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Heavy Menstrual Bleeding

  • Michelle Badash, MS
Publication Type:


Heavy Menstrual Bleeding

(Menorrhagia; Hypermenorrhea)


Heavy menstrual bleeding is losing a higher amount of blood 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.

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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)

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 a change of sanitary napkin during the night
  • Large clots
  • Problems going through a normal day because of very heavy flow

Long periods of heavy flow can also lead to fatigue and shortness of breath.


The doctor will ask about symptoms and past health. A physical exam, including a pelvic exam, will be done. Tests to look for possible causes may include:


The goal of treatment is to ease the heavy flow. How this is done will be based on what is causing it. Some steps may include:


There are no steps to prevent heavy menstrual bleeding.

When Should I Call My Doctor?

People with symptoms of menorrhagia should call their doctor.





  • Abnormal uterine bleeding. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/abnormal-uterine-bleeding.
  • Apgar, B., Kaufman, A., et al. Treatment of menorrhagia. American Family Physician, 2007; 75 (12): 1813-1819.
  • 11/20/2009 DynaMed's Systematic Literature Surveillance: FDA approves Lysteda to treat heavy menstrual bleeding. United States Food and Drug Administration website. Available at: https://www.dynamed.com/approach-to/abnormal-uterine-bleeding.


  • Chelsea Skucek, MSN, BS, RNC-NIC
Last Updated:

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.