Heavy Menstrual Bleeding
Condition
(Menorrhagia; Hypermenorrhea)
Definition
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.
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http://services.epnet.com/getimage.aspx?imageiid=25282528si2229.jpgMenstrual FlowNULLjpgMenstrual FlowNULL\\filer01\Intellect\images\si2229.jpgCopyright © 2002 Nucleus Communications, Inc. All rights reserved.19NULL2002-10-012553912528_22631254390Copyright © Nucleus Medical Media, Inc.Causes
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
Symptoms
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.
Diagnosis
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:
- Pap test
- Blood tests
- Transvaginal ultrasound
- Removal of a sample of endometrial tissue— endometrial biopsy
- Scraping the inner lining of the uterus— dilation and curettage
- Closely viewing the uterus and fallopian tubes— hysteroscopy
Treatment
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:
Prevention
There are no steps to prevent heavy menstrual bleeding.
When Should I Call My Doctor?
People with symptoms of menorrhagia should call their doctor.
The American College of Obstetricians and Gynecologists
Office on Women's Health—US Department of Health and Human Services
CANADIAN RESOURCES:
Health Canada
The Society of Obstetricians and Gynaecologists of Canada
The American College of Obstetricians and Gynecologists
Office on Women's Health—US Department of Health and Human Services
CANADIAN RESOURCES:
Health Canada
The Society of Obstetricians and Gynaecologists of Canada
References
- 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.
Contributors
- Chelsea Skucek, MSN, BS, RNC-NIC
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