A monthly challenge: Excessive flow during periods could be a sign of immune thrombocytopenia

Representational image. AFP

Heavy bleeding during periods can be a distressing problem, to say the least. Menorrhagia, as heavy menstrual periods are medically called, is a condition when periods last longer than 7 days, and/or a menstruation cycle is less than 21 days. Excessive and prolonged monthly flow might require lifestyle modifications, and thereby prevent one from living life to the fullest. Menorrhagia also puts one at a higher risk of anaemia.

Menorrhagia as a symptom of Immune Thrombocytopenic (ITP)

While in many cases the underlying cause of heavy menstruation is not known, it would be prudent to know that menorrhagia might be an indication of a condition called Immune Thrombocytopenic (ITP). ITP is a blood disorder wherein the immune system attacks an individual’s platelets and destroys them. It is, therefore, characterised by a low platelet count which interferes with blood clotting. This lack of ability for the blood to clot leads to excessive bleeding making heavy period flow one of the most common tell-tale signs of ITP.

Easy bruising, fatigue, rash, and frequent nosebleeds are some of the other warning signs of this condition.

Diagnosing ITP

If a woman has been experiencing abnormal bleeding during her periods for quite some time, it is advised that she undergoes a blood test- usually a complete blood count (CBC). The blood test will provide an overview of the platelet count, which if low, might be an indication of ITP. A normal platelet count is between 150,000 and 450,000 but with ITP, the count is less than 100,000.

Managing ITP

It is essential to point out that ITP is not a life-threatening condition and can be easily managed through medication. The treatment course depends on an individual’s platelet count and the bleeding frequency/period flow. Regular blood tests, thus help in monitoring the condition and enable the physician to prescribe the relevant course of treatment.

A word of caution- it is not advisable to undergo blood tests too frequently. It has been witnessed that many patients keep undertaking blood tests to keep a check on their platelet count. This only adds to their anxiety and while doing so, they also end up consulting multiple doctors. Some of them also tend to stop the medication when the report showcases a normal platelet count. It needs to be understood that while routine testing is important, it should only be done when prescribed by a doctor. Moreover, regular medication is the key to effectively managing this condition and one should not break the treatment cycle.

Keeping a menstrual diary

To understand the underlying cause of heavy bleeding, it is advised that women keep a menstrual diary to detail the frequency, the flow, the specific days when the bleeding is heavier, and the number of days the bleeding lasts. In the case of ITP, with regular medication, the heavy bleeding remains in check and the patient can lead an improved quality of life.

The author is Head of Internal Medicine, Fortis Hospital, Chandigarh. Views are personal.

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