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Notes on Women's Health
Notes on Women's Health

Taking Control of Heavy Menstrual Bleeding

heavy menstrual bleeding

This is the fourth in a series of five blogs about abnormal uterine bleeding.

What is normal menstrual bleeding and what isn’t?

Many of our patients experience abnormally heavy bleeding during their periods. In many cases, they suspect it’s not normal, but because they’re used to menstrual bleeding every month, they think that it’s just because of how their bodies are made, and that they just have to make some lifestyle adjustments.

Many women begin to experience heavy menstrual bleeding in their 30’s or 40’s, or when menopause is getting closer. Menstrual periods vary for each woman, so it may be hard to know what’s normal and what’s abnormal bleeding. But although there is no solid definition for abnormal bleeding amounts, you may be bleeding too much if you:

  • change your pad or tampon once an hour or more throughout the day
  • get up in the middle of the night to change a pad
  • miss work, sports or hobbies because of heavy bleeding or related fatigue

If you think you are experiencing excessive menstrual bleeding, meaning it lasts longer than a week, greatly impacts your everyday life, or just seems different than normal, contact your gynecologist. Other signs that you should contact your healthcare provider include bleeding between periods, after menopause, after sex or bleeding during pregnancy.

Possible effects of heavy periods

Up to one in every five women suffer from heavy menstrual bleeding at some time in their lives. Also known as menorrhagia, heavy bleeding can interfere with your sex life and your energy levels. Many women feel like periods are taking over their lives. There are medical concerns as well: Women who bleed heavily during menstruation can experience iron deficiency, which can lead to anemia (a lack of red blood cells) and make it hard to conceive.

What causes of heavy menstrual bleeding

Menorrhagia can be caused by many different conditions, including:

  • changes in hormone levels, including certain types of birth control, thyroid problems and the approach of menopause
  • difficulties with blood clotting or other bleeding disorders
  • uterine fibroids
  • endometriosis or endometrial polyps
  • infections or sexually transmitted diseases
  • fluctuations in weight
  • a very restricted diet
  • high stress levels levels of stress
  • conditions related to pregnancy
  • uterine cancer

Diagnosing and treating menorrhagia

If you’re experiencing menorrhagia, it’s a good idea to start keeping a record of your bleeding and clotting so that you and your gynecologist can evaluate and decide on proper treatment. Your gynecologist may draw blood or take other samples and use X-rays or ultrasound imagery to rule out cancer and to help determine the cause of menorrhagia.

Depending on what’s causing the heavy bleeding, as well as factors such as your age and your plans for having children, your treatment might consist of a new or different birth control pill, the non-hormonal drug tranexamic acid, progesterone therapy, or a surgical procedure such as endometrial ablation, which removes the uterine lining. In a few cases, a hysterectomy (removal of the uterus) might be considered. Treatment for anemia might be needed as well. Just keep in mind that whether the cause of your bleeding is something simple or a more serious condition, there are many options for treatment.

Additional information

If you have any questions about abnormal uterine bleeding or menorrhagia, feel free to contact us for more information and to discuss your particular situation. More information can be found below.

Dr. John M. Garofalo, M.D.: abnormal uterine bleeding

American Congress of Obstetricians and Gynecologists: frequently asked questions on heavy menstrual bleeding

About the practice

Dr. John Garofalo, M.D., is an ob-gyn located in Fairfield County, Connecticut. He has more than 20 years of practice and surgical experience covering many facets of obstetrics and gynecology.

Laury Berkwitt, APRN, is a nurse practitioner specializing in women’s health in Fairfield County, Connecticut. Laury has a passion for providing quality women’s health care in a safe and comfortable manner by creating a trusting patient-practitioner relationship. She has been in practice for more than 10 years, caring for women of all ages.

For more information, go to www.garofaloobgyn.com. John Garofalo, MD, and Laury Berkwitt, APRN, can be reached for personal consultations by calling 203.803.1098.