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
In some cases, the cause is not known. However, many conditions have been associated with menorrhagia, such as:
- Uterine fibroid
- Bleeding disorders, such as von Willebrand disease
- Hormonal imbalance
- Cervical or endometrial polyp
- Ovarian cyst
- Certain medications
- Intrauterine device (IUD)
Risk Factors
Factors that may increase your chances of menorrhagia include:
- Adolescence
- Approaching menopause
Symptoms
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
You will be asked about your symptoms and medical history. A physical examination, including a pelvic exam, will be done. Tests may include:
- Pap test
- Blood tests
- Transvaginal ultrasound
- Removal of a sample of endometrial tissue—endometrial biopsy
- Scraping of the inner lining of the uterus—dilation and curettage
- Examination of the uterus and fallopian tubes—hysteroscopy
Treatment
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
Revision Information
- Reviewer: EBSCO Medical Review Board Beverly Siegal, MD, FACOG
- Review Date: 09/2017 -
- Update Date: 09/30/2013 -