Heavy Menstrual Bleeding

(Menorrhagia; Hypermenorrhea)


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.

Menstrual Flow

Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.


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)

Risk Factors

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

Surgical Procedures

Surgery may be needed if the bleeding is severe and not responding to other treatment. Surgery choices include:

  • 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


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
...(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, 2019.
Last reviewed September 2020 by EBSCO Medical Review Board Chelsea Skucek, MSN, BS, RNC-NIC
Last Updated: 08/07/2020

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.