Menorrhagia

Menstrual bleeding is considered heavier than normal when one or more of the following conditions occur:

• Using one or more tampons or sanitary pad every hour for several hours
• The need to double up on sanitary protection to control menstrual bleeding
• Waking up in the night to change pads or tampons
• Periods of bleeding lasting more than a week
• Passing blood clots more than one day of the period
• Anemia, typically indicated by tiredness, fatigue, and shortness of breath

Treatment is based on what’s causing the problem as well as an assessment of the patient’s health. Drug therapy solutions include:

• Nonsteroidal anti-inflammatory drugs, or NSAIDs, help reduce menstrual blood flow with the added benefit of pain relief
• Oral contraceptives regulate the menstrual cycle and may reduce prolonged or excessive bleeding
• Oral progesterone may be helpful to restore hormone balance, which may stop menorrhagia
• An intrauterine device that releases progestin
• Tranexamic acid, a medication that helps decrease the blood loss
• Iron supplements may offset the symptoms or onset of anemia

Surgical treatments of menorrhagia include:

• Dilation and curettage
• Ultrasound ablation to shrink fibroids, if they’re causing the bleeding
• Endometrial ablation
• Uterine artery embolization
• Hysterectomy

When menorrhagia results from another condition, such as thyroid disease, treating the precipitating condition usually reduces menstrual blood flow. Call or schedule an appointment online.

For a woman who’s made the decision to postpone childbearing for several years, choosing long-acting reversible contraception may be the ideal option. There are two choices:

Intrauterine devices, or IUDs, have been around the longest. IUDs works two ways: by creating conditions hostile to sperm to prevent fertilization, and by preventing an egg that does become fertilized from implanting in the uterine walls IUDs can be placed and removed during short appointments.

Contraceptive implants are thin plastic rods, about the size of a matchstick. These are implanted in the upper arm, and they work in much the same way as birth control pills. The implant typically lasts up to three years. While women who are done having children may choose LARCs, permanent sterilization is also an option.