Menorrhagia

Every woman’s menstrual cycle is unique, and most women experience heavy or prolonged bleeding at some time during their childbearing years. On average, a woman’s menstrual flow (“getting your period”) occurs about every 28 days, with bleeding lasting from 4-7 days. However, some women suffer from severe bleeding during every cycle, sometimes lasting even a week or more. The medical term for this very heavy and long-lasting menstrual bleeding is menorrhagia; it is also sometimes referred to as hypermenorrhea.

What Causes Menorrhagia?

In some women, there is no clear cause for menorrhagia, but most often it is brought on by one of a number of conditions. The most frequent causes of menorrhagia include hormonal imbalance (most common in still developing adolescent girls who are not yet ovulating regularly and women approaching menopause), uterine fibroids (benign tumors growing inside the uterus), endometrial polyps (small, benign growths on the inner lining of the uterus), abnormal thyroid or pituitary functioning, anovulation (ovaries that are not producing or releasing eggs, resulting in hormonal imbalance), pregnancy complications (miscarriage or ectopic pregnancy), using an intrauterine device (IUD) for birth control, pelvic inflammatory disease (PID) or other infections, endometriosis, endometrial cancer or use of medications such as steroids or blood thinners.

Signs you may have Menorrhagia

It’s normal to experience heavier bleeding at some point in your menstrual cycle, but if you’re bleeding so much that you have to change your sanitary pad or tampon every hour for several consecutive hours, you might be suffering from menorrhagia. The same is true if steady bleeding continues for more than 4-7 days or if you need to double your sanitary protection (wear two pads or use a pad plus a tampon) or get up to change your protection during the night. Check your blood flow for large clots, and keep a record of the length of your menstrual period and how often you need to change sanitary pads or tampons; if over the course of 2-3 cycles you bleed heavily for more than seven days and/or are in constant, severe abdominal pain throughout your period, schedule a visit with your doctor. Menorrhagia can also result in iron deficiency anemia, the symptoms of which include tiredness, fatigue and shortness of breath.

Treatments for Menorrhagia

If excessive menstrual bleeding is severe enough to warrant a visit to the doctor, blood or pap tests, an ultrasound scan or endometrial biopsy can determine what is causing the menorrhagia and how to treat it.

Iron Supplements

Iron supplements can be taken for anemia symptoms. For relieving menstrual cramps, ibuprofen is often helpful and can be purchased in low doses without a prescription. (Do not take aspirin to alleviate menstrual pain, as aspirin can actually prolong bleeding.)

Birth Control Pills

Oral contraceptives (birth control pills) are sometimes prescribed to regulate ovulation and help reduce excessive bleeding; this is especially effective when menorrhagia is linked to a hormonal imbalance.

Surgery

If surgical treatment is required, a doctor may perform a dilation and curettage (D and C) to remove tissue from the uterine lining and reduce bleeding. An operative hysteroscopy can remove polyps or small fibroid tumors from the uterus. In more serious cases, endometrial ablation or resection may be performed, removing the lining of the uterus; these treatments will take care of menorrhagia but will also impact a woman’s ability to become pregnant.

In the most extreme cases of menorrhagia, a woman might undergo a hysterectomy, which removes the uterus; however, this procedure totally eliminates a woman’s ability to bear children and should be considered only if a medical necessity or as a last resort or after a woman has already had children or has gone through or is approaching menopause.