What’s heavy menstrual bleeding?

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Heavy menstrual bleeding or menorrhagia refers to prolonged or excessive menstrual bleeding, or sometimes both. Frequently, heavy menstrual bleeding is seen in premenopausal women, but it can occur at any age. It is not uncommon for a woman to experience a few episodes of heavy menstrual bleeding. Repeated incidences of menorrhagia, however, should be medically evaluated to rule out abnormal gynecological conditions.

Typical causes of heavy menstrual bleeding include uterine fibroids, which are benign uterine tumors. Fibroid tumors can cause excessive or prolonged bleeding and may be accompanied by abdominal cramps and back pain. Additionally, hormonal imbalances can cause the lining of the uterus to thicken. When this occurs, the shedding of the lining can cause heavy menstrual bleeding. Sometimes uterine polyps can cause abnormal menstrual bleeding. These most often occur due to high hormone levels.

Frequently, medications can contribute to heavy menstrual bleeding. Medications such as aspirin or blood thinners can thin the blood, contributing to heavy menstrual flow. Heavy bleeding can also signal a pregnancy complication. Rarely, ectopic pregnancies can cause heavy menstrual bleeding. Also, some bleeding disorders that don’t allow blood to clot properly can promote menorrhagia.

It is very important to get a physical exam including a Pap smear and pelvic exam to determine the cause of heavy menstrual bleeding. Sometimes excessive blood loss during your period can be related to uterine, cervical or ovarian cancer. The blood loss can sometimes be so great that the patient can become severely anemic. When severe anemia occurs, the patient may experience extreme tiredness, dizziness, and heart palpitations.

Typically, during a physical exam, your doctor will ask about past and present illnesses, medications, and family history. In addition, the patient may undergo further tests, such as blood tests and thyroid tests. A diagnosis of hypothyroidism can often cause heavy bleeding during menstrual periods. In addition to blood tests, other diagnostic tests may include a pelvic ultrasound and an endometrial biopsy.

Common treatments for heavy and abnormal menstrual periods can include hormones and iron supplements. A dilation and curettage or D and C, in which tissue is removed from the uterus, can reduce heavy bleeding. Sometimes, endometrial ablation can be done to ablate the lining of the uterus and reduce blood flow. In extreme cases, the doctor may recommend a hysterectomy which will cause the patient to undergo surgical menopause, resulting in a complete stop of menstrual periods.

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