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Dr. Andrew Rynne
Dr. Andrew Rynne

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Exp 50 years

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Article Home Women's Health Excessive menstrual bleeding

Excessive menstrual bleeding

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It is also known as menorrhagia.

Menorrhagia is the medical term used for excessive or prolonged menstrual bleeding and for the periods that are both heavy and prolonged. It is also known as hyper menorrhea.

The menstrual cycle is not same foe every woman. Normal menstrual flow occurs every 21 to 35 days, lasts four to five days and produces a total blood loss of 30 to 40 mille liters (about 2 to 3 tablespoons). Your period may be regular or irregular, light or heavy, painful or pain free, long or short and still be considered normal. Menorrhagia refers to loss of 80 mille liters or more of blood during the menstrual cycle or menstrual cycle lasting more than 7 days.

Symptoms and signs of Menorrhagia

  • Menstrual flow that soaks through one or more sanitary pads or tampons every hour for several consecutive hours.
  • The need to use double sanitary protection to control your menstrual flow.
  • The need to change sanitary protection during the night.
  • Menstrual periods lasting longer than seven days.
  • Menstrual flow that includes large blood clots.
  • Heavy menstrual flow that interferes with your regular lifestyle.
  • Constant pain in the lower abdomen during the menstruation.
  • Tiredness, fatigue or shortness of breath (symptoms of anemia). Metrorrhagia (Bleeding between menstrual periods).


  • Hormonal imbalance: In a normal menstrual cycle, a balance between the hormones estrogen and progesterone regulates the uterine lining (endometrium), which is shed during menstruation. If a hormonal imbalance occurs, the endometrium develops in excess which is shed as heavy menstrual bleeding.
  • Uterine fibroids: It will cause heavy bleeding than normal or prolonged bleeding.
  • Polyps: Polyps are small, benign growths on the uterine wall can lead to heavy or prolonged bleeding.
  • Dysfunction of ovaries: Lack of ovulation (anovulation) can cause hormonal imbalance leading to excessive bleeding.
  • Adenomyosis
  • Intrauterine contraceptive devices
  • Cancer: Uterine, ovarian or cervical cancer
  • Medications: Anti-inflammatory drugs, anti-coagulants can lead to heavy or prolonged bleeding.
  • Other medical conditions: like thyroid disease, endometriosis, pelvic inflammatory disease
  • Stress.
  • Abortions.
  • Psychological upsets and overwork.
  • Ectopic pregnancy.
  • Cancer: Uterine cancers.

Complications: Iron deficiency anemia, dysmenorrhea, (cramps during menstrual bleeding), infertility.

Diagnosis methods

  • General examination.
  • Medical history.
  • Menstrual history.
  • Physical examination.
  • Pap smear.
  • Blood tests like hemoglobin level, serum iron, and serum ferritin, bleeding and clotting factors to rule out bleeding disorders.
  • Vaginal ultrasound.
  • Endometrial biopsy.


  • Iron supplements: If the condition is associated with anemia.
  • Non steroidal anti-inflammatory drugs like ibuprofen, mefenamic acid helps to control bleeding as well as it helps in relieving pain.
  • Oral contraceptives: It helps to regulate the ovulation and to reduce excessive or prolonged bleeding.

General measures to prevent Menorrhagia

  • Bed rest.
  • Avoid over exertion.
  • No vigorous exercise.
  • Cold showers.
  • Avoid anxiety and tension.