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Last Updated: October 26, 2017

Menorrhagia

Overview

Menorrhagia is defined as heavy periods, or excessive uterine bleeding, lasting over seven days. The classic definition for menorrhagia is the loss of greater than 80 mL of blood per cycle, but this metric is no longer used in the clinic due to the difficulty of obtaining accurate measurements from patients. Instead, physicians use the frequency of tampon change to diagnose the disease. This condition disrupts routine activities and can be very emotionally stressful for the women involved.

The most common complication associated with menorrhagia is anemia - a lower than normal red blood cell count, which leaves the body feeling weak and tired. In some cases women also experience severe menstrual cramps that require medical intervention.

Menorrhagia is treatable with drugs or surgical therapies that include a hysterectomy (complete removal of the uterus). The choice of treatment depends on the symptoms, patient’s age, other health factors and intent to have children. Menorrhagia affects 30% of reproductive-age women in the United States. 30% of hysterectomies performed before the age of 60 are due to menorrhagia.

Illustration showing cross-section of uterus

Causes and Risk Factors

The exact cause of menorrhagia is not known, but an imbalance in the amounts of female hormones progesterone and estrogen plays an important role. The following are known causes and risk factors for menorrhagia:

Symptoms

The following symptoms may be indicative of menorrhagia.

Diagnosis

The phrase “heavy bleeding” is open to interpretation by patients and is not a reliable metric for diagnosing menorrhagia. Most women with this condition experience bleeding that lasts more than 7 days (4-5 days is typical), and lose greater than 2-3 tablespoons of blood. The need to change sanitary protection almost every hour is a key diagnostic sign of menorrhagia. Other tests used to diagnose menorrhagia include:

Treatment

A range of treatments are available to lessen the symptoms of menorrhagia or cure it. The choice depends on the patient’s age, medical history, ideal outcome and future plans to have children. Surgery is generally reserved for patients who do not respond to drug therapies.

Prevention

Currently there is no way to prevent most causes of menorrhagia. The likelihood of developing pelvic inflammatory disease, which is a known risk factor for menorrhagia, can be lowered by avoiding unsafe sexual intercourse and other activities that cause infection.

Sources

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Authored by: Tina Shahian, PhD