Definition

Heavy menstrual bleeding (also called menorrhagia) is excessive menstrual blood loss that interferes with a woman’s quality of life.

Causes

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 disease
• Hormonal imbalance
• Cervical or endometrial polyp
• Ovarian cyst
• Certain medications
• Intrauterine device (IUD)

Risk Factors

Factors that may increase your chances of menorrhagia include:

• Adolescence
• Approaching menopause

Symptoms

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 anemia)

Diagnosis

Your doctor will ask 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

Treatment depends on the underlying cause of the heavy menstrual bleeding. Your doctor will work with you to create a treatment plan.

Prevention

There are no current guidelines to prevent heavy menstrual bleeding.

The American Congress of Obstetricians and Gynecologists http://www.acog.org/Patients

The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org/

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.