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Heavy Periods (Menorrhagia)

Heavy or prolonged menstrual periods, or menorrhagia, are the most common type of abnormal bleeding from the uterus. Periods are considered heavy if there is enough blood to soak a pad or tampon every hour for several consecutive hours.

Other symptoms of a heavy period can include:

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  • Nighttime bleeding that requires getting up to change pads or tampons
  • Passing large blood clots during menstruation
  • A period that lasts longer than seven days

In severe cases, heavy menstruation can interfere with sleep and daily activities. Blood loss from heavy periods can also lead to anemia, causing symptoms such as fatigue and shortness of breath.

Causes of Menorrhagia

There are many possible causes of heavy menstrual bleeding. They include:

  • Hormonal imbalance, particularly in estrogen and progesterone; this is most common in adolescents who recently began their periods and women who are getting close to menopause. Hormonal imbalance may also occur if there is a problem in the function of the ovaries.
  • Fibroids or noncancerous tumors of the uterus; fibroids typically occur during childbearing years.
  • Miscarriage or ectopic pregnancy -- the implantation of a fertilized egg outside the uterus, such as in the fallopian tube
  • Use of blood thinners
  • Problems with a non-hormonal intrauterine device (IUD) used for birth control 
  • Adenomyosis, a condition in which the glands from the lining of the uterus become imbedded in the muscular wall of the uterus; this is most likely to occur in middle-aged women who have had several children. 
  • Pelvic inflammatory disease (PID), an infection of the uterus, fallopian tubes, and other organs of the reproductive system
  • Uterine, ovarian, and cervical cancer; these are rare but possible causes of heavy menstrual bleeding.
  • Other medical conditions that can prevent normal blood clotting, including liver, kidney, or thyroid disease, and bleeding or platelet disorders

 

Treatments for Heavy Periods

If you are having heavy menstrual bleeding, it is important to see your doctor to determine the cause. Treatment will depend on what's causing the bleeding.

Medication treatment for menorrhagia may include one or more of the following:

  • Nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen to reduce the amount of blood loss and help with pain
  • Hormone therapy to stabilize the endometrium (lining of the uterus), regulate menstrual cycles, or correct hormonal imbalances
  • Hormone secreting IUD (Mirena)
  • Lysteda (tranexamic acid), a non-hormonal medication that promotes blood clotting

Depending on the cause of the menorrhagia and your history, your doctor may recommend one of several surgical procedures. They include:

  • D&C (dilation and curettage). D&C involves dilating the cervix and scraping the lining of the uterus.
  • Hysteroscopy. This is a procedure in which a long, thin scope is inserted into the uterus through the vagina and cervix. It allows the doctor to see and remove fibroids (a type of procedure called myomectomy) or other growths that may cause bleeding.
  • Endometrial resection or ablation. In this procedure, the lining of the uterus is removed or destroyed. After this procedure is done, it will not be possible to have a baby.
  • Hysterectomy. This is the surgical removal of the uterus and cervix. This procedure also makes it impossible to have a baby.

The loss of blood through heavy periods can lead to iron-deficiency anemia. Your doctor may prescribe or recommend an iron supplement until bleeding is controlled.

WebMD Medical Reference

Reviewed by David T. Derrer, MD on August 27, 2013
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