Menorrhagia (heavy menstrual bleeding) is a common disorder in women. It refers to bleeding lasting longer than 7 days that can be heavy at times.

What is menorrhagia?

Menorrhagia or heavy bleeding is a common disorder in women. Menorrhagia is the medical term for menstrual bleeding lasting for longer than 7 days. About 1 in every 20 women has menorrhagia.

Some of the bleeding can be very heavy, meaning you would change your tampon or pad after less than 2 hours. It can also mean you pass clots the size of a quarter or even larger.

Heavy bleeding can lead to anemia if not treated. Also, the heavy bleeding can affect sleep, cause lower abdominal pain and make enjoyable activities a burden.

If you are experiencing weakness and a disruption to everyday life due to heavy bleeding, you should ask your doctor for treatment options.

What are the signs and symptoms of menorrhagia?

Signs of menorrhagia include:

• Soaking 1 or more tampons or pads every hour for many consecutive hours
• Doubling up on pads
• Changing pads or tampons during the night
• Long-lasting menstrual periods (longer than 7 days)
• Blood clots the size of a quarter or larger
• Bleeding that is keeping you from doing normal activities
• Constant pain in lower part of stomach
• Lacking energy
• Shortness of breath

How is heavy bleeding diagnosed?

Menorrhagia is diagnosed by your doctor through a series of questions about your medical history and menstrual cycles. Usually for women with menorrhagia bleeding lasts for more than 7 days and more blood is lost (80 milliliters compared to 60 milliliters).

Your doctor may ask for information about:

• Your age when you got your first period
• Length of your menstrual cycle
• Number of days your period lasts
• Number of days your period is heavy
• Quality of life during your period
• Family members with a history of heavy menstrual bleeding
• Stress you are facing
• Weight problems
• Current medications

Physical tests or exams done to diagnose menorrhagia may include:

• Pelvic exam
• Blood test to check thyroid, check for anemia and how the blood clots
• Pap test to check cells from cervix for changes
• Endometrial biopsy to check uterine tissue for cancer or abnormalities
• Ultrasound to check function of blood vessels, tissues and organs

Sometimes additional tests are still required to understand the cause of bleeding, including:

• Sonohysterogram to check for problems in the lining of the uterus
• Hysteroscopy to check for polyps, fibroids or other problems
• Dilation and curettage (“D&C”). This test can also treat the cause of the bleeding. During this test, the lining of the uterus is scraped and examined under sedation.

How is menorrhagia treated?

Treatment for menorrhagia depends on how serious the bleeding is, the cause of the bleeding, your health, age, and medical history. Also, treatment depends on your response to certain medicines and your wants and needs. You may not want to have a period at all, or just want to reduce the amount of bleeding. In addition, your decision to get pregnant or not will affect what treatment you choose. If you do not have anemia, you can choose to not have treatment.