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Heavy Menstrual Bleeding
Heavy menstrual bleeding (also called menorrhagia) is excessive menstrual blood loss that interferes with a woman's quality of life.
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In some cases, the cause is not known. However, many conditions have been associated with menorrhagia, such as:
Factors that may increase your chances of menorrhagia include:
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
When Should I Call My Doctor?
Call your doctor if you have symptoms of menorrhagia.
Your doctor will ask about your symptoms and medical history. A physical examination, including a pelvic exam, will be done. Tests may include:
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
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—
Removal of the uterus—
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.