Heavy Menstrual Bleeding

(Menorrhagia; Hypermenorrhea)


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    TOP

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

Risk Factors    TOP

Factors that may increase your chances of menorrhagia include:

Symptoms    TOP

Symptoms of menorrhagia include:

  • Menstrual bleeding lasting more than 7 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    TOP

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

Treatment    TOP

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 (NSAIDs)
  • 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
  • Removal of the lining of the uterus—endometrial ablation
  • Removal of the uterus—hysterectomy

Prevention    TOP

There are no current guidelines to prevent heavy menstrual bleeding.


The American Congress of Obstetricians and Gynecologists
Office on Women's Health


The Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada


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
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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. Updated April 16, 2013. Accessed August 18, 2014.
Last reviewed September 2015 by Andrea Chisholm, MD
Last Updated: 9/30/2013

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