Is the medical term used to describe menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern, most women do not experience blood loss severe enough to be defined as menorrhagia.
If you have menorrhagia, you can’t do your usual activities when you have your period because you lose too much blood and have cramps. If your menstrual bleeding is so heavy that you are afraid when you have your period, talk to your doctor. There are many effective treatments for menorrhagia.
Signs and symptoms of menorrhagia may include the following:
- Soak one or more sanitary pads or tampons every hour for several consecutive hours.
- Need to use double hygienic protection to control menstrual flow
- Need to wake up during the night to change the hygienic protection
- Bleeding for more than a week
- Throwing out blood clots larger than a quarter-dollar coin
- Limiting daily activities due to heavy menstrual flow
- Symptoms of anemia, such as tiredness, fatigue, or shortness of breath
When to see a doctor
Seek medical help before your next scheduled visit if you have one:
Vaginal bleeding so heavy that it soaks at least one pad or tampon per hour for more than two hours
Bleeding between periods or irregular vaginal bleeding
Vaginal bleeding after menopause
- Fibroid Locations
- Uterine polyps
- Normal uterus and uterus with adenomyosis
In some cases, the cause of heavy menstrual bleeding is not known, but various diseases can cause menorrhagia. Some of the most common causes are:
Hormonal imbalance. In a normal menstrual cycle, the balance of the hormones estrogen and progesterone regulates the accumulation of the lining of the uterus (endometrium), which is removed during menstruation. If a hormonal imbalance occurs, the endometrium overdevelops and is eventually shed through heavy menstrual bleeding.
Hormonal imbalance can be caused by a variety of conditions, including polycystic ovary syndrome, obesity, insulin resistance, and thyroid problems.
Ovarian dysfunction. If the ovaries do not release an egg (ovulation) during a menstrual cycle (anovulation), the body does not produce the hormone progesterone as it would during a normal menstrual cycle. This causes a hormonal imbalance and can result in menorrhagia.
Uterine fibroids. These non-cancerous (benign) tumors of the uterus appear during the fertile years. Uterine fibroids can cause heavier or longer-than-normal menstrual bleeding.
Polyps. Small benign tumors in the lining of the uterus (uterine polyps) can cause heavy or prolonged menstrual bleeding.
Adenomyosis. Adenomyosis occurs when the endometrial glands integrate into the uterine muscle, often causing heavy bleeding and painful menstrual periods.
intrauterine device (IUD). Menorrhagia is a known side effect of using a nonhormonal intrauterine device as a contraceptive. Your doctor will help you plan alternative management options.
Pregnancy Complications. A single heavy late menstrual period may be due to miscarriage. Another cause of heavy bleeding during pregnancy is an unusual location of the placenta, such as a low or previous placenta.
Cancer. Uterine cancer and cervical cancer can cause heavy menstrual bleeding, especially if you are menopausal or have had an abnormal Pap in the past.
Hereditary bleeding disorders. Some bleeding disorders, such as von Willebrand’s disease, in which there is a significant deficiency or alteration of a blood clotting factor, can cause abnormal menstrual bleeding.
Medications. Certain medications, including anti-inflammatory medications, hormonal medications, such as estrogen and progesterone, and blood thinners, such as warfarin (Coumadin, Jantoven) or enoxaparin (Lovenox), may promote heavy or prolonged menstrual bleeding.
Other conditions. Other medical conditions, such as kidney and liver diseases, may be associated with menorrhagia.
Excessive or prolonged menstrual bleeding can cause other medical conditions, including:
- Anemia. Menorrhagia can cause blood loss anemia by reducing the number of circulating red blood cells. The number of circulating red blood cells is measured by hemoglobin, a protein that allows red blood cells to carry oxygen to tissues.
- Iron deficiency anemia occurs when the body tries to compensate for the loss of red blood cells by using iron stores to produce more hemoglobin, which can then carry oxygen in red blood cells. Menorrhagia can lower iron levels enough to increase the risk of iron-deficiency anemia.
- Some of the signs and symptoms include pale skin, weakness, and fatigue. Although diet is important in iron-deficiency anemia, the problem is complicated by heavy menstrual periods.
- Severe pain. In addition to heavy menstrual bleeding, you may have painful menstrual cramps (dysmenorrhea). Sometimes the cramps associated with menorrhagia are severe enough to require medical evaluation.