Heavy Menstrual Bleeding

(Menorrhagia; Hypermenorrhea)

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    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. Treatments may include:

Medications

The doctor may advise:

  • 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.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org
Women's Health—US Department of Health and Human Services
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:

Abnormal uterine bleeding. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated February 18, 2017. Accessed September 12, 2017.
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
...(Click grey area to select URL)
FDA approves Lysteda to treat heavy menstrual bleeding. United States Food and Drug Administration website. Available at:http://www.dynamed.... Accessed September 12, 2017.
Last reviewed September 2017 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG
Last Updated: 9/30/2013

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