Summary of the Core Content
This article, in conjunction with a recent editorial published in a subsidiary of The Lancet, exposes a "hidden public health issue for women" that has been collectively overlooked by society worldwide: Currently, 30%-50% of women of childbearing age suffer from excessive menstrual bleeding. Influenced by menstrual shame and misconceptions, the vast majority of affected individuals tolerate this condition as a normal part of their "genetic makeup" or a sign of good health, failing to realize that it may be indicative of underlying health problems such as uterine fibroids and polyps. This can lead to a range of health issues, including iron deficiency, anemia, and cognitive impairments (often referred to as "brain fog"). As a result, women miss an average of 3.6 weeks of work or school each year, which significantly impacts their studies, careers, and life choices, creating a substantial, unmeasured socioeconomic burden.
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Detailed Analysis
1. Why has this issue gone unnoticed for so long?
Surely you know women who avoid wearing white pants during their periods, always look for a toilet before going out, or quickly borrow an outerwear garment to cover any leaks in class or at work. However, these "minor inconveniences" are not something that everyone experiences. The reason this problem has remained hidden for so long lies in two layers of shame: First, there is the shame surrounding menstruation itself; from a young age, no one properly educates people about what a normal menstrual cycle is, and it is considered a private matter that should not be discussed openly. As a result, women are too embarrassed to seek medical help. Second, there are widespread misconceptions passed down from generation to generation, with many women mistaking their symptoms for normal parts of being female, even spreading rumors that heavy menstrual bleeding is a sign of healthy estrogen levels. This has led to a situation where a significant number of women are in distress, yet the actual scale of the problem is greatly underestimated.
2. Why can't you tell if you have excessive menstrual bleeding on your own?
Medically, a normal menstrual flow is defined as losing no more than 80 milliliters of blood per period, which is roughly half a cup of disposable tampons. However, it is impossible for most people to accurately measure this. Different brands of tampons have significantly different absorbency levels; what may seem like a small amount of bleeding with thinner tampons could actually indicate a larger loss. The most practical method for self-assessment, according to medical experts, involves checking for three criteria: large blood clots larger than a one-dollar coin, a period lasting more than 7 days, and being so distressed by the bleeding that you can't concentrate on work or school. These criteria are much more reliable than relying on assumptions like "my mother had the same problem."
3. The hidden costs of excessive menstrual bleeding are staggering
Excessive menstrual bleeding is not just a minor inconvenience; it comes with serious health and economic consequences. Up to 40% of women with this condition suffer from iron deficiency, which can cause dizziness, fatigue, hair loss, and other symptoms. During pregnancy, iron deficiency can also harm the developing baby. Economically, women with excessive menstrual bleeding miss an average of 3.6 weeks of work each year, resulting in a significant loss of productivity. In the United States, this amounts to nearly a month's worth of lost work. In China, with 300 million women of childbearing age, the annual loss in productivity could exceed 6 million person-years, equivalent to a loss of hundreds of billions of yuan in GDP. Moreover, the decreased work efficiency due to discomfort during menstruation means that many women miss out on career opportunities.
4. Why do so many people continue to endure this without treatment?
There are effective treatments available. Conditions like polyps and uterine fibroids can be treated, and short-acting contraceptives or special intrauterine devices can help reduce menstrual flow. In severe cases, a hysterectomy may be an option. However, the main barrier to seeking treatment lies in societal attitudes: Many doctors dismiss the issue, suggesting that the problem will resolve itself after having children. Parents often view the use of contraceptives as negative, and some doctors refuse to perform surgeries, fearing that the patient may need them in the future if they divorce and remarry. This societal logic emphasizes that a woman's ability to conceive is more important than her well-being.
5. Overcoming the barriers to treatment
More than a century ago, a study involving 2,000 women demonstrated that healthy women are not hindered by their periods. The current lack of recognition for this issue reflects a historical neglect of women's public health. When you or a friend faces these challenges, don't settle for self-imposed limitations. Seek medical help and make sure your needs are addressed. You have every right to live a life free from the constraints of excessive menstrual bleeding.