Heavy Menstrual Bleeding
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 anemia )
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:
- Pap test
- Blood tests
- Transvaginal ultrasound
- Removal of a sample of endometrial tissue— endometrial biopsy
- Scraping of the inner lining of the uterus— dilation and curettage
- Examination of the uterus and fallopian tubes— hysteroscopy
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
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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a (Menorrhagia; Hypermenorrhea)
The American Congress of Obstetricians and Gynecologists http://www.acog.org
Women's Health—US Department of Health and Human Services http://www.womenshealth.gov
The Canadian Women's Health Network http://www.cwhn.ca
The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org
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.