Heavy Menstrual Bleeding
Heavy menstrual bleeding is higher amount of blood lost during a period than expected. It is also called menorrhagia. It is normal for women to have a heavy menstrual flow at some point. This is a more severe form that happens often.
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The cause is not always known. Excess bleeding can be caused by other health issues such as:
- Adenomyosis—abnormal uterine tissue growth
- Cervical or endometrial polyp
- Uterine fibroid
- Pelvic infections
- Bleeding disorders, such as von Willebrand disease
- Medicine that slows blood clotting
- Anti-inflammatory medicine
- Liver, kidney, or thyroid disease
- Hormonal imbalance
- Ovarian cyst
- Intrauterine device (IUD)
Menorrhagia is more common in:
- Teens to early adulthood
- Women who are close to menopause
Menorrhagia may be:
- Bleeding that lasts more than 7 days
- Very heavy bleeding (soaking through a sanitary napkin or tampon every hour)
- Flow that needs change of sanitary napkin during the night
- Large clots
- Problems going through normal day because of very heavy flow
Long periods of heavy flow can also lead to fatigue and shortness of breath.
When Should I Call My Doctor?
Call your doctor if you have symptoms of menorrhagia.
The doctor will ask about symptoms and past health. A physical examination, including a pelvic exam, will be done. Tests to look for possible causes may include:
Treatment will be based on the cause. Some steps may include:
Medicine may help to stop or ease heavy flow, such as:
- Hormonal therapy
- An IUD that releases the hormone progesterone
Other medicine may help to ease symptoms of a heavy flow, such as:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Iron supplement
Surgery may be needed if the bleeding is severe and not responding to other treatment. Surgery choices include:
There are no steps to prevent heavy menstrual bleeding.
The American Congress of Obstetricians and Gynecologists
Women's Health—US Department of Health and Human Services
The Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada
Abnormal uterine bleeding. EBSCO DynaMed website. Available at:https://www.dynamed.com/approach-to/abnormal-uterine-bleeding. Accessed September 12, 2020.
Apgar B, Kaufman A, et al. Treatment of menorrhagia. Am Fam Physician. 2007;75(12):1813-1819.
11/20/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: FDA approves Lysteda to treat heavy menstrual bleeding. United States Food and Drug Administration website. Available at:http://www.dynamed.com/topics/dmp~AN~T361089/Abnormal-uterine-bleeding. Accessed September 12, 2019.
Last reviewed September 2020 by EBSCO Medical Review Board Chelsea Skucek, MSN, BS, RNC-NIC Last Updated: 8/7/2020