One week is long enough: Signs of menorrhagia

One thing parents can do to be sure their adolescent daughters are healthy is encourage them to be open and honest with doctors about menstrual cycles.

Mothers might be doing their daughters a disservice without even realizing it. Because menorrhagia - excessively heavy or long periods - can be genetic, moms may tell their daughters that having a period for more than seven days is normal because the moms themselves actually suffer or have suffered from the same condition without even realizing it. It's healthy and recommended to be sure your adolescent isn't too shy or embarrassed to talk to her doctor about her menstrual cycle. A physician can recognize a potential problem more than a family member or friend.

It's normal for a girl's period to be heavier on some days than others. But signs of menorrhagia can include soaking through one sanitary napkin per hour for several hours in a row, periods that last longer than seven days, or periods that lead to iron deficiency. Girls with menorrhagia sometimes stay home from school or away from social functions because they may be worried they won't be able to control the bleeding.

The most frequent cause of menorrhagia is an imbalance between the levels of estrogen and progesterone in the body, which causes the lining of the uterus to keep building up over time. When the lining of the uterus is finally shed during menstruation, the resulting bleeding is particularly heavy.

Because many adolescents have slight hormone imbalances during puberty, menorrhagia isn't uncommon in teens. But in some cases, heavy menstrual bleeding can be one of the first indicators of a more serious bleeding disorder.

Nationwide Children's Hospital's new Adolescent Hematology Clinic, the only one of its kind in Ohio, has an all-female hematology and adolescent medicine team, led by Sarah O'Brien, M.D., MSc and Cynthia Holland-Hall, M.D., MPH, to help adolescent girls with excessive vaginal bleeding. Not only can they help girls with heavy periods, but they also can determine if a more serious bleeding issue needs to be treated.

"Of the new patients we see in the clinic, approximately 40 percent of the girls have turned out to have an underlying bleeding disorder," said Dr. O'Brien. "Parents and their daughters have appreciated our all-female staff and often are comforted by the fact that an examination does not necessarily include a pelvic exam. Since many of our patients are young adolescents who are not sexually active, this gives them the opportunity to seek care without seeing a gynecologist, something they might not quite feel ready for."

Early diagnosis of bleeding disorders is crucial to help prevent complications after injuries later in life, and especially during childbirth or surgery. Diagnosed bleeding disorders can be controlled with proper treatment, enhancing your daughter's safety and

quality of life.

Signs & symptoms

Possible indicators of a bleeding disorder (symptoms may vary):

• Heavy periods, particularly when adolescent girls start their first period
• Easy bruising or large bruises from minor bumps or injuries
• Frequent or prolonged nosebleeds
• Mouth and gum bleeding
• Excessive bleeding after injury, surgery or at an immunization site
• Iron deficiency and/or anemia
• Family history of easy bruising or bleeding

Inherited bleeding disorders can lead to menorrhagia:

• von Willebrand disease
• Platelet function defects
• Factor XI deficiency
• Hemophilia A or B carrier
• Rare factor deficiencies
• Collagen vascular disease (Ehlers-Danlos syndrome)

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Each month, Pediatric HealthSource shares the latest treatment and research advancements from Nationwide Children's Hospital. This column is part of an ongoing community education project brought to you by: Discount Drug Mart.