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Heavy Menstrual Bleeding

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Heavy menstrual bleeding (also called menorrhagia) is excessive menstrual blood loss that interferes with a woman's quality of life.

Menstrual Flow
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In some cases, the cause is not known. However, many conditions have been associated with menorrhagia, such as:

Risk Factors

Factors that may increase your chances of menorrhagia include:


Symptoms of menorrhagia include:

  • Menstrual bleeding lasting more than 7 days
  • Unusually heavy bleeding (soaking through a sanitary napkin or tampon every hour)
  • Menstrual flow requiring change of sanitary protection during the night
  • Menstrual flow including large clots
  • Menstrual flow interfering with lifestyle
  • Fatigue and/or shortness of breath (symptoms of anemia)

When Should I Call My Doctor?

Call your doctor if you have symptoms of menorrhagia.


You will be asked about your symptoms and medical history. A physical examination, including a pelvic exam, will be done. Tests may include:


Treatment depends on the underlying cause of the heavy menstrual bleeding. Your doctor will work with you to create a treatment plan.


Your doctor may recommend:

  • Hormonal therapy
  • An IUD that releases the hormone progesterone
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Iron supplement

Surgical Procedures

In some cases, surgery may be needed, such as:

  • Dilation and curettage
  • Operative hysteroscopy—may be used along with other tools to remove a polyp
  • Removal of the lining of the uterus—endometrial ablation
  • Removal of the uterus—hysterectomy


There are no current guidelines to prevent heavy menstrual bleeding.

Revision Information

  • The American Congress of Obstetricians and Gynecologists

  • Office on Women's Health

  • The Canadian Women's Health Network

  • The Society of Obstetricians and Gynaecologists of Canada

  • Apgar B, Kaufman A, et al. Treatment of menorrhagia. Am Fam Physician. 2007;75(12):1813-1819.

  • 11/20/2009 DynaMed's Systematic Literature Surveillance FDA approves Lysteda to treat heavy menstrual bleeding. United States Food and Drug Administration website. Available at: Updated April 16, 2013. Accessed August 18, 2014.