Normal menstrual flow occurs every 21 to 35 days, lasts three to seven days and the total blood loss is about 30 to 80 mls (2 to 5 1/2 tablespoons). Every woman’s menstrual cycle is different. Menorrhagia or heavy menses affects 9-14% of menstruating women and is defined as menstruation at the expected intervals but with duration lasting longer than 7 days or excessive flow with more than 80 mls (> 5 1/2 tablespoons) of blood loss during each menstrual cycle. When symptoms like dizziness, tiredness or when menorrhagia is prolonged or persistent for several months,then women should not suffer in silence and should seek early diagnosis and treatment. In severe cases, the anaemia may be life-threatening. Common causes include fibroids, adenomyosis, hormonal imbalance, endometrial polyps and even cancer of the uterus, cervix and ovaries. Effective treatment depends on the cause and can range from non-hormonal medication, hormonal medication and surgery.
Question
When is abnormally heavy menstrual flow that contains clots a cause for concern?
Doctor's Answers 1
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Where should I go to confirm a diagnosis of PCOS in Singapore?
I agree that seeing a gynaecologist directly might make the most sense as regardless of history taking by the GP, the ultimate confirmatory diagnosis is still ultrasound of your ovaries. They would be better placed to discuss with you on treatment modalities.
Should I visit a GP or gynae for further tests if I have large period clots and bad cramping?
Yes it is best to see a gynae for some blood tests and a pelvic ultrasound. Prolonged heavy menses may result in iron deficiency anemia, and this needs to be corrected. Issues which need to be excluded include any gynaecological problems like fibroids or endometrial polyps, as well as any problems with blood clotting. Even if all is normal on testing, heavy periods are not something you have to put up with with.