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: Uterine fibroid
Bleeding disorders, such as
von Willebrand diseaseHormonal imbalanceCervical or endometrial polypOvarian cystCertain medicationsIntrauterine device (IUD)
Factors that may increase your chances of menorrhagia include: Adolescence
Symptoms of menorrhagia include: Menstrual bleeding lasting more than seven daysUnusually heavy bleeding (soaking through a sanitary napkin or tampon every hour)Menstrual flow requiring change of sanitary protection during the nightMenstrual flow including large clotsMenstrual flow interfering with lifestyle
Fatigue and/or shortness of breath (symptoms of
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: Pap testBlood testsTransvaginal
Removal of a sample of endometrial tissue—
Scraping of the inner lining of the uterus
dilation and curettage
Examination of the uterus and fallopian tubes—
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 therapyAn IUD that releases the hormone progesteroneNonsteroidal anti-inflammatory drugs (NSAIDs)Iron supplement
In some cases, surgery may be needed, such as: Dilation and curettageOperative 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.
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.
Last reviewed August 2014 by Andrea Chisholm, MD
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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