Menorrhagia is excessive and/or prolonged menstrual bleeding at regular intervals. Although about 30% of women have heavy periods, only 10% of women have menorrhagia. On average, menstrual flow occurs every 28 days and lasts for five days. Four tablespoons to one cup (60 to 250 milliliters) of blood is lost during this time.
Your healthcare provider will ask about your symptoms and medical history. A physical examination including pelvic exam will be done as part of the evaluation. Tests may include:
Hysteroscopy—examination of the cervix and fallopian tubes using a telescope-like viewing device
Treatment
Treatment of menorrhagia will depend on the underlying cause. Women who experience persistent excessive bleeding should discuss with their healthcare provider whether to take iron supplements to prevent
anemia.
If there is no medical disorder causing your menorrhagia, your doctor may prescribe the following:
Medications
These may include:
Hormone therapy
(estrogen and/or progestogen hormones by mouth, skin application, vaginal application, or injection)
An IUD that releases a progestogenic drug (Mirena)
Nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and mefenamic acid (Ponstel, Ponstan)
Surgical Procedures
Procedures may include:
Dilation and curettage (D&C)
Operative hysteroscopy—A long, thin instrument is inserted into the uterus that can aid in removal of a polyp or fibroid.
Endometrial ablation or resection—The surgical removal of the lining of the uterus using heat, microwave, or surgical tools. After this procedure, you will not be able to carry a pregnancy.
Hysterectomy
—The surgical removal of the uterus. After this procedure, you will not be able to carry a pregnancy. If the ovaries are also removed, early menopause will follow.
Your age, overall health, and medical history should be considered when choosing treatment. Discuss with your doctor your plans for having children.
Prevention
For most women there are no specific steps for prevention. However, if your menorrhagia is caused by a medication, you may prevent the condition by discontinuing use of this medicine.
Menstrual discomfort is better treated with pain relievers, such as Motrin and Advil.
RESOURCES:
The American College of Obstetricians and Gynecologists http://www.acog.org
The National Women’s Health Information Center http://www.4woman.gov
CANADIAN RESOURCES:
The Canadian Women's Health Network http://www.cwhn.ca/indexeng.html
The Society of Obstetricians and Gynaecologists of Canada http://sogc.medical.org/
References:
Harvard Guide to Women’s Health
. Harvard University Press; 1996.
Mayo Foundation for Medical Education and Research website. Available at:
http://www.mayo.edu/
. Accessed October 13, 2005.
US National Library of Medicine, National Institutes of Health website. Available at:
http://www.nlm.nih.gov/
. Accessed October 13, 2005.
University of Utah Health Sciences Center. Available at:
http://www.med.utah.edu/healthinfo/adult/women/menor.htm
.
Accessed October 13, 2005.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
