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About Menorrhagia

Get everything you need to know about menorrhagia at The Sisterhood Health Forum! Here’s an overview to get you started.

Menorrhagia, or hypermenorrhea, is an abnormally heavy and prolonged menstrual period. This condition may be associated with abnormally painful periods (dysmenorrhea), depending upon the cause of the problem.

Signs of this condition may include:

  • Menstrual flow that soaks through one or more sanitary pads or tampons every hour for several consecutive hours
  • The need to change sanitary protection during the night
  • Menstrual periods lasting longer than seven days
  • Menstrual flow that includes large blood clots
  • Heavy menstrual flow that interferes with your regular lifestyle
  • Constant pain in the lower abdomen during menstrual periods
  • Tiredness, fatigue or shortness of breath (symptoms of anemia)

Causes

There are a number of conditions that can cause of heavy menstrual bleeding, although in some cases the reason is unknown. Conditions that may cause menorrhagia include:

  • Hormonal imbalance. An imbalance in the hormones estrogen and progesterone can cause an irregular buildup of the lining of the uterus (endometrium). As a result, heavy bleeding occurs as the edometrium is shed during menstruation.
  • Uterine fibroids. Non-cancerous tumors of the uterus. For more information visit the Uterine Fibroids page.
  • Polyps. Small, benign growths on the lining of the uterine wall.
  • Dysfunction of the ovaries. Lack of ovulation (anovulation) may cause hormonal imbalance, which results in irregular bleeding.
  • Adenomyosis. This condition occurs when glands from the endometrium become embedded in the uterine muscle.
  • Intrauterine device (IUD). Menorrhagia is a well-known side effect of using a nonhormonal IUD for birth control.
  • Pregnancy complications. A single, heavy, late period may be due to a miscarriage or be a sign of an ectopic pregnancy.
  • Cancer. In some rare cases, cancer of the uterus, ovaries and cervix can cause excessive menstrual bleeding.
  • Medications. Certain drugs, including anti-inflammatory medications and anticoagulants can contribute to heavy or prolonged menstrual bleeding.
  • Other medical conditions. A number of other medical conditions, including pelvic inflammatory disease (PID), thyroid problems, endometriosis, and liver or kidney disease, may cause menorrhagia.

Treatment

There are a variety of options available for the treatment of menorrhagia, and the course your physician will take largely depends on the cause of the problem.

  • Medications for treating menorrhagia include iron supplements, over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs), oral contraceptives and hormone therapy.
  • Surgical options range from minimally invasive to open abdominal procedures. Common procedures include:
    • Dilation and curettage (D and C). In this procedure, your doctor opens (dilates) your cervix and then scrapes or suctions tissue from the lining of your uterus to reduce menstrual bleeding.
    • Operative hysteroscopy. This procedure uses a tiny tube with a light (hysteroscope) to view your uterine cavity and can aid in the surgical removal of a polyp that may be causing excessive menstrual bleeding.
    • Endometrial ablation. Using ultrasonic energy, your doctor permanently destroys the entire lining of your uterus (endometrium).
    • Endometrial resection. This surgical procedure uses an electrosurgical wire loop to remove the lining of the uterus.
    • Hydrothermablation. A hot saline solution is delivered into the uterus through a tube inserted into the cervix. The water destroys most, if not all, of the lining of the uterus in about 10 minutes.
    • Hysterectomy. Complete removal of the uterus using laparoscopic or open abdominal surgical techniques.

      • Except for hysterectomy, these surgical procedures are usually done on an outpatient basis.

Always remember that anytime your body starts to behave in ways that you find unusual, you should see a health-care professional.

An initial evaluation by your doctor should include, at a minimum, an assessment of the symptoms and a physical examination, including a pelvic exam. Your doctor may also ask you to keep a diary of activity during menstration. Blood tests, an endometrial biopsy and/or an ultrasound scan may also be included in an evaluation for menorrhagia. The Sisterhood Health Forum can help you prepare for your doctor’s appointment by educating you about potential problems and related solutions.

Prevention

There is no known way to prevent menorrhagia.

Some data obtained from HealthyWomen.org and MayoClinic.com