Heavy Menstrual Bleeding

Heavy menstrual bleeding, clinically known as menorrhagia, is a prolonged or abnormally heavy menstrual period. The condition is a common problem, affecting one in every five women.1

See treatment of heavy menstrual bleeding discussed on The Doctors TV show.

If you are experiencing any of the following symptoms, talk to your doctor. You may be suffering from menorrhagia:2,3

  • Periods lasting longer than seven days
  • Soaking through one or more pads or tampons in an hour
  • Menstrual flow that includes large blood clots
  • Menstrual flow that is heavy enough to interfere with or limit:
    • Social engagements
    • Work
    • Exercise
    • Sexual activity
  • Fatigue or other anemia-like symptoms

If you are experiencing any of these symptoms consult with your doctor.


Causes of Heavy Menstrual Bleeding

There are several different causes of heavy menstrual bleeding.4,5 The most common of these are:

  • Hormonal Imbalance - An imbalance of estrogen and progesterone - hormones that control the build up and monthly shedding of endometrium, the inner lining of the uterus - can lead to heavy periods.
  • Uterine Fibroids and Polyps - These usually benign (noncancerous) growths can occur almost anywhere in the uterus. Fibroids and polyps may contribute to heavy periods.
  • Infection - Infections of the uterus and cervix may cause heavy bleeding.
  • Bleeding Disorders - Disorders that impair the blood from coagulating and clotting can result in excessive menstrual bleeding.3,4
  • Uterine Cancer - A rare, but potential cause of heavy bleeding. For this reason, your doctor will determine the cause of your heavy bleeding before deciding on a treatment option.


Your physician will best be able to determine what is causing your heavy menstrual bleeding.


Treatment Options

There are a variety of treatment options available and following are some of them. To determine the right course of action and to make sure that you thoroughly understand the benefits and risks of each, talk to your doctor.

Drug Therapy

Hormones and NSAIDs are both commonly used drug therapies. Hormones are delivered through a variety of methods, most commonly birth control pills or an intrauterine device (IUD). However, it is not always effective at controlling excessive bleeding.

Additionally, some women may experience an increased risk of blood clots and breast cancer, or side effects such as high blood pressure, headaches or migraines, depression and weight fluctuation.5,6,7

Talk to your physician about other drug therapy options. Drug therapy may be a treatment for women who wish to have more children as the treatments are reversible.

Endometrial Ablation

Endometrial Ablation is a procedure that is intended to treat and remove the lining of the uterus. The uterine lining or endometrium is tissue that thickens and sheds in cycles causing your period. After this tissue is removed most women see a marked reduction in the heaviness of their menstrual flow, and some may never experience a period again.

It may be performed in an outpatient or office setting. There are several ways in which endometrial ablation can be done; through heated fluid, a heated balloon, microwave energy, freezing, radiofrequency, or electrosurgery. Not all patients will experience a satisfactory reduction in bleeding so all treatment options should be discussed with your physician.

Risks for endometrial ablation procedures include infection, bleeding, injury to organs including perforation and/or burns. Although endometrial ablation significantly decreased the likelihood of pregnancy, it is not a sterilization procedure.8 You should seek advice from your physician about appropriate birth control methods.

Dilatation and Curettage

Dilatation and Curettage is an outpatient procedure that scrapes away the endometrium and may provide temporary relief of heavy periods. This is generally not a long term solution as relief usually lasts for only a few cycles.

Risks include perforation of the uterus wall, injury to the bowel or other internal organs, bleeding and infection. This treatment may be an option for you if you want to have more children because it should not have an effect on fertility.


Hysterectomy, the surgical removal of the uterus, will eliminate periods or stop heavy bleeding. For women in whom the cervix is left, some may experience light spotting.

This is a major surgery done under general or regional anesthesia. A hospital stay is usually required and the recovery time is significantly longer than for other treatments.9

Your physician may determine that a hysterectomy is appropriate when other therapies have failed or are not an option. A woman cannot get pregnant after a hysterectomy.

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