Approximately one in five women of reproductive age struggle with a condition known as menorraghia, the medical term for abnormally heavy or prolonged bleeding. Most women have a heavy period occasionally, but for women with menorraghia, the heavy bleeding occurs regularly and is often accompanied by extreme fatigue and intense pain that interferes with daily life. Some signs and symptoms of menorraghia include:
- Periods that last longer than one week
- Menstrual flow that soaks through one or more tampons or napkins every hour for several consecutive hours
- The need to “double up” on sanitary protection or rise during the night to change your pad and/or tampon
- Menstrual flow that includes large blood clots, particularly if it lasts for more than one day
- Symptoms of anemia, such as fatigue or shortness of breath
Heavy periods may be caused by hormone imbalances, fibroids, polyps, medications such as anti-inflammatories or anti-coagulants, and, in some cases, infection or more serious conditions, including certain types of cancer. Sometimes there is no known cause. Menorrhagia due to hormone imbalances is most often seen in adolescent girls who have just begun menstruating or older women who are approaching menopause.
Fortunately, menorraghia is a treatable condition. Although treatment recommendations vary based on the root cause, the age of the woman, and other factors, some of the most common treatment options include:
- Oral contraceptives
- Intrauterine device (IUD)
- Endometrial ablation
Oral contraceptives are usually the first treatment option recommended, because they are the least invasive and may be withdrawn at any time with no long-term impact on fertility, although heavy periods are likely to return. For some women, the potential side effects of oral contraceptives lead them to seek out other alternatives.
The Mirena IUD is a small device that is placed into the uterus through the cervix. The Mirena IUD releases a type of progestin which makes the uterine lining thin and decreases menstrual blood flow and cramping. The procedure takes about ten minutes in our office and lasts for up to five years, although it can be removed at any time. Similar to oral contraceptives, heavy periods will likely return after the removal of the IUD.
Endometrial ablation is an outpatient surgical procedure using a heat source to destroy the uterine lining (endometrium) while leaving the uterus intact. The uterine lining sheds for several days following the procedure, much like it would during menstruation. Scar tissue then forms, and monthly menstrual flow and any accompanying pain typically decrease, often dramatically. Endometrial ablation is not recommended for women who may wish to become pregnant in the future. Learn more about endometrial ablation.
Hysterectomy is surgical removal of the uterus, an option for women who have not had success with other treatment methods. Learn more about hysterectomy.