Heavy Menstrual Bleeding
Heavy menstrual bleeding (also called menorrhagia) is excessive menstrual blood loss that interferes with a woman's quality of life.
In some cases, the cause is not known. However, many conditions have been associated with menorrhagia, such as:
Factors that may increase the risk of menorrhagia include:
- Being an adolescent
- Approaching menopause
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)
Your doctor will ask about your symptoms and medical history. A physical examination, including a pelvic exam, will be done. Tests may include:
Treatment depends on the underlying cause of the heavy menstrual bleeding. Your doctor will work with you to create a treatment plan.
Your doctor may recommend:
- Hormonal therapy
- An IUD that releases the hormone progesterone
- Nonsteroidal anti-inflammatory drugs
- Iron supplement
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.
There are no specific steps to prevent this condition.
The American Congress of Obstetricians and Gynecologists
The National Women’s Health Information Center
The Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada
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 http://www.ebscohost.com/dynamed/what.php: 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.
Last reviewed September 2013 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.