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 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
When Should I Call My Doctor?
Call your doctor if you have symptoms of menorrhagia.
You will be asked 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. Treatments may include:
The doctor may advise:
- 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—endometrial ablation
Removal of the uterus—hysterectomy
There are no current guidelines to prevent heavy menstrual bleeding.
The American Congress of Obstetricians and Gynecologists
Women's Health—US Department of Health and Human Services
The Canadian Women's Health Network
The Society of Obstetricians and Gynaecologists of Canada
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.