Menorrhagia – Patient Education Overview
Menorrhagia refers to menstrual periods with heavier bleeding than normal or periods that last for seven days or longer each month. For women with menorrhagia, every period causes so much blood loss and cramping that they can’t perform their usual daily activities. Read more in our patient education guide.
Menorrhagia is more common in the years when women first begin their periods and in the years right before menopause. Common causes of menorrhagia include hormone imbalances, dysfunction of the ovaries, abnormal growths in the uterus, inherited bleeding disorders, or certain medications. Rarely, menorrhagia may be a sign of cancer of the uterus, ovaries, or cervix.
Symptoms of menorrhagia include:
- Menstrual bleeding that soaks through one or more sanitary pads or tampons every hour for several consecutive hours
- Needing to use both a tampon and a pad to control bleeding
- Needing to get up in the night to change a pad or tampon
- Periods that last one week or longer
- Passing large blood clots in the menstrual blood
- Restricting activities due to heavy bleeding
- Signs of anemia, such as tiredness, fatigue or shortness of breath
Written by Laurie LaRusso, MS, ELSShow All
Doctors Who Treat Menorrhagia
As your menorrhagia is diagnosed, treated and managed, you may encounter the following team of doctors and specialists listed in this patient education guide.
- Gynecologist or Obstetrician/Gynecologist (OB/GYN) – A doctor who specializes in the reproductive and sexual health of women. A gynecologist or OBGYN diagnoses, treats, and monitors menstrual problems such as menorrhagia.
- Internist or Family Physician – Doctors who provide general medical care for adults. Women with menorrhagia may be monitored by both an internist or family physician and a gynecologist or OB/GYN.
- Pediatrician – A doctor who specializes in the medical care of children. Girls who are menstruating and experience menorrhagia may be monitored by both a pediatrician and a gynecologist or OB/GYN.
How to Prepare for Your Menorrhagia Doctor Visit
Having made your appointment with a healthcare provider, there are certain actions you can take to maximize the benefit of your doctor visit for menorrhagia.
- Keep notes about the dates, length and heaviness of your bleeding on a calendar.
- Keep notes about how many pads or tampons you use each day and how often you change them.
- Write down a list of the symptoms that occur during or near your period, such as breast tenderness or menstrual cramps or other symptoms that may be not seem to be related to your period.
- Write down key personal information, including any major stresses or recent life changes, such as changes in job, physical activity, or weight gain or loss.
- Make a list of any medical conditions you have and all medications, vitamins and supplements that you are taking. Include the dosage you are taking of each.
- Check with family members to find out if any relatives have been diagnosed with bleeding disorders.
Questions to Ask Your Doctor About Menorrhagia
From your initial diagnosis throughout your treatment and care, you will have questions about your condition. This patient education guide lists questions to discuss with your doctor so you can make informed decisions about menorrhagia and your care.
Question About My Diagnosis
- How can you tell what is causing my menorrhagia?
- Are there tests to determine the cause of my menorrhagia?
- Does menorrhagia put me at risk for other, more serious, medical conditions?
- Is there a chance that the heavy bleeding and cramping will resolve on its own?
Questions About My Treatment
- Will I need to see a specialist? Will insurance pay for this?
- What types of medications are used to treat menorrhagia? Are there side effects?
- Will I have to take medication for the rest of my life?
- Will other medications I take interact with my menorrhagia medications?
- Will I need to have surgery?
- Which treatment do you recommend trying first? Why?
Questions About My Lifestyle & Family
- Are there changes to my diet that would help ease my menorrhagia symptoms?
- Would certain types of exercise help ease my menorrhagia symptoms?
- Is it okay for me to have sex?
- Is it okay for me to get pregnant?
Common Tests or Labs to Diagnose Menorrhagia
The doctor will ask questions about your medical history, your menstrual cycles, and any medications you are taking, and perform a physical exam. A diagnosis of menorrhagia is made by ruling out other menstrual disorders, medical conditions or medications as possible causes or contributors to the bleeding. In addition, the following tests may be used to determine the cause of excessive menstrual bleeding.
|Test||Why Test?||What Happens?||Normal Result|
|Blood Test||To test for anemia (low iron in the blood) or for thyroid or blood-clotting disorders||Blood is drawn with a syringe, typically from the arm.||Low iron in the blood can indicate anemia resulting from excessive blood loss; abnormal levels of thyroid hormones or clotting factors can indicate the cause of menorrhagia.|
|Pap Smear||To detect infection, inflammation or changes in the cervix that may be
cancerous or lead to cancer
|While lying on your back with your feet in stirrups, an instrument is inserted through the vagina to collect a sample of tissue from the cervix.||A normal result means the cells in the sample have no abnormalities or signs of cancer.|
|Endometrial Biopsy||To test the for abnormal cells or signs of cancer in the lining of the uterus (called the endometrium)||While lying on your back with your feet in stirrups, an instrument is inserted through the vagina and cervix to collect a sample of tissue from the lining of the uterus.||A normal result means the cells in the sample have no abnormalities or signs of cancer.|
|Sonohysterogram (ultrasound)||To look for problems in the lining of the uterus, such as abnormal growths or scarring||While lying on your back, a small ultrasound device is inserted through the vagina and cervix into the uterus; after it is removed, fluid is injected into your uterus through a tube; finally an ultrasound scan of the uterus is performed by placing another ultrasound device on the abdomen.||A normal result means that there is no sign of abnormal growths or scarring inside the uterus.|
|Hysteroscopy||To look for problems in the lining of the uterus, such as abnormal growths or scarring||While you are under general or local anesthesia, a tube with a tiny light and camera on the end is inserted through the vagina and cervix into the uterus.||A normal result means there is no sign of abnormal growths or scarring inside the uterus.|
Common Medications and Treatments for Menorrhagia
The table below in this patient education guide describes the common medications used to treat menorrhagia.
|Drug Category||How it works|
|Oral Contraceptives||In addition to preventing pregnancy, oral contraceptives help regulate menstrual cycles and reduce episodes of excessive or prolonged menstrual bleeding.|
|Oral Progesterone||The hormone progesterone can help correct hormonal imbalances and reduce bleeding.|
|Hormonal Intrauterine Device (IUD)||A small device inserted inside the uterus that contains the hormone progestin, which thins the lining of the uterus to reduce bleeding and cramping.|
|Iron Supplements||Pills that increase iron levels in the blood for women with either anemia or low iron levels that are not quite low enough be anemia.|
|Nonsteroidal Anti-Inflammatory Drugs (Nsaids)||Oral drugs that reduce inflammation and can help reduce menstrual blood loss, with an added benefit of relieving painful menstrual cramps, if present.|
If medications are unable to control menorrhagia symptoms, one of the surgical procedures below may be recommended.
|Drug Category||How it works|
|Dilation And Curettage (D&C)||The doctor opens (dilates) the cervix and then scrapes or suctions tissue from the lining of uterus to reduce menstrual bleeding.|
|Operative Hysteroscopy||A tube with a tiny light and camera (called a hysteroscope) is inserted through the vagina and cervix into the uterus to aid in the surgical removal of a polyp that may be causing excessive menstrual bleeding.|