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[Heavy Menstrual Bleeding in 40s] Not yet menopause, but anxious about excessive bleeding?

"My periods were always heavy, but they've become much heavier since I entered my 40s. I lose sleep at night, and I'm worried it might be another problem." Many women in their 40s feel anxious when their menstrual volume increases noticeably or their periods last longer than usual. Leaking onto pads, clothes, and bedding is a discomfort any woman can empathize with, and it often leads to psychological withdrawal. You might wonder if it's menopause, but at an age that feels a bit early for it, the changes in your body can be even more confusing. Simply dismissing it as part of aging is difficult because the impact on daily life is so significant. It is crucial to identify the exact cause and start appropriate management.

💡 [Key Answer] The 3 most common causes of "excessive menstrual volume in your 40s": ① Hormonal imbalance: Uterine lining hyperplasia due to estrogen excess ② Uterine diseases: Uterine fibroids, adenomyosis, endometrial polyps, etc. ③ Autonomic imbalance: Decreased uterine control due to stress and overwork Dalimchae Oriental Medicine Clinic helps restore the fundamental balance of uterine health through a constitution improvement approach, helping you regain a comfortable daily life.

The 40s is a period when a woman's body enters the menopausal transition. During this time, hormonal imbalances are likely to occur as ovarian function gradually declines. In particular, estrogen levels may remain relatively stable or even become excessive, while progesterone secretion tends to decrease. This hormonal imbalance causes the uterine lining to proliferate excessively, which is a major cause of heavy menstrual bleeding, known as menorrhagia.

Along with this, the incidence of uterine diseases such as uterine fibroids, adenomyosis, and endometrial polyps also increases. Uterine fibroids are benign tumors that grow in the uterine muscle layer and can cause menorrhagia depending on their size or location. Adenomyosis is a condition where endometrial tissue grows into the uterine muscle layer, causing the uterus to enlarge abnormally, often accompanied by severe menstrual pain and massive bleeding. In addition, imbalances in the autonomic nervous system caused by stress, lack of sleep, and overwork can also affect the microcirculation of the uterus, increasing the amount of menstrual flow.

Menorrhagia goes beyond the discomfort of heavy periods and can seriously impact a woman's overall health and quality of life. The most direct problem is anemia. Repeated excessive blood loss every month can easily lead to iron-deficiency anemia, causing chronic fatigue, dizziness, headaches, heart palpitations, and shortness of breath, making daily life difficult.

Furthermore, the constant need to change pads and the worry about leaking hinder social life and psychological stability. You may have to lose sleep throughout the night or cancel important appointments, leading to feelings of depression or anxiety. Occasionally, when an underlying disease like uterine fibroids or adenomyosis is the cause, menstrual or pelvic pain may worsen. These symptoms are like warning lights for a woman's health. At the Songdo Menorrhagia Clinic, we propose treatment for fundamental health recovery, not just symptom relief, when these symptoms appear in combination.

Many women continue to suffer from menorrhagia even when Western medical tests show no specific abnormalities. At Dalimchae Oriental Medicine Clinic, we interpret menorrhagia as a signal of imbalance in uterine and overall health. It is seen as a symptom resulting not just from uterine issues, but from a general decline in the body's Qi and blood circulation, autonomic nervous system regulation, and organ function. In Oriental medicine, menorrhagia is referred to as 'Bungnu' or 'Wolgyeongseongi,' and its causes are diagnosed as blood stasis (waste products from circulatory disorders), Qi deficiency (lack of energy), or blood heat (excessive heat accumulation in the body).

In particular, Dalimchae's constitution improvement treatment principle goes beyond simply stopping the bleeding. Instead of temporarily masking symptoms, we focus on fundamentally improving the constitution so the body can maintain a healthy menstrual cycle and optimize the uterine environment on its own. We regulate the imbalanced hormonal system, remove blood stasis in the uterus to smooth blood circulation, replenish overall energy, and stabilize the autonomic nerves exhausted by stress to help the uterus regain its function. It's like improving the performance of the entire engine so the car runs smoothly, rather than just replacing a broken part. This is the goal of Songdo Dalimchae Clinic in integrally improving various discomforts such as chronic fatigue and dizziness that appear alongside menorrhagia.

Research results consistently report that Oriental medical treatment has a significant effect on improving menorrhagia symptoms.

In a study by Kashani's team published in the journal 『Phytotherapy Research』 in 2015, 92 young women with menorrhagia were given either ginger (Zingiber officinale) capsules or a placebo for three menstrual cycles. The results showed a statistically significantly greater reduction in menstrual blood volume in the ginger group compared to the placebo group (p<0.001). The researchers concluded that ginger has a positive effect on reducing menstrual blood volume through mechanisms that inhibit prostaglandin synthesis and regulate blood coagulation.

Also, in a double-blind randomized clinical trial by Masoomi's team published in the 『Avicenna Journal of Phytomedicine』 in 2020, 100 women with menorrhagia (82 completed) were given either Golnar (pomegranate flower) product capsules or a placebo for three menstrual cycles. The results showed that the Golnar group's menstrual blood volume assessment chart (PBAC) scores significantly decreased from an average of 201.62 to 109.44 (p<0.001), and quality of life survey (MQ) scores also significantly improved from 0.58 to 0.39 (p<0.001). In contrast, no significant changes were observed in the placebo group. Furthermore, in the Golnar group, hemoglobin levels increased from 12.78 mg/dl to 12.97 mg/dl (p<0.048), showing a positive effect on anemia improvement. The researchers concluded that Golnar products can be an effective treatment for patients with menorrhagia.

These research data show that Oriental medical herbs and treatments have a scientific basis for improving menorrhagia symptoms. At Dalimchae Songdo, based on these research results, we help patients regain a healthy menstrual cycle by restoring uterine function and hormonal balance through Oriental medical complex treatments such as customized herbal prescriptions, acupuncture, moxibustion, and pharmacopuncture tailored to each individual's constitution and symptoms.

If three or more of the items below apply to you, you need a consultation and review of your uterine health related to menorrhagia.

• ◻ Menstrual flow is so heavy that I need to change pads every 1-2 hours.
• ◻ Blood clots larger than a 500-won coin frequently appear in the menstrual blood.
• ◻ Menstrual periods often last longer than 7 days or up to 10 days.
• ◻ I frequently feel a sudden gush of blood during my period.
• ◻ I have been diagnosed with anemia or feel dizzy, short of breath, or fatigued due to excessive menstruation.
• ◻ I have lost sleep or ruined bedding because of worries about leaking at night.
• ◻ I often face restrictions on important appointments or external activities due to menstrual volume.
• ◻ Menstrual volume has noticeably increased or become irregular after my 40s.

Judgment Criteria:

• If 3 or more apply: Menorrhagia and decreased uterine function suspected. We recommend reviewing Oriental medical complex treatment through a precise diagnosis at Dalimchae.
• If 5 or more apply: Please visit immediately for an examination by a professional Oriental medical doctor. It can lead to serious complications such as chronic anemia.

Q. Is excessive menstrual volume in my 40s a pre-menopausal symptom? A. Excessive menstrual volume in your 40s can be one of the common symptoms of the menopausal transition (perimenopause). Hormonal imbalance due to declining ovarian function is the main cause, and since the incidence of uterine diseases like fibroids also increases during this period, an accurate diagnosis is necessary.

Q. Does anemia also occur if menstrual volume increases? A. Yes, excessive blood loss every month due to menorrhagia can easily lead to iron-deficiency anemia. This can result in chronic fatigue, dizziness, and headaches, so it must be managed.

Q. Is Oriental medical treatment possible even if I have uterine fibroids? A. Yes, menorrhagia caused by uterine fibroids can be a good indication for Oriental medical treatment. In Oriental medicine, removing blood stasis in the uterus and improving Qi and blood circulation helps inhibit the growth of fibroids and alleviate symptoms.

Q. What treatments are provided at the Songdo Menorrhagia Clinic? A. At Dalimchae Songdo, we identify each patient's constitution and uterine health through precise diagnosis. Based on this, we perform complex Oriental medical treatments, including customized herbal prescriptions to improve the uterine environment and regulate hormonal balance, acupuncture and moxibustion to aid uterine blood flow, and pharmacopuncture effective for inflammation relief and blood stasis removal.

Menorrhagia is not a problem that can be solved by just enduring it. You no longer have to ignore the signals your body has been sending for a long time. When approached in the right direction, the body responds faster than you think. Bring the symptoms you are experiencing as they are. Dalimchae Oriental Medicine Clinic will find the cause together.

Where life blossoms. For herbal medicine, it's Dalimchae. Check for symptoms similar to yours through the AI consultation on the Dalimchae homepage first!

This health information was compiled by the Dalimchae medical staff based on questions frequently asked in the examination room. Medical Supervision | Dalimchae Songdo, Oh Hyun-min, Oriental Medical Doctor (Menorrhagia Column)

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