Heavy menstrual bleeding after giving birth

The article was professionally consulted by Specialist Doctor I Nguyen Thi Man - Department of Obstetrics and Gynecology - Vinmec Danang International General Hospital. The doctor has more than 10 years of experience in diagnosing, consulting and treating in the field of Obstetrics and Gynecology.

Normally, the amount of menstrual blood in a normal woman will fluctuate around 50-80ml. However, many women after giving birth have menstrual periods more than 80ml than usual, this phenomenon is called hypermenorrhea.

Heavy menstrual bleeding, also known as hypermenorrhoea, is a common menstrual disorder. In 2007, the National Institute for Health and Care Excellence, in the United Kingdom, defined "Hypermenorrhea or heavy menstrual bleeding is a large amount of menstrual blood loss, affecting the body. women's physical, mental, social, and quality of life. Hypermenorrhoea may occur alone or may be associated with other symptoms.
This definition of hypermenorrhoea was later accepted by the World Federation of Obstetrics and Gynecology (FIGO) in 2011. The phenomenon of heavy menstrual bleeding during the day causes a lot of discomfort in daily life, work, and study. If you exercise for a long time, if your period lasts a long time, it can lead to iron deficiency anemia, so it should be treated early.
For women who have heavy menstrual bleeding after giving birth, they are pale, tired and often have dizziness and headaches due to excessive blood loss.

In fact, it is very difficult to determine the exact amount of menstrual blood. Usually only indirect assessment is based on the effect on the general condition due to heavy blood loss of patients with heavy menstrual bleeding. However, when you have a lot of menstrual bleeding, there will also be some telltale signs such as:
Constantly changing tampons. In the middle of the night, I have to get up and change tampons constantly. Menstrual bleeding is heavy, continuous, menstrual blood clots, menstruation has many blood clots. Long menstrual period or menorrhagia (the number of days of menstruation lasts up to more than 7 days). Dizziness, headache due to loss of blood

Heavy menstrual bleeding can be caused by a number of reasons:

The lining of the uterus in the second half of the ovulatory cycle (i.e., a cycle with both estrogen and progesterone effects) has a junctional formation between the adjacent torsion arterioles and veins. Before menstruation, these vascular-vein junctions expand and break, this blood is mixed blood-vein, so it is brown. In anovulatory cycles, that is, the menstrual cycle has only the effect of estrogen but no effect of progesterone, arteriovenous continuity does not take place, menstrual blood is due to rupture of torsion arterioles, There, menstruation is more frequent and the menstrual blood is bright red.
After giving birth, the hormone in the mother's body is still not stable, the hormone prolactin increases to stimulate the secretion of breast milk. Meanwhile, progesterone and estrogen decrease. When estrogen drops, the mucosa sheds but sloughs off unevenly, here and there it regenerates. This directly affects the menstrual cycle, leading to menstrual disorders, after giving birth, menstruation is more or less.

Heavy menstrual bleeding after childbirth can be a symptom of some gynecological conditions such as endometritis, uterine fibroids - especially submucosal fibroids despite their small size It can also cause heavy menstrual bleeding.
In the case of an enlarged uterus, total fibrosis can also lead to heavy menstrual bleeding. Due to the reduction of muscle tissue in the uterus, it will be replaced by fibrous tissue. When menstruation occurs, the ability of the uterus to contract to stop bleeding is reduced, the blood vessels in the muscular layer of the uterus are not constricted, so the bleeding is profuse and continuous.

Diseases causing typical clotting disorders such as hemophilia, hepatitis, liver failure... can cause heavy and prolonged menstruation.
Vasomotor disorders, autonomic dysfunction, cause the blood vessels in the uterine lining to contract poorly, also cause irregular menstruation.
However, it is important to distinguish heavy menstrual bleeding from other bleeding from the vagina, uterus or cervix, which is not menstruation
Uterine bleeding: bleeding due to miscarriage, ectopic pregnancy, polyps uterine necrosis, endometrial cancer... Cervical hemorrhage: necrotic cervical polyp, cervical cancer, cervicitis, cervical condyloma... Hemorrhage due to injury Vaginal injuries: vaginal cancer, vaginal trauma, vaginal ulcers...

Heavy menstrual bleeding, if not treated promptly, can cause some typical dangerous consequences such as:
Body fatigue, paleness due to blood loss, anemia. It can even lead to coma and unconsciousness due to severe anemia, directly affecting daily activities. Heavy menstrual bleeding is prone to infections due to frequent and prolonged use of tampons. Blood and tampons are a favorable environment for bacteria to multiply and grow, causing gynecological inflammatory diseases.

The goal of treating Menstrual Cycle is to treat the cause. Before treating heavy menstrual bleeding, patients need to have a full body examination and gynecological examination, in order to clearly determine the cause of heavy menstrual bleeding, and how much menstrual bleeding affects health. . Cancerous causes and abnormal vaginal bleeding other than menstrual bleeding should be ruled out.
If menstruation is heavy due to endocrine disorders, it is necessary to cure the uterus with drugs or instruments, in combination with the use of artificial menstrual cycles. If due to endometritis: treat inflammation If due to submucosal fibroids, uterine fibrosis, hysterectomy may be considered If due to medical conditions such as coagulopathy, dysfunction If liver dysfunction or vasomotor dysfunction requires medical treatment, if not effective, consider hysterectomy.

To prevent and limit menstrual bleeding after giving birth, it is necessary to:
Balance hormones: have a reasonable lifestyle, get enough sleep; eat a lot of fruit, fiber; Limit eating cold or fatty foods (because fat increases the amount of estrogen in the body). Light activities and activities, avoid overwork or vigorous exercise. Gentle exercise (eg, yoga) is recommended to regulate the body's menstrual flow. Clean the intimate area, change tampons regularly every time you menstruate to avoid gynecological diseases. Do not arbitrarily use or abuse sex hormone drugs. If you find that there are abnormalities in the amount of menstrual blood or menstrual period, it is necessary to immediately go to reputable medical facilities or gynecological clinics to be examined by gynecologists, and diagnosed and confirmed. Identify the cause for prompt treatment.
Vinmec International General Hospital now has a basic gynecological examination and screening package to help customers detect inflammatory diseases early for easy and inexpensive treatment. Screening for early detection of gynecological cancer (cervical cancer)
Vinmec International General Hospital is highly appreciated in the field of obstetrics and gynecology thanks to the gathering of a team of leading specialists in the country, not only professional but also rich in experience; system of equipment and modern facilities.
Especially at Vinmec, the security of customers' personal information is always focused, the hospital environment is civil and polite, helping women with difficult problems talking about obstetrics and gynecology when coming to Vinmec no longer feel feel apprehensive.