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This topic covers heavy menstrual bleeding, including information about symptoms, tests, and home treatment. For more information, see the topics Normal Menstrual Cycle, Abnormal Uterine Bleeding, Uterine Fibroids, and Endometriosis.
If you bleed a lot during your menstrual cycle, you're not alone. Many women do. When you have heavy menstrual periods (also called menorrhagia), you may:
Heavy periods can be messy and unpleasant, and they may disrupt your life. But in most cases, they aren't a sign of a serious problem.
Still, it's a good idea to see your doctor. A doctor can suggest treatments to ease your symptoms and make sure that you don't have a more serious condition.
A number of things can cause heavy periods. These include:
Sometimes a cause can't be found.
When you lose a lot of blood during your period, your iron levels can drop. This can cause anemia. Anemia can make you feel tired and weak. Call your doctor if you think you have anemia.
In rare cases, heavy periods may be a sign of a serious problem, such as an infection or cancer.
Call your doctor now or seek immediate medical care if:
Your doctor will ask about your menstrual periods and do a pelvic exam. During the exam, your doctor will check for signs of disease, infection, and abnormal growths.
If needed, your doctor may also do one or more tests to find out what's causing heavy periods. These tests may include:
In most cases, heavy menstrual periods can be managed with medicines or hormone treatments. If those treatments don't help, you may need surgery to help control your bleeding.
Your doctor may suggest that you take a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen (such as Advil or Motrin) or naproxen (such as Aleve). Taking an NSAID can reduce bleeding and pain during your period. But NSAIDs usually don't help as much as hormone treatments.
Hormone treatments that may be prescribed include:
Sometimes doctors prescribe a medicine called tranexamic acid (such as Lysteda). It is not a hormone treatment. It reduces bleeding by helping blood to clot.
You may want to think about surgery if medicines don't help or if you have a growth in your uterus. Your choice will depend partly on whether you want to get pregnant in the future. Surgery options include:
If you have severe cramping during your periods, taking an NSAID such as ibuprofen or naproxen may help. An NSAID works best when you start taking it 1 to 2 days before you expect pain to start. If you don't know when your period will start next, take your first dose as soon as bleeding or cramping starts.
Heavy periods can make you feel weak and run-down and can lead to anemia. Your doctor may suggest that you take an iron supplement if your iron levels are low. You may be able to prevent anemia if you increase the amount of iron in your diet. Foods rich in iron include red meat, shellfish, eggs, and beans.
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Other Works Consulted
Duckitt K, Collins S (2012). Menorrhagia, search date June 2011. BMJ Clinical Evidence. Available online: http://www.clinicalevidence.com.
Lentz GM (2012). Primary and secondary dysmenorrhea, premenstrual syndrome, and premenstrual dysphoric disorder. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 791–803. Philadelphia: Mosby.
Lobo RA (2012). Abnormal uterine bleeding: Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 805–814. Philadelphia: Mosby.
ByHealthwise StaffPrimary Medical ReviewerSarah Marshall, MD - Family MedicineSpecialist Medical ReviewerFemi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
Current as ofAugust 26, 2014
Current as of:
August 26, 2014
Sarah Marshall, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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