Menorrhagia (Heavy Period)

What Is Menorrhagia?

Menorrhagia is the medical term for unusually heavy or long menstrual periods. Many women have heavy flow days and cramps when they have their period. But menorrhagia is not common.

With menorrhagia, your flow is so heavy that you’ll need to change your tampon or pad every hour for at least an entire day. You also have cramps so severe that they stop you from doing your usual activities.

Heavy periods are sometimes caused by subtle health problems, and they can lead to other health issues. If you soak through a pad or tampon every hour or so on a regular basis, talk with your doctor. They may be able to help.

Menorrhagia Symptoms

Some women have heavy periods all the time, from their very first menstrual flow. For others, they start after years or decades of typical periods.

It’s always a good idea to talk with your doctor about your heavy periods, especially if the problem is new for you. It could lead to anemia (low levels of red blood cells), which can make you feel weak, tired, or out of breath.

Women who have menorrhagia may have to:

• Change pads or tampons at least once an hour for a day or more
• Change pads in the middle of the night
• Wear two pads at a time to manage heavy flow

They may also:

• Skip things they like doing because of painful cramps
• Pass blood clots that are the size of quarters
• Have periods that last longer than 7 days
• Feel tired or short of breath
• Bleed between periods
• Bleed after menopause

Menorrhagia Causes and Risk Factors

Common causes of heavy periods include:

• Hormone problems. Every month, a lining builds up inside your uterus (womb), which you shed during your period. If your hormone levels aren’t balanced, your body can make the lining too thick, which leads to heavy bleeding when you shed the thicker lining. If you don’t ovulate (release an egg from an ovary), this can throw off the hormone balance in your body, too, leading to a thicker lining and a heavier period.
• Growths in the uterus (womb). Polyps are growths within the lining of your uterus. Fibroids are benign (non-cancerous) tumors that grow within your uterus. Both can make your periods much heavier or make them last longer than they should.
• Certain IUDs. Many women use a small intrauterine device (IUD) for birth control. If your IUD doesn’t have hormones, it may make your periods heavier.
• Problems related to pregnancy. In rare cases, after sperm and egg meet, the growing ball of cells implants itself outside the uterus instead of inside. This is called an ectopic pregnancy. It can’t be a viable pregnancy, and it may cause serious health problems, such as heavy bleeding, which you may mistake for a heavy period. A miscarriage, which is when a baby dies in the womb, can also be the cause of heavy bleeding.
• Some female cancers. Rarely, cancer of the uterus, cervix, or ovaries may cause excess bleeding in some women, which may appear to be a heavy period.
• Bleeding disorders. They’re not common, but bleeding disorders -- which run in families -- make it hard for someone to stop bleeding when they’ve been cut. They can also make a woman’s period heavier and make it last longer.
• Certain medications.Blood thinners or drugs that fight inflammation may cause heavy periods.
• Other health problems including: EndometriosisThyroid problemsPelvic inflammatory disease (PID)Kidney diseaseLiver disease

• Endometriosis
• Thyroid problems
• Pelvic inflammatory disease (PID)
• Kidney disease
• Liver disease

Menorrhagia Diagnosis

Your doctor will ask about your health history and ask you to describe your symptoms. They’ll do a physical exam and may need to order tests, like an ultrasound, Pap test, or blood tests. They may also take a sample of the tissue that’s lining your uterus.

Menorrhagia Treatment

Your doctor may be able to treat your heavy periods with these methods:

• Birth control. Taking birth control pills can alter the balance of hormones in your body, which can put an end to heavy periods. Getting an IUD that gives off hormones is another choice that can help lighten your periods.
• Certain drugs. Your doctor may prescribe medications to reduce the flow of your heavy periods. You may need to take the medication only when you have your period.
• Surgery. If your doctor finds polyps or fibroids, you can have them shrunk or removed. This may stop the heavy bleeding.
• Removing the lining of your uterus. There are a few ways that doctors can do this. The simplest procedure, called dilation and curettage (D&C), removes only the outermost layer of the lining of your uterus. It often stops heavy periods, but some women need to get this done more than once.
• Other procedures such as endometrial ablation and endometrial resection permanently remove or destroy the lining of the uterus. Women have much lighter periods or no periods afterward. Doctors advise women not to get pregnant after endometrial ablation or resection. You’ll still need to use birth control, because these treatments aren’t a form of contraception.
• Hysterectomy. In severe cases, you may need this surgery, which will remove your uterus. You won’t have your period anymore, but you also won’t be able to get pregnant.

Menorrhagia Complications

The bleeding of menorrhagia can lead to other problems including:

• Blood loss anemia
• Iron deficiency
• Pale skin
• Weakness
• Fatigue
• Severe pain

If you have complications, talk to your doctor about what might help control your menorrhagia and related symptoms.

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