Know the Signs of Heavy Menstrual Bleeding and Your Treatment Options

If you dread your period because you have such heavy bleeding, talk with your doctor.

Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding during the menstrual cycle. With menorrhagia, you can't maintain your usual activities when you have your period because you have so much blood loss and cramping. If you dread your period because you have such heavy bleeding, talk with your doctor. There are many effective treatments for menorrhagia.

Your heavy menstrual bleeding during the menstrual cycle may require treatment if you have any of the following:

• Soaking through one or more pads/tampons every hour for several consecutive hours
• Needing to “double up” on pads/tampons to control your menstrual flow
• Needing to wake up to change pad/tampon during the night
• Bleeding for longer than a week
• Passing blood clots larger than a quarter
• Restricting daily activities due to heavy menstrual flow
• Symptoms of anemia, such as tiredness, fatigue, or shortness of breath

When you see your doctor, we will review how long and how much you’re bleeding and try to understand why you may be bleeding heavily during your menstrual cycle. We will perform a pelvic exam. This will confirm that the bleeding is from the uterus and not from another site. We will look for any lesions, examine the cervix, and feel the size and shape of the uterus.

We may order swabs for infection, a pap smear, and/or blood work. We will likely order an ultrasound to take a closer look at the uterus. You may need a biopsy of the lining of the uterus to rule out endometrial cancer or abnormal endometrial growths. Risks for endometrial cancer include obesity, unpredictable ovulation, history of breast cancer, tamoxifen use or a family history of breast cancer or colon cancer.

The good news is that there are many treatment options for heavy menstrual bleeding.

• Nonsteroidal anti-inflammatory drugs (NSAIDs; eg, ibuprofen, naproxen sodium)
• Tranexamic acid
• Birth control pills
• Progestin pills
• Progestin injection, implant, or intrauterine device (IUD)
• Surgery to remove abnormal uterine structures (eg, fibroids, polyps)
• Endometrial ablation
• Uterine artery embolization
• Hysterectomy

No one should have to suffer through an unbearable menstrual cycle. If you are struggling with your heavy periods, I recommended making an appointment to discuss with your doctor.

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References:

Kaunitz, A. M. (n.d.). Patient education: Abnormal uterine bleeding (Beyond the Basics). UpToDate. Retrieved March 17, 2023, from https://www.uptodate.com/contents/abnormal-uterine-bleeding-beyond-the-basics? search=aub&topicRef=3263&source=see_link#H20

Mayo Foundation for Medical Education and Research. (2022, June 25). Menorrhagia (heavy menstrual bleeding). Mayo Clinic. Retrieved March 17, 2023, from https://www.mayoclinic.org/diseases-conditions/menorrhagia/diagnosis-treatment/d rc-20352834