The duration and severity of menstrual bleeding varies from
woman to woman. It’s known as menorrhagia if a woman’s menstrual period is
excessively heavy, prolonged, or irregular.
Symptoms of menorrhagia include a menstrual period that
lasts longer than seven days, and bleeding is so heavy that you must change
your tampon or pad more than once per hour. You should see your doctor if you
have excessively heavy or prolonged menstrual periods that interfere with your
Excessive bleeding can cause anemia, or iron deficiency, and
may signal an underlying medical condition. In most cases, a doctor can
successfully treat abnormal periods.
What Causes Heavy or Irregular Menstrual Periods?
Heavy or irregular periods can be due to a variety of
Some anti-inflammatory drugs, anticoagulants, or hormone
medications can affect menstrual bleeding.
Heavy bleeding can be a side effect of intrauterine devices
used for birth control.
The hormones estrogen and progesterone regulate the buildup
of the lining of the uterus. An excess of these hormones can cause heavy
bleeding. Hormone imbalances are most common among girls who began menstruating
in the past year and a half. They’re also common in women who are getting close
inflammatory disease (PID) and other infections can cause irregular
periods, as can endometriosis.
This is a condition in which tissue that lines the inside of the uterus begins
to grow elsewhere inside the body. This can cause heavy bleeding, as well as
Inherited Blood Disorder
Heavy menstrual bleeding can also be due to some inherited
blood disorders that affect clotting.
Benign Growths or Cancers
Cervical, ovarian, or uterine cancer can all cause heavy
bleeding, but these conditions are not common. Benign, or noncancerous, tumors
in the uterus can cause heavy bleeding or long periods. Benign growths in the uterine lining (endometrium) can cause
a heavy or prolonged period. These growths are known as polyps, when the growth
is made up of endometrial tissue, or fibroids, when the growth is made up of
Other Possible Causes
Lack of ovulation, or anovulation, results in a lack of the
hormone progesterone, causing heavy periods.
When glands from the uterine lining embed in uterine muscle,
heavy bleeding can occur. This is known as adenomyosis.
You should contact your doctor if you bleed during
pregnancy. Normal pregnancy interrupts menstruation. Some spotting during
pregnancy, especially during the first trimester, is often nothing to worry
about. Seek immediate medical attention if you bleed heavily during pregnancy.
It can be a sign that the fertilized egg implanted in the fallopian tube rather
than the uterus, which is called an ectopic pregnancy. It can also indicate a
miscarriage. Your doctor will be able to help you figure out what’s causing any
bleeding during pregnancy.
What Are the Symptoms of Heavy or Irregular Periods?
The length of the menstrual cycle and amount of blood flow
is unique to each woman. However, most women have a cycle that ranges from 24
to 34 days. Blood flow averages about four or five days, with a blood loss of
about 40 cc (3 tablespoons). It’s important to remember that these are just
averages, and that your “normal” may fall outside of these ranges.
A blood loss of 80 cc (5 tablespoons) or more is an
abnormally heavy flow. Signs that your flow may be abnormally heavy include
soaking through more than one tampon or sanitary pad in an hour, for several
hours at a time. You may need to double up on sanitary pads, or use both a
tampon and a pad. An abnormally heavy flow may cause you to wake up during the
night because you need to change protection. You may not be able or willing to
participate in your normal activities because your flow is too heavy. Sometimes,
an abnormally heavy flow will contain large blood clots, or last more than a
week. Also, an abnormally heavy flow can cause you to experience the following
symptoms, which may be an indication of anemia:
- pale skin
- shortness of breath
While every woman’s cycle is different, irregularities such
as bleeding mid-cycle or bleeding after intercourse are abnormal symptoms.
When Should I Seek Medical Care?
You should see your gynecologist once a year for a checkup.
However, you should make an appointment right away if you have bleeding or
spotting in the following circumstances:
- between periods
- after sex
- while pregnant
- after menopause
Other indicators that you should consult your doctor include
- if your periods consistently last for more than
- if you require more than one tampon or sanitary
pad in an hour, for several hours in a row
- severe pain
- abnormal discharge or odor
- unexplained weight gain or loss
- unusual hair growth
- new acne
- nipple discharge
Keep track of your menstrual cycles, including how long your
blood flow lasts, and how many tampons or sanitary pads you use during each
cycle. This information will be helpful at your gynecological appointment.
Avoid products that contain aspirin because they may
How Are Heavy or Irregular Menstrual Periods Diagnosed?
If you have abnormal menstrual periods, your doctor will
probably begin with a pelvic examination. They will take your medical history,
and you should list all the medications and supplements you’re taking.
Depending on your specific symptoms, diagnostic testing may
This test is to check for various infections or cancerous
Blood tests will be used to check for anemia, blood-clotting
problems, and thyroid function.
A pelvic ultrasound will produce images of your uterus,
ovaries, and pelvis.
If your doctor wants to evaluate possible issues with your
uterus, they may order an endometrial biopsy,
in which a sample of your uterine tissue is taken so it can be analyzed. They
may also use a diagnostic hysteroscopy to view the inside of your uterus. For a
hysteroscopy, your doctor will use a lighted tube to view the uterus and remove
They may also use a sonohysterogram, an ultrasound that
involves the injection of fluid into your uterus to help make an image of your
uterine cavity. Your doctor will then be able to look for polyps or fibroids.
Your doctor may request a pregnancy test.
What Are the Treatment Options for Heavy or Irregular Menstrual Periods?
Treatment will depend on your overall health, the reason for
your menstrual abnormalities, and your reproductive history and future plans. Your
doctor will also need to address any underlying medical conditions, such as
thyroid dysfunction. Treatments may include the following.
Possible medication treatments your doctor may suggest
- Nonsteroidal anti-inflammatory drugs (NSAIIDS),
such as ibuprofen
can reduce mild blood loss.
- Iron supplements can treat anemia.
- Hormone replacement injections can treat hormonal
- Oral contraceptives can regulate your cycle and
You can work with your doctor to find alternatives if your
irregularities are due to medications you are already taking.
Dilation and curettage, also known as D&C, is a
procedure in which the doctor dilates your cervix and scrapes tissue from the
lining of your uterus. This is a fairly common procedure and generally cuts
down on menstrual bleeding.
Surgery is the common treatment for cancerous tumors.
Surgery is also an option to treat fibroids, but it’s not always necessary. Removal
of polyps can occur using a hysteroscopy.
Endometrial ablation is a procedure used in women who have
had no success with medications to control heavy bleeding and related symptoms.
In this procedure, the doctor will destroy the uterine lining, leaving little
or no menstrual flow. Endometrial resection removes the uterine lining. This
procedure significantly decreases your chances of a future pregnancy, so women
who plan on having children should discuss and consider other treatment
Hysterectomy is the surgical removal of the uterus and
cervix. This may be the preferred treatment for those with cancers or fibroids.
It can also treat endometriosis that hasn’t responded to other less invasive
forms of treatment. A hysterectomy will end your ability to bear children. Your
doctor will also remove your ovaries, if necessary. This results in premature
What Are the Complications Associated with Heavy or Irregular Menstrual
Heavy blood flow isn’t always a sign that something is
wrong. However, excessive loss of blood can deplete the body’s supply of iron
and cause anemia. A mild case of anemia can cause fatigue and weakness. A more
severe case can result in the following symptoms:
- shortness of breath
- rapid heart rate
A very heavy flow can also cause painful cramping, or
dysmenorrhea, which sometimes requires medication.