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If you bleed a lot during your menstrual cycle, you're not alone. Many women do. For some women, having heavy menstrual periods (also called menorrhagia) means passing large blood clots and changing sanitary pads and tampons often.
Several things can cause heavy periods. These may include:
Sometimes a cause for your bleeding can't be found.
In most cases, having heavy periods isn't serious. But it can affect your daily activities. In rare cases, heavy periods may mean that you have a more serious problem, such as an infection, an unknown pregnancy, or cancer.
When you have heavy periods, you may pass large blood clots and soak through your usual pads or tampons. You may also have periods that last longer than 7 days.
When you lose a lot of blood during your period, your iron levels can drop. This can cause anemia. Anemia can make you feel tired, weak, and short of breath.
Your doctor will ask about your symptoms and menstrual periods. You'll have a pelvic exam. To get a closer look, your doctor may also do an ultrasound or another type of test that shows the lining of your uterus. Sometimes a tiny sample (biopsy) of tissue is taken from your uterus to look for infection and abnormal cell changes.
Your doctor may also do blood tests to check for anemia or other problems.
Your doctor may recommend medicine or hormone treatments to slow or stop your periods. If these treatments don't help, you may need surgery to help control your menstrual bleeding.
If a growth, such as a polyp or fibroid, is causing your heavy periods, your doctor may recommend surgery or other treatments to remove the growth. This can help reduce or stop heavy bleeding.
Because blood loss from heavy periods can make you feel very tired and weak (anemic), your doctor may recommend that you take extra iron.
Learning about heavy menstrual periods:
When you have heavy periods, you may:
Feel tired, weak, and short of breath. This can be a sign of anemia.
Call your doctor now or seek immediate medical care if:
Watch closely for changes in your health, and be sure to contact your doctor if:
Your doctor will first try to rule out certain causes for your heavy menstrual periods, such as a miscarriage or a growth in your uterus.
Your doctor will ask how often, how long, and how much you have been bleeding. You'll have a pelvic exam. During the exam, your doctor will check for signs of disease, infection, and abnormal growths.
Based on the results of your pelvic exam, your doctor may also want to do:
Your doctor may also order blood tests to check for anemia. When you lose a lot of blood during your period, your iron levels may drop. This can make you feel tired, weak, and short of breath.
Blood tests may also be done to check to see if you have a blood clotting disorder or problems with your thyroid gland or pituitary gland.
In most cases, heavy menstrual periods can be managed with:
But if these treatments don't work, surgery may be needed to control your bleeding.
If you plan to become pregnant in the future, or if you're nearing the time when your periods will stop (menopause), you may want to try medicine first.
Hormone treatments that are used to help control heavy bleeding include:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as over-the-counter ibuprofen (Advil and Motrin, for example), also can help. They lower prostaglandins, which cause menstrual pain, and they reduce bleeding during your period.
Because blood loss from heavy menstrual periods can make you feel very tired and weak (anemic), your doctor may want you to take extra iron.
A medicine called tranexamic acid (such as Lysteda) is sometimes used for women who have bleeding that is heavier than normal. This medicine isn't a hormone. It prevents bleeding by helping blood to clot. Talk with your doctor to find out if this option is right for you.
If medicine doesn't help, or if you have a growth in your uterus (such as a polyp or fibroid), you may need surgery or another procedure to help control your menstrual bleeding.
The following procedures are used to treat heavy menstrual periods:
If heavy menstrual periods are affecting your daily life, you're no doubt looking for relief. Here are some things you can do on your own to ease your symptoms:
Lobo RA (2007). Abnormal uterine bleeding: Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In VL Katz et al., eds., Comprehensive Gynecology, 5th ed., pp. 915–931. Philadelphia: Mosby Elsevier.
August 7, 2012
Sarah Marshall, MD - Family Medicine & Kirtly Jones, MD - Obstetrics and Gynecology
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