Heavy Menstrual Bleeding

(Menorrhagia; Hypermenorrhea)
  • 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 seven 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

    Your doctor will ask 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. Your doctor will work with you to create a treatment plan.
    Your doctor may recommend:
    • 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.

    Office on Women's Health http://www.womenshealth.gov

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


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

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


    Apgar B, Kaufman A, et al. Treatment of menorrhagia. Am Fam Physician. 2007;75(12):1813-1819.

    Heavy menstrual bleeding. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 7, 2013. Accessed August 18, 2014.

    Menorrhagia (heavy menstrual bleeding). Mayo Clinic website. Available at: http://www.mayoclinic.org/diseases-conditions/menorrhagia/basics/definition/con-20021959. Updated July 2, 2014. Accessed August 18, 2014.

    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.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm190551.htm. Updated April 16, 2013. Accessed August 18, 2014.

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