What to do if there is heavy menstrual flow and blood clots

Every girl has such a few days every month, which is often called the girls' menstrual period. During this period, every girl has a different physique and the manifestations of the menstrual period are also different. Some girls will have stomach pain and feel very tired, while some girls will have a lot of blood during menstruation. What impact does this have on the body? Let's see what impact this has on girls' bodies.

The definition of menorrhagia is heavy menstrual bleeding in several consecutive menstrual cycles, but the menstrual intervals and bleeding time are regular, without intermenstrual bleeding, bleeding after sexual intercourse, or a sudden increase in menstrual blood. It is a type of ovulatory dysfunctional uterine bleeding. Clinically, ovulatory dysfunctional uterine bleeding is divided into two categories: heavy menstrual flow and intermenstrual bleeding, based on the comparison of bleeding time and basal body temperature (BBT) curve.

1. Drug treatment

(1) For patients who do not require contraception or are unwilling to use hormone treatment, antifibrinolytic drugs can be used: such as tranexamic acid 1g, 2 to 4 times/day, or anti-PG synthetic drugs: flufenamic acid (flufenamic acid) 0.2g, 3 times/day; mefenamic acid (mefenamic acid) 0.5g, 3 times/day. All should be taken from the first day of menstruation for 5 consecutive days. The results of a randomized, double-blind, controlled study reported that tranexamic acid can reduce menstrual volume by 54%, and mefenamic acid (methfenamic acid) can reduce menstrual volume by 20%. Adverse reactions may include nausea, dizziness, headache, etc. A study by Preston JT (1995) et al. showed that for patients with menstrual blood loss of less than 200 ml before treatment, 92% of them could achieve menstrual blood loss within the normal range of less than 80 ml after treatment with tranexamic acid. There have been no reports of this drug causing an increase in embolism in the 19 years since it was launched on the market.

(2) For patients who require contraception, endometrial atrophy treatment can be used:

①19-Demethyltestosterone derivatives: It has been reported that oral administration of levonorgestrel from day 5 to 26 of the cycle can reduce blood loss by 30%. However, Preston JT (1995) showed that oral administration of levonorgestrel 5 mg twice a day from day 19 to day 26 of the cycle did not significantly reduce blood loss.

②Levonorgestrel-releasing intrauterine system (LNG-IUS, trade name Mirena), releases 20μg of LNG into the uterine cavity every 24 hours, with an effective period of 5 years. The drug acts directly on the endometrium, causing it to shrink and thin, reducing menstruation, and causing amenorrhea in 20% to 30% of women. It has few systemic side effects, and the blood E2 level is not low. 12% to 30% of women may have small follicular cysts. The effect disappears after 1 month of discontinuation. However, breakthrough bleeding may occur within the first 6 months.

(3) Others: Danazol is a derivative of 17a-ethynyltestosterone. It can inhibit the secretion of GnRH, the peak of the Gn cycle and the production of ovarian sex hormones. 200 mg/d can reduce blood loss by 60%, but attention should be paid to side effects such as rash, liver damage, and virilization. GnRH enhancers are definitely effective in suppressing ovarian function, but due to side effects caused by low estrogen, they can only be used for a short period of time. Cottonpol has a strong effect in atrophying the endometrium and can also act directly on the ovaries. 20 mg per day. After 2 months, change to twice a week, 20 mg each time. Potassium chloride (sustained-release potassium) 3 tablets/d should be taken to prevent the side effect of hypokalemia. Suitable for patients in the menopausal transition period who no longer desire fertility.

2. Surgical treatment

For patients who are ineffective with drug treatment, whose disease persists, are elderly, and have no desire to have children, surgical removal of the hysterectomy can be performed. In recent years, the transcervical endometrial resection (TCRE) procedure has been developed. It uses laser, microwave, or electrocoagulation to destroy the functional layer and part of the basal layer of the endometrium through hysteroscopy under the monitoring of B-ultrasound examination, so that it loses the ability to respond to ovarian sex hormones, thereby reducing menstrual blood loss. This type of operation takes a short time, involves little trauma, and has a quick recovery. It is suitable for those who are not suitable for or unwilling to have their uterus removed and have no desire to have children. It can also remove small submucosal fibroids at the same time. Before surgery, GnRH enhancers are used to shrink the endometrium.

According to the above statement, if the amount of blood during menstruation is too heavy and the duration is long, it is best to go to the hospital for treatment. The above two methods can be chosen according to your own situation. During menstruation, girls should maintain a happy mood and drink more water. I hope girls can be happy. This is a very important thing. It has a protective effect on the uterus.