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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:

Risk Factors

Factors that may increase your chances of menorrhagia include:

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:

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
Prevention

There are no current guidelines to prevent heavy menstrual bleeding.

RESOURCES:

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

Women's Health—US Department of Health and Human Services
http://www.womenshealth.gov

CANADIAN RESOURCES:

The Canadian Women's Health Network
http://www.cwhn.ca

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org

References:

Abnormal uterine bleeding. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T361089/Abnormal-uterine-bleeding. Updated February 18, 2017. Accessed September 12, 2017.

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 http://www.ebscohost.com/dynamed: FDA approves Lysteda to treat heavy menstrual bleeding. United States Food and Drug Administration website. Available at: http://www.dynamed.com/topics/dmp~AN~T361089/Abnormal-uterine-bleeding. Accessed September 12, 2017.



Last reviewed September 2017 by EBSCO Medical Review Board Beverly Siegal, MD, FACOG

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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