Heavy bleeding, cramps and tiredness: signs to look out for

Any discomfort that interferes with quality of life should be evaluated, says specialist; abnormal uterine bleeding affects around 40% of women worldwide

Menstruation is often associated with pain, discomfort and limitations. Because it is a natural process of the female body during reproductive life, many women live with these discomforts without seeking medical help. "Even with access to information, it's not uncommon for women to have their quality of life compromised during their menstrual period, either by intense crampsphysical exhaustion or heavy flow. Although it's a common physiological process, knowledge of the symptoms is essential for women to be able to maintain their routine with well-being," explains Morgana Domingues, a gynecologist and mastologist at UNIFESP and consultant at Biolab Farmacêutica.

In most cases, hormonal fluctuations are the main cause of these discomforts. O menstrual cycleThe premenstrual period, which can last from 21 to 35 days, involves different phases in the female body. It is in the premenstrual period that the most intense symptoms usually appear, due to the fall in the hormones oestrogen and progesterone. "Self-knowledge is a fundamental tool. The way each woman feels and deals with her cycle is individual, so it's important to monitor all the phases to identify which symptoms appear and when. This way, you can seek medical help and find the treatment that best suits you," says Morgana.

Another factor that deserves attention is heavy menstrual flow, which can develop into more serious conditions. The condition known as abnormal uterine bleeding (AUB) affects around 40% of women worldwide, according to the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo). The specialist points out that identifying the exact volume of bleeding can be difficult, but one indication is the frequency with which the patient needs to change her pad or menstrual cup.

"In a normal cycle, the blood loss is around 70 to 80 ml. In cases of heavy bleeding, this volume can double. Among the signs that patients may notice is leakage through their clothes, as well as excessive changing of pads in a short period of time, between 2 and 3 hours. The need to change at night and the loss of clots in large quantities are also warning signs. It's also important to note how many days your period lasts. According to Febrasgo, bleeding should not exceed eight days. Excessive blood loss leads to iron deficiency and, consequently, anemia, characterized by constant tiredness and other health impacts," she warns.

But when is it time to seek help? Morgana stresses that any discomfort that interferes with a woman's quality of life should be assessed. "In milder cases, the doctor may recommend practicing physical activities while respecting the body's limits, as well as the use of anti-inflammatories. Treatment with hormonal contraceptives also shows good results, some of which are even indicated in the package leaflet to reduce abnormal uterine bleeding, such as a four-phase regimen and the use of IUDs", explains the gynecologist.

Morgana stresses the importance of access to information and treatment options that are suited to each patient's reality. "Respecting the rhythm of each phase and accommodating their needs doesn't have to be synonymous with suffering. Today, women have the tools to maintain autonomy over decisions involving their bodies, seeking alternatives that offer comfort and well-being during all phases of the menstrual cycle," she says.

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