Overview
Heavy menstrual periods (menorrhagia) are periods in which bleeding is heavier or lasts longer than normal. You may pass large blood clots and have to change pads or tampons often. Or your periods may last longer than 7 days.
With heavy menstrual periods (also called menorrhagia), you may:
- Pass large blood clots and soak through your pads or tampons often.
- Bleed for more than 7 days. (A normal period usually lasts 4 to 6 days.)
- Have menstrual cramps.
- Heavy periods may disrupt your life. But in most cases, they aren't a sign of a serious problem.
Still, it's a good idea to see your doctor. A doctor can suggest treatments to ease your symptoms and make sure that you don't have a serious condition.
What causes menorrhagia?
Heavy bleeding can be caused by not ovulating regularly. It can also be caused by other problems, such as fibroids (growths that aren't cancer). If you are overweight, you may be more likely to have heavy menstrual periods. But in some cases, there may not be a specific cause for your heavy periods.
How are heavy menstrual periods treated?
Your doctor may recommend hormone treatments to slow or stop your periods. If you have a fibroid, your doctor may recommend surgery or other treatments to remove the growth. Because blood loss from heavy periods can make you very tired and weak (anemic), your doctor may recommend that you take extra iron.
In most cases, heavy menstrual periods can be managed with medicines or hormone treatments. If those treatments don't help, you may need surgery to help control your bleeding.
Medicine options
Your doctor may suggest that you take a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen (such as Advil or Motrin) or naproxen (such as Aleve). Taking an NSAID can reduce bleeding and pain during your period. But NSAIDs usually don't help as much as hormone treatments.
Hormone treatments that may be prescribed include:
- Birth control pills, patch, or ring. These release two hormones, estrogen and progestin. They prevent pregnancy and also can reduce menstrual bleeding and pain.
- Progestin-only birth control, such as mini-pills, implants, and shots. These types of birth control can reduce bleeding and cramping.
- Progestin pills. These are progestin-only pills that help reduce bleeding but do not prevent pregnancy.
- Hormonal IUD. This is a birth control device that your doctor places inside your uterus. It releases a type of progestin that can reduce bleeding and cramping.
Sometimes doctors prescribe a medicine called tranexamic acid (such as Lysteda). It is not a hormone treatment. It reduces bleeding by helping blood to clot.
Surgery options
You may want to think about surgery if medicines don't help or if you have a growth in your uterus. Your choice will depend partly on whether you want to get pregnant in the future. Surgery options include:
- Hysteroscopy. This procedure is done to diagnose heavy periods. But it can also treat some problems at the same time. For example, fibroids or polyps may be removed during this procedure.
- Endometrial ablation. This procedure destroys the endometrium. This reduces or stops uterine bleeding. But it is not an option if you hope to get pregnant.
- Hysterectomy, a surgery to remove the uterus. This may be an option if heavy bleeding can't be controlled or when the cause of bleeding can't be found and treated. It ends your ability to get pregnant.
