or multiple, lead to heavy menstruation. In this case, the uterus is not able to quickly contract, during menstruation vessels are exposed, which do not fall down for a long time and lead to large blood losses.
- Reception of preparations. Medications that affect the coagulation ability of the blood - lowering it - can lead to more prolonged and heavy bleeding, and they are brighter, scarlet. For example, regular intake of aspirin, warfarin and other means.
- The first periods after childbirth, abortion. Often women report heavy menstruation in the first month or two during such periods. This is normal, but if the discharge is close to bleeding (more than two maxi pads are used in two hours), consult a doctor immediately.
Не характерно обильные месячные (с задержкой или без) всегда должны насторожить в пользу беременности, особенно если женщина замечает и другие симптомы (тошноту, слабость, нагрубание молочных желез). In this case, you should do a test, with a positive result, immediately consult a doctor.
And here more about how they go after the monthly installation of the spiral.
The nature of menstruation is a reflection of women's health. It should not be blamed on the fact that all relatives have abundant / scarce monthly or during such a period of life (for example, in premenopause), many suffer from such violations. This may be the first signal of serious illness, so you should consult your doctor for a detailed examination.
About what is important to know about the menstrual cycle, look in this video:
Sometimes long periods become quite trivial and normal (after an abortion, with heredity). If they are more than 7 days, with severe pain and red clots, then this is a reason to go to a doctor. It is extremely undesirable to carry out treatment independently.
Often the monthly with a spiral go the same way as without it. However, sometimes an individual reaction may be the opposite - bleeding will begin. When is it better to remove the spiral? What are normal periods?
For those who have not encountered, it is difficult to understand what is happening - uterine bleeding or menstruation, how to distinguish them and whether to panic. Indeed, abundant periods are similar to uterine bleeding. Nevertheless, there are important differences that are worth knowing.
Often, menstruation with clots may appear in a perfectly healthy girl. But more often it indicates the presence of pathologies. Special attention - monthly black with bunches.
How does age affect?
Of course, it is important to take into account the age of the woman.
After all, after the menarche (first menstruation), the menstrual cycle is just beginning to form in girls. Reguli can go 1 or 2 days, and the allocation can be scanty or less abundant. Habitual periods are also significantly different during menopause and menopause. During this period, the bleeding can be either insignificant or too abundant. Long delays often occur.
Influence of individual features
The volume of lost milliliters of blood also depends on the characteristics of the body. For some women, the amount of discharge below the norm is completely normal and permissible.
Abundance depends on the duration of the menstrual period, as well as on:
- the presence of chronic diseases
- hereditary predisposition
- hormonal disruptions
- weight and body features,
- infectious, inflammatory and other pathologies,
- negative environmental impact
- climate change
- neurological and psycho-emotional diseases,
- improper nutrition.
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Anna Ponyaeva. Graduated from Nizhny Novgorod Medical Academy (2007-2014) and Residency in Clinical Laboratory Diagnostics (2014-2016). Ask a question >>
What is the norm?
Scientists estimate that in all of their lives, due to menstruation, the body loses about 90 liters of blood. The figure is impressive, but nothing critical in this. Everything lost in the near future is replenished.
It was found out how much blood a woman loses over the period of one period: about 60 ml. But this is a volume of pure blood, and mucus is the basis of discharge.
Thus, in aggregate, the number of discharge is about 250 ml per menstruation. Indicators of 10 to 50 grams of blood per day are also considered normal. Again, it all depends on the characteristics of the female body.
However, if earlier discharge ranged within the normal range, and then meager leakages or heavy bleeding suddenly began, you should listen to your body and consult a gynecologist.
This phenomenon often occurs in girls after menarche for the first two years. This age is characterized by hormonal fluctuations, so an insufficient amount of progesterone is produced. This hormone is responsible for the amount of blood that a girl loses during menstruation.
Scanty menstruation also occurs in adulthood. This option is allowed and can be considered the norm. But still it is a reason to visit the doctor and check the level of estrogen. Lack of hormone can be caused by the following reasons:
- endocrine system diseases
- weight problems - thinness or obesity,
- malfunction of the ovaries,
- congenital diseases of the genital organs,
- hormonal drugs,
- endometrial diseases.
In the premenopausal period ovarian work worsens, because of which only a small amount of blood can be lost.
Scanty discharge is also possible after delivery or during pregnancy.
More abundant discharge
Heavy bleeding should be treated with caution, especially if before this was not noticed. Such a phenomenon may indicate uterine bleeding. Abundant secretions also occur due to the overgrown layer of the endometrium (endometritis). With the arrival of monthly layering rejected, forming a large amount of blood and clots. The reason for the increase in the number of clots can also be polyps on the walls of the uterus.
The volume of discharge increases due to the following factors:
- previous severe stress
- moral depression or severe physical fatigue,
- pathological state of pregnancy
- injuries, blows.
When changes - pathology?
Sometimes it is difficult to distinguish a normal state from pathology. After all, deviations from the norm occur in every woman. If any change in the menstrual cycle happened once (once a year) and was limited to an interval from several days to a week, no treatment is required. That is, if the monthly came earlier or later for a few days, it does not mean that there is a problem in the body. If, after suffering stress, a little more blood is released in the first days than usual - this is also not a sign of illness.
How to distinguish pathology?
To distinguish pathology from the norm, should closely monitor the work of your body. The following factors may indicate the presence of the disease:
- menstruation lasts more than 7 days and is distinguished by a special abundance of discharge,
- weak subtle discharge over several months,
- pain is much stronger than before
- lack of periods for several months,
- the blood is too light or too dark
- increased number of blood clots,
- interval between menses more than 35 days,
- Regulary attack several times a month
- the appearance of menstruation a year or more after menopause.
Hazards and consequences
For any menstrual disorders there may be many dangerous diseases. Thus, uterine fibroids, uterine polyps, ovarian dysfunction, lowered platelet count, cysts, von Willebrand disease, and endometriosis are often found.
Such diseases are fraught with serious consequences, such as infertility, cancer and even death.
In addition to severe abdominal pain, alarming calls indicating disease can include:
- high temperature
- strong weakness
If serious abnormalities are found should see a doctor immediately. Perhaps prolonged heavy periods - a symptom of uterine bleeding. And suddenly appeared "daub" instead of normal discharge - sign of hormonal failure. In the future, most neglected diseases can lead to infertility or death.
Blood rate during menstruation
An interesting question is how much blood a woman loses during menstruation. In the normal allocation of 50-150 ml per menstrual cycle. This is not only blood, but also mucus from the uterus. That blood should be lost from 30 to 50 ml per month. Everything else is leaving the uterus (endometrium), as well as the egg and follicle residues.
Why are the periods
The formation of menstrual function begins during puberty (10-13 years) and depends on:
- hormonal levels
- power supply,
- body mass
- previous diseases,
- maturity of the nervous system.
At the time of intrauterine development in the girl's ovaries, 120 thousand eggs (female germ cells) are laid. At birth, their remains 40 thousand. Upon reaching puberty, ovarian maturation begins, the level of the hormone progesterone rises, eggs are released, changes in the body are cyclical.
Adverse environmental factors, ecology, stress, infections, inflammatory diseases, smoking, alcohol consumption ruin eggs every month. From the beginning of growth of one egg to the beginning of growth of another, one cycle passes.
The menstrual cycle consists of two phases.
- Follicular The hormone estrogen dominates. There is a growth of the follicle and the beginning of the maturation of the egg.
- Luteal. Predominantly hormone progesterone. Egg maturation ends. She should exit the follicle and wait for the male reproductive cell sperm. It is possible to conceive a child.
Desquamation - rejection of the inner mucous membrane of the uterine cavity - the endometrium. Actually there are monthly. It occurs after the growth, maturation of the endometrium and the death of an unfertilized egg. As a result of this, small vessels are injured. Blood flows from their lumen.
Causes of heavy discharge
If the duration of menstruation is longer than 9 days, or the amount of discharge more than 150 ml, this can be considered uterine bleeding (menorrhagia). Abundant menstruation leads to anemia (iron deficiency in the blood), impaired metabolic processes, social discomfort. The reasons may be.
- Hereditary factors (genetic predisposition in the family).
- Endocrine disorders (an important role is played by the thyroid gland, which regulates the level of all hormones in the body).
- Hormonal dysfunction (excessive estrogen production, resulting in abundant growth of the inner lining of the uterus).
- Inflammatory diseases (disrupt the structure of the endometrium).
- Tumors of the pelvic organs (excessive hormonal activity).
- Blood coagulation disorder (in the place of endometrial rejection a blood clot cannot form for a long time).
- Emotional overstrain (disrupts communication in the body between brain signals and sensory organs - the uterus, ovaries, adrenal glands).
- Intrauterine devices (increase the amount of menstrual flow due to overstretching of the uterus).
If during the menstrual cycle a girl uses more than one package of gaskets, then her period is considered abundant. Change the gasket every 4 hours.
Abundant menstruation may be accompanied by pain in the lower abdomen, sometimes even cramping, dizziness, nausea, weakness, drowsiness.
To diagnose diseases of the genital organs, it is necessary to know exactly how much blood a woman loses during menstruation. With the menstrual blood can come out clots and endometrial particles. Clots form in the vagina during blood clotting. It is important to note which impurities have secretions. A large number of blood clots, tissue particles, a lot of mucus - a reason to contact a gynecologist.
Causes of scanty discharge
Scanty periods are the result of hormonal deficiency, a breakdown in the connections between the brain and the reproductive system, and malnutrition and metabolism. It is very important how much blood comes during menstruation. With a poor menstruation (hypomenorrhea), the volume of discharge does not reach 50 ml.
During breastfeeding, the menstrual flow is scanty and irregular. This is due to the restructuring of the body to motherhood.
The first scanty menstruation, with the release of dark blood, as well as soreness in the lower abdomen, can be a sign of ectopic or missed abortion.
- Primary, after the end of puberty, menstrual function has not recovered.
- Secondary. The woman had normal cycles, but afterwards the discharge became scarce.
Monthly meager with insufficient production of the hormone estrogen during the formation of sexual function. This is normal. The body only sets the optimal balance of hormones. There may be pain in the lumbar region, headache, irritability, swelling, nausea.
In the period before menopause, this condition can also be observed. Female body rebuilt. Reproductive function fades away.
When taking hormonal contraceptive drugs is the suppression of their own hormones and the thinning of the endometrium. As a result, menstruation becomes scarce.
Scraping and surgery on the genitals disrupt the production of hormones and affect the maturation of the endometrium. The appearance of bloody discharge with an unpleasant smell is a sign of an inflammatory process. Inflammatory and venereal diseases, tumors and chemotherapy, as well as tuberculosis, cause endometrial inferiority and cycle disorders. In the reproductive period, scanty discharge may be due to underdevelopment or congenital anomalies of the genitals. This condition requires treatment by a gynecologist.
How much blood a woman loses during menstruation indicates the internal state of her body and the health of the pelvic organs. Blood flows out every month at about the same time, but its amount varies from cycle to cycle. The structure of the reproductive system largely determines certain gynecological indicators.
Already a newborn baby in a certain period starts the reproductive program. It is known that over the course of a lifetime, the female organism produces more than a hundred thousand eggs. The girl, who first went monthly, can consider this the beginning of a very serious period of life.
During the cycle, one of the eggs expands and leaves the ovary, falling into the fallopian tube. This process has been called ovulation. For a couple of days during this period, you can conceive a baby. If the conception process has not occurred, the egg cell leaves and menstruation begins.
Their duration is from 3 to 7 days. The largest blood volume is released in the first 2 days. During this period, the distribution of secretions occurs unevenly. They go continuously: something more, a little less. When a girl has a heavy monthly period during the whole period, you should consult a gynecologist and get tested to find out the cause of this manifestation of menstruation.
Factors affecting the process
Many women will not understand why any volume of blood comes out. As soon as the egg cell is not fertilized, the mucous membrane is injured with a strong increase in the endometrium and cell rejection. The uterus gets rid of the unnecessary substance, and the mucus and blood begin to flow out of it through the vagina. The decrease in the amount of blood occurs due to the gradual healing of the injured mucous.
How much blood does a woman lose during menstruation? This or that blood flow is excreted for various reasons. Consider a few of them:
- If a woman uses a spiral as a contraceptive, it is believed that such a measure contributes to an increase in monthly volumes. Menstruation becomes quite painful. With a helix, a weekly period of critical days is quite a normal option.
- When taking hormonal pills, the monthly go not too plentiful. But at the same time, for some women, critical days increase slightly, for others, they are shortened.
- If a woman decided to conceive a child during this period, her period is coming naturally.
They may be affected by:
- diseases that are currently available,
- hereditary factors
- constitution and constitution (for fragile women, the monthly period is scarce)
- nature of power,
- product quality
- instability of the nervous system (women who have neurasthenic states during the period of critical days, suffer from copious secretions),
- age (at 16–17 years of age, blood volume on critical days is much less than that of an adult who gave birth to women),
- the presence of excess weight.
The color of the discharge also says a lot. Light - a sign of the development of a certain pathology. If the color of the blood is too dark or it is thick at the very beginning of these days - this is normal, but when the color is brown, you should consult a specialist. If there is a lot of blood, it can be assumed that there are problems with the endometrium. But only a doctor can help identify the causes.
Everything is individual, but on average every day, the female organism “forgives” from 25-40 ml of blood during the menstruation period. This volume decreases by the end of the critical days. But every second of women will doubt any of these numbers. At first glance it seems that the body loses a much larger volume of blood.
Scientists have an answer to this. The main component of the discharge is mucus, which is mixed with blood, which makes it seem like only the last one is coming out. Therefore, the above figures are close to real indicators. At first, after menstruation, all blood loss is restored. Constant replenishment and renewal of blood is very beneficial for women's health. There are no problems with this in women, with the exception of those patients who suffer from blood diseases.
A very small amount of blood is lost by those women in whom the cycle is just beginning to be established or who are on the threshold of menopause. If the representative of the fair sex is sitting on a rigid diet, sometimes menstruation may not appear at all or go almost unnoticed, in the form of several blood stains within 1-2 days. In this case, it is necessary to contact the doctor and try to adjust the diet, because the reproductive activity of the body depends on it.
Impurities at the end of menstruation with yellowish or brown shades may indicate problems in the gynecological field. Especially if the suspicious discharge was delayed for a long time.
In women who suffer from impaired development of the hormonal system or impaired functioning, menstruation with little bleeding can last a long time (up to 20-25 days). In this case, the blood loss is small, but the situation itself should alert the woman. Such manifestations of critical days are possible if the woman has any infection. After its elimination the cycle is getting better again.
You need to carefully monitor their health and periodically visit the gynecologist. The doctor asks about the abundance of menstruation, the cycle, the beginning of the critical days and their nature. Wary of too much bleeding. They can force the doctor to make a decision about the urgent examination of the patient to find out the reasons for this situation.
By the nature of the discharge, which a woman observes on the hygienic means used by her, one can judge the volume of losses:
- One - two drops physicians equate to 5 ml. In this case, the volume of blood loss is called scanty.
- Slight blood loss occurs if up to 9 ml is released per day.
- Moderate blood loss - when the loss of the main fluid reaches 12-18 ml.
- Severe blood loss - hygiene products are completely soaked for 2-3 hours or require replacement even earlier.
Each woman has his own blood loss volume during the critical days period. If the monthly always go abundantly and it does not affect health, then it is considered the norm. The same applies to scanty periods.
Symptoms of deviations in women's health
If a representative of the fair sex for a long period of time had volumetric menstruation and suddenly they began to decrease, while she did not give birth and the menopause was not soon, you should contact a specialist as soon as possible. Such a manifestation, if not normal and permanent, indicates the following problems:
- Low concentration of the female hormone estrogen.
- Problems endocrinological type.
- Dysfunction of the ovaries.
- Congenital abnormalities.
- Endometrial problems.
- Uncontrolled hormones.
A large amount of blood during the critical days period speaks of deviations of another type. If such metamorphosis began abruptly, the doctors first sent for screening for fibroids. This is a benign formation that is centered in the uterus, affecting the nature of the discharge in the period of menstruation and not only.
The presence of polyps in the cervix leads to heavy bleeding. A gynecologist will easily determine the presence of one or several neoplasms already at the first examination of a woman. The mucus at the same time, in the period of menstruation, goes not just clots, and bloody formations. Bleeding with cervical polyps is not only abundant, but also prolonged.
Deviations in the functioning of the endometrium not less often lead to abundant blood loss during the period of critical days. Endometritis is also characterized by severe lower abdominal pain during the period when menstruation occurs. If the disease develops intensively, the nature of the menstruation can go into long, tedious bleeding. To detect abnormalities in the functioning of the endometrium, ultrasound is performed and blood tests are taken.
Malignant neoplasms in the female genital organs can cause severe bleeding.
They can "break through" and in those days of the cycle, when menstruation should not be. In such cases, the woman should immediately be examined and identify the cause of breakthrough bleeding. A characteristic feature of these types of ailments is that the periods from cycle to cycle increase in volume. Critical days are accompanied by severe pain in the abdomen, and the discharge passes with uncharacteristic impurities for menstruation.
What is the menstrual cycle and why does it bleed
Monthly - changes in the female body associated with the onset of childbearing age, which help in the further conception. The menstrual cycle ends with blood discharge from the vagina. This condition is considered normal and occurs throughout life until the climacteric period arrives. Menopause means - the reproductive function of a woman has died away.
Blood loss during menstruation occurs continuously at a certain time, sometimes with small deviations in a couple of days. Failures of the menstrual cycle occur due to various gynecological diseases, hormonal imbalance. During menstruation, a woman may experience various kinds of discomfort, and not just blood discharge.
The menstrual cycle is 28-35 days, it was invented by nature to continue the race. With the advent of menopause, menstruation ceases to bother a woman. In some cases, menstruation continues in old age until death occurs due to natural causes. This may be due to a disruption of the ovaries.
From the moment of birth, reproductive processes are laid in the girl's body, because the ovaries contain a huge number of eggs. With the onset of the age of 10-12 years, puberty begins, starting the menstrual cycle. A woman's body becomes ready to conceive and bear a fetus. The amount of blood that a woman loses during menstruation is affected by various factors, such as a bleeding disorder.
When a mature egg moves into the uterus, ovulation occurs. During this period, the probability of conception increases. Due to ovulation, the body works more intensively, an increase in the amount of hormones is observed, the woman is ready for conception. If during this period the egg cell is fertilized by a spermatozoon, it is attached to the wall of the uterus, the process of fetal development begins (pregnancy).
If fertilization does not occur, the body begins the process of renewal, recovery. The endometrium that has expanded during the period of the menstrual cycle exfoliates, the egg cell, blood vessels (formed for the development of the fetus) are destroyed. As a result, with the onset of critical days, these elements are removed from the body through the vagina - this process is called menstruation. Progesterone regulates all processes associated with the menstrual cycle. When the amount of this hormone decreases, menstruation occurs.
Intense bleeding indicates possible gynecological problems. No need to panic, if the outflowing fluid is accompanied by lumps and other unpleasant particles - this is biological waste. They leave the body, contributing to its renewal, cleansing.
Blood rate during menstruation
Considering the question of how much blood flows in a lifetime during menstruation, it is necessary to take into account that the volume of blood loss is much less than it seems to a woman. Each month approximately 30-50 ml of blood should come out of the vagina. Everything else is biological waste in the form of endometrium, follicle, egg. During the day about 50 milliliters of fluid can be excreted from the body. The amount of blood leaving the body is affected by normal menstruation, hormonal fluctuations, gynecological pathologies. The blood rate may vary depending on the individual characteristics of the woman, her lifestyle.
Factors affecting the amount of blood
Experts identify the following factors affecting the amount of discharge for menstruation:
- Menstruation Day - the peak of blood discharge occurs at the beginning of menstruation. This is due to damage to the mucous layer of the uterus, the amount of endometrium secreted along with the vessels. After some time, normalization of menstruation occurs, the level of blood loss decreases.
- The amount of discharge may vary due to the use of contraceptive coils. This type of contraceptive significantly increases the amount of blood secreted, increases pain. Quite often, the menstrual period increases - bleeding becomes profuse for at least one week.
- Hormonal medications can reduce fluid volume. Depending on the individual characteristics of the body, the woman is faced with an increase or decrease in the menstrual period.
What determines how much blood is lost during menstruation:
- hormonal fluctuations
- exacerbation of chronic diseases
- inflammatory, infectious diseases,
- heredity factor
- long-term negative impact of the environment,
- physiological features of physique,
- disturbed, unbalanced diet,
- low quality products
- psycho-emotional diseases
- menstruation at an early age.
The body will never give up more blood than necessary. Therefore, with excessively abundant or small secretions, it is necessary to consult a specialist. Even the color of blood can tell about the state of health. Light or brown blood is a sign of disturbance, thick and dark is the norm.
Abundant blood loss
During the critical days, the level of bleeding from each girl is different. However, copious bleeding should be treated with extreme caution - contact a specialist for examination. Large blood loss can be a sign of uterine bleeding, which is an extremely dangerous condition.
The cause of heavy discharge can be many factors:
- moral or physical exhaustion,
- chronic fatigue,
- pathological conditions of pregnancy.
The sooner a woman turns to a specialist for help, the sooner the cause of violations will be identified and eliminated. If heavy bleeding occurs suddenly, uterine fibroids may develop. Although such a neoplasm is benign in nature, it still affects the duration of menstruation and the level of fluid released during this period.
In the case when the number of clots increases during menstruation, polyps may form on the walls of the uterus. In modern medicine, there are many methods of early diagnosis of such tumors, however, subject to regular examinations by a gynecologist.
Endometritis is one of the factors affecting the increase in bleeding. The surface layer of the endometrium grows excessively, and with the arrival of menstruation, it begins to flake off, thereby increasing the number and duration of secretions. The amount of discharge is also influenced by external factors in the form of injuries due to a blow, a sharp jolt.
Quite often, women, especially young girls, are faced with scanty discharge instead of menstruation. Typically, such menstruation is not dangerous, because in a healthy woman they are never abundant, but may indicate a pathological condition. The main reason is the formation of the menstrual cycle. The reproductive system is trying to find the best way to produce progesterone responsible for menstruation.
However, if such periods are observed in mature women, their cause may be:
- reducing the amount of estrogen
- endocrine disorders
- unexplained weight loss or weight gain
- ovarian dysfunction,
- hereditary diseases, aggravated with age,
- hormonal imbalance, including due to the use of hormone therapy,
- pathological conditions of the endometrium.
To control the amount of fluid excreted by the body during the month is quite important. It is necessary to determine the general state of health and timely diagnosis of pathological conditions. Of course, it is quite difficult to find the exact amount of blood, but each girl can develop her own method and control the process, determining the intensity, consistency of secretions.