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 the risk of menorrhagia include:

Symptoms    TOP

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    TOP

Your doctor will ask 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.

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    TOP

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 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... . Published November 13, 2009. Accessed November 20, 2009.
Last reviewed September 2013 by Andrea Chisholm, MD
Last Updated: 9/30/2013
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