Heavy monthly bleeding, or bleeding that lasts a long time

· Monthly bleeding is heavy if a pad or cloth is soaked through in less than one hour

· Monthly bleeding is long if it lasts for more than 8 days.

· Blood clots (soft, dark red, shiny lumps in the blood that look like liver) are also a sign of heavy bleeding,

· Heavy bleeding that goes on for many weeks, months or years can cause weak blood (anemia).

Causes: · The hormones may be out of balance so the ovary does not release an egg. This is common for women under 20 and women over 40 years of age. · An intra-uterine device (IUD) may be making monthly bleeding more heavy. Figure · Miscarriage, even if you did not think you were pregnant. Figure · If you have pain in the abdomen with bleeding, you may have a pregnancy outside the womb in the tube. URGENT. Go to a hospital right away. Figure · You may have a problem with the thyroid gland. · You may have growths (fibroids or polyps) or cancer in your womb. Figure

IMPORTANT
See a health worker trained to do pelvic exams if you have heavy bleeding and:

· blood gushes from your vagina.
· monthly bleeding has been heavy and long for 3 months.
· you think you might be pregnant.
· you have severe pain with the bleeding.

Light monthly bleeding

Light bleeding each month is not a health problem.

Figure

Causes:

· Some family planning methods - like injections, implants, and the pill - can make you bleed less after you have been using them for some time.

· Your ovaries may not have released an egg.

Monthly bleeding that comes too often, or bleeding at other times

Something may be wrong if monthly bleeding comes more often than every 3 weeks, or if it comes and goes without a regular pattern.

Causes:

· The ovary may not have released an egg.

· There may be growths (fibroids or polyps) or cancer in the womb, especially if monthly bleeding is heavy and not regular.

· Taking the medicine called estrogen after menopause.

Figure

· Some family planning methods - like the pill, implants, and injections - can cause you to bleed more often.

Figure

¨ Hormonal family planning methods such as pills, implants, or injections, can change monthly bleeding.

When monthly bleedings come too far apart, or have stopped

Monthly bleeding usually comes about every 21 to 35 days. It may be normal to have an even longer time between bleeding. But something may be wrong, or you may be pregnant, if your monthly bleeding does not come at all.

¨ If you are over 18 and have never had a monthly period, get medical help.

Causes:

· You may be pregnant.
· You may be pregnant and having a miscarriage.
· The ovary may not have released an egg.
· You may have a serious illness - like malaria, tuberculosis or AIDS.
· If you are over 40 or 45, you may be nearing menopause.
· Some family planning methods - like the pill, injections, and implants - can make monthly bleedings come far apart.

When a woman grows older, her monthly cycle changes.