Health Library

Heavy Menstrual Bleeding

Definition

Heavy menstrual bleeding (also called menorrhagia) is excessive menstrual blood loss that interferes with a woman's quality of life.

Menstrual Flow
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Causes

In some cases, the cause is not known. However, many conditions have been associated with menorrhagia, such as:

Risk Factors

Factors that may increase the risk of menorrhagia include:

Symptoms

Symptoms of menorrhagia include:

  • Menstrual bleeding lasting more than seven days
  • Unusually heavy bleeding (soaking through a sanitary napkin or tampon every hour)
  • Menstrual flow requiring change of sanitary protection during the night
  • Menstrual flow including large clots
  • Menstrual flow interfering with lifestyle
  • Fatigue and/or shortness of breath (symptoms of anemia )

When Should I Call My Doctor?

Call your doctor if you have symptoms of menorrhagia.

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical examination, including a pelvic exam, will be done. Tests may include:

Treatment

Treatment depends on the underlying cause of the heavy menstrual bleeding. Your doctor will work with you to create a treatment plan.

Medications

Your doctor may recommend:

  • Hormonal therapy
  • An IUD that releases the hormone progesterone
  • Nonsteroidal anti-inflammatory drugs
  • Iron supplement

Surgical Procedures

In some cases, surgery may be needed, such as:

  • Dilation and curettage
  • Operative hysteroscopy (may be used along with other tools to remove a polyp)
  • Endometrial ablation (removal of the lining of the uterus)—This procedure reduces your chance of becoming pregnant.
  • Hysterectomy (removal of the uterus)—After this procedure, you will not be able to become pregnant.

Prevention

There are no specific steps to prevent this condition.

Resources

The American Congress of Obstetricians and Gynecologists
http://www.acog.org/
The National Women’s Health Information Center
http://www.womenshealth.gov/

Canadian Resources

The Canadian Women's Health Network
http://www.cwhn.ca/
The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org/

References

Apgar B, Kaufman A, George-Nwogu U, Kittendorf A. Treatment of menorrhagia. American Academy of Family Physicians website. Available at: http://www.aafp.org/afp/2007/0615/p1813.html. Published June 15, 2007. Accessed August 14, 2012.
Heavy menstrual bleeding. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated May 25, 2012. Accessed August 14, 2012.
Menorrhagia (heavy menstrual bleeding). Mayo Clinic website. Available at: http://www.mayoclinic.com/health/menorrhagia/DS00394. Updated June 25, 2011. Accessed August 14, 2012.
11/20/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : FDA approves Lysteda to treat heavy menstrual bleeding. United States Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm190551.htm. Published November 13, 2009. Accessed November 20, 2009.