Comprehensive Details About
Heavy Menstrual Bleeding
Menorrhagia is heavy or prolonged menstrual bleeding. Many women have this type of abnormal uterine bleeding. It can be related to a number of conditions including problems with the uterus, hormone problems, or other conditions.
Menorrhagia is menstrual bleeding that lasts more than 7 days. It can also be bleeding that is very heavy. How do you know if you have heavy bleeding? If you need to change your tampon or pad after less than 2 hours or you pass clots the size of a quarter or larger, that is heavy bleeding. If you have this type of bleeding, you should see a doctor.
Untreated heavy or prolonged bleeding can stop you from living your life to the fullest. It also can cause anemia. Anemia is a common blood problem that can leave you feeling tired or weak. If you have a bleeding problem, it could lead to other health problems. Sometimes treatments, such as dilation and curettage (D&C) or a hysterectomy, might be done when these procedures could have been avoided.
What Causes Heavy Menstrual Bleeding?
It’s normal to experience some heavy flow days during your monthly period. But your bleeding shouldn’t be so severe that it starts lowering your quality of life.
Possible causes fall into the following three areas:
- Uterine-related problems
- Growths or tumors of the uterus that are not cancer; these can be called uterine fibroids or polyps.
- Cancer of the uterus or cervix.
- Certain types of birth control—for example, an intrauterine device (IUD).
- Problems related to pregnancy, such as a miscarriage or ectopic pregnancy, can cause abnormal bleeding. A miscarriage is when an unborn baby (also called a fetus) dies in the uterus. An ectopic pregnancy is when a baby starts to grow outside the womb (uterus), which is not safe.
- Hormone-related problems
- Other illnesses or disorders
- Bleeding-related disorders, such as von Willebrand disease (VWD) or platelet function disorder.
- Nonbleeding-related disorders such as liver, kidney, or thyroid disease; pelvic inflammatory disease; and cancer.
In addition, certain drugs, such as aspirin, can cause increased bleeding. Doctors have not been able to find the cause in half of all women who have this problem. If you have bleeding such as this, and your gynecologist has not found any problems during your routine visit, you should be tested for a bleeding disorder.
When Should I See a Doctor for Heavy Menstrual Bleeding?
The dedicated team of physicians at VERITAS OBGYN wants to evaluate you if your heavy menstrual bleeding lowers your quality of life. It’s especially important to schedule an evaluation if your abnormal bleeding is:
- Vaginal bleeding so heavy it soaks at least one pad or tampon an hour for more than two hours
- Bleeding between periods or irregular vaginal bleeding
- Any vaginal bleeding after menopause
Can I Get Treatment for Heavy Menstrual Bleeding?
The type of treatment you get will depend on the cause of your bleeding and how serious it is. Your doctor also will look at things such as your age, general health, and medical history; how well you respond to certain medicines, procedures, or therapies; and your wants and needs. For example, some women do not want to have a period, some want to know when they can usually expect to have their period, and some want just to reduce the amount of bleeding. Some women want to make sure they can still have children in the future. Others want to lessen the pain more than they want to reduce the amount of bleeding. Some treatments are ongoing and others are done one time. You should discuss all of your options with your doctor to decide which is best for you. Following is a list of the more common treatments.
Drug Therapy
- Iron supplements. To get more iron into your blood to help it carry oxygen if you show signs of anemia.
- Ibuprofen (Advil). To help reduce pain, menstrual cramps, and the amount of bleeding. In some women, NSAIDS can increase the risk of bleeding.
- Birth control pills. To help make periods more regular and reduce the amount of bleeding.
- Intrauterine contraception (IUC). To help make periods more regular and reduce the amount of bleeding through drug-releasing devices placed into the uterus.
- Hormone therapy (drugs that contain estrogen and/or progesterone). To reduce the amount of bleeding.
- Desmopressin Nasal Spray (Stimate®). To stop bleeding in people who have certain bleeding disorders, such as von Willebrand disease and mild hemophilia, by releasing a clotting protein or “factor”, stored in the lining of the blood vessels that helps the blood to clot and temporarily increasing the level of these proteins in the blood.
- Antifibrinolytic medicines (tranexamic acid, aminocaproic acid). To reduce the amount of bleeding by stopping a clot from breaking down once it has formed.
Surgical Treatment
- Dilation and Curettage (D&C). A procedure in which the top layer of the uterus lining is removed to reduce menstrual bleeding. This procedure might need to be repeated over time.
- Operative hysteroscopy. A surgical procedure, using a special tool to view the inside of the uterus, that can be used to help remove polyps and fibroids, correct abnormalities of the uterus, and remove the lining of the uterus to manage heavy menstrual flow.
- Endometrial ablation or resection. Two types of surgical procedures using different techniques in which all or part of the lining of the uterus is removed to control menstrual bleeding. While some patients will stop having menstrual periods altogether, others may continue to have periods but the menstrual flow will be lighter than before. Although the procedures do not remove the uterus, they will prevent women from having children in the future.
- Hysterectomy. A major operation requiring hospitalization that involves surgically removing the entire uterus. After having this procedure, a woman can no longer become pregnant and will stop having her period.
VERITAS OBGYN practitioners specialize in minimally invasive surgery, which helps you have a faster recovery if you do need surgical repairs.
Our Specialists
Virginia Elizabeth Mclean, MD, FACOG
Dr. Virginia McLean, MD is an Obstetrics & Gynecology Specialist in New York, NY. Her office accepts telehealth appointments.
Dr. Mclean graduated from the Medical University of South Carolina College of Medicine in 2014. She works in Port Jefferson Station, NY and 8 other locations and specializes in Obstetrics & Gynecology.
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