Oasis Women's Center
7500 Greenway Center Drive
Greenbelt, MD 20770
Heavy Menstrual Bleeding
About one-third of women seek treatment for heavy menstrual bleeding. Heavy menstrual bleeding is not normal. It can disrupt your life and may be a sign of a more serious health problem.
Any of the following is considered to be heavy menstrual bleeding:
- Bleeding that lasts more than seven days.
- Bleeding that soaks through one or more tampons or pads every hour for several hours in a row.
- Needing to wear more than one pad at a time to control menstrual flow.
- Needing to change pads or tampons during the night.
- Menstrual flow with blood clots that are as big as a quarter or larger.
Heavy menstrual bleeding may be a sign of an underlying health problem that needs treatment. Blood loss from heavy periods also can lead to a condition called iron-deficiency anemia. Severe anemia can cause shortness of breath and increase the risk of heart problems.
Many things can cause heavy menstrual bleeding. Some of the causes include fibroids and polyps, adenomyosis, irregular ovulation, bleeding disorders, certain medications, cancer, endometriosis, or issues related to pregnancy, such as ectopic pregnancy and miscarriage. Pelvic inflammatory disease also can cause heavy menstrual bleeding. Sometimes, the cause is not known.
Which Medications Can Be Used To Treat Heavy Menstrual Bleeding?
Medications often are tried first to treat heavy menstrual bleeding:
- Heavy bleeding caused by problems with ovulation, endometriosis, polycystic ovary syndrome, and fibroids often can be managed with certain hormonal birth control methods. Depending on the type, these methods can lighten menstrual flow, help make periods more regular, or even stop bleeding completely.
- Hormone therapy can be helpful for heavy menstrual bleeding that occurs during perimenopause.
- Gonadotropin-releasing hormone (GnRH) agonists stop the menstrual cycle and reduce the size of fibroids. They are used only for short periods (less than six months). Their effect on fibroids is temporary.
- Tranexamic acid is a prescription medication that treats heavy menstrual bleeding. It comes in a tablet and is taken each month at the start of the menstrual period.
- Nonsteroidal antiinflammatory drugs, such as ibuprofen, also may help control heavy bleeding and relieve menstrual cramps.
Which Procedures Can Be Used To Treat Heavy Menstrual Bleeding?
If medication does not reduce your bleeding, a surgical procedure may be needed:
- Endometrial ablation destroys the lining of the uterus. It stops or reduces menstrual bleeding. Pregnancy is not likely after ablation, but it can happen. If it does, the risk of serious complications is greatly increased.
- Uterine artery embolization (UAE) is used to treat fibroids. In UAE, the blood vessels to the uterus are blocked, which stops the blood flow that allows fibroids to grow.
- Myomectomy is surgery to remove fibroids without removing the uterus.
- Hysteroscopy can be used to remove fibroids or stop bleeding caused by fibroids in some cases.
- Hysterectomy is surgical removal of the uterus. Hysterectomy is used to treat fibroids and adenomyosis when other types of treatment have failed or are not an option. It also is used to treat endometrial cancer. After the uterus is removed, a woman can no longer get pregnant and will no longer have periods.
Information provided from the American College of Obstetricians and Gynecologists