When young people learn about what happens during puberty, they are told that menstruation is normal vaginal bleeding that lasts a few days during the monthly cycle. However, it’s not so simple for all women. One out of every five women experiences menorrhagia — heavy bleeding — that lasts several days and can keep them from doing the things they enjoy.
Normal monthly bleeding usually lasts just three to five days and the blood loss is roughly two to three tablespoons. Women with menorrhagia may bleed for seven or more days and can lose six or more tablespoons of blood each period.
“While most of the time heavy menstrual cycles are not dangerous, they can affect a woman’s quality of life,” says Dr. Andrea Journagin, an OBGYN with Sharp Rees-Stealy Medical Group. “Occasionally, the loss of blood due to menorrhagia may even cause a woman to become anemic and need a blood transfusion.”
Along with menstrual periods that last seven days or more, the Centers for Disease Control and Prevention (CDC) reports that there are other signs of menorrhagia, including:
- Menstrual flow that soaks through one or more pads or tampons every hour
- The need to use multiple pads to control menstrual flow
- The need to change pads or tampons during the night
- Menstrual flow with quarter-sized blood clots
- Heavy menstrual flow that inhibits activities
- Constant pain in lower stomach during period
- Fatigue, low energy and shortness of breath
“In general, younger women experience heavy periods due to hormones, endometriosis or polycystic ovary syndrome, a disorder causing the formation of small cysts on the outer edges of the ovary,” says Dr. Journagin. “Older women may have heavy periods due to hormonal changes, or uterine-related problems, such as fibroids.”
The cause of heavy bleeding will likely determine the recommended treatment. Some treatments will address only the bleeding, while others can also help reduce pain and act as a form of birth control.
Treatments for menorrhagia include:
• Iron supplements, if anemia is present
• Ibuprofen to reduce pain and bleeding
• Hormonal birth control, including pills, progestin-releasing IUDs, patches or injections, to regulate periods and reduce or stop bleeding • Hormone-therapy drugs
• Tranexamic acid (Lysteda®), a hormone-free prescription drug
• Dilation and curettage (D and C) to remove the top layer of the uterus lining
• Operational hysterectomy to remove polyps, fibroids and the lining of the uterus
• Endometrial ablation or resection to remove all or part of the uterus • Hysterectomy to remove the entire uterus
According to Dr. Journagin, most cases of heavy bleeding can be treated without surgery. Women who are unable or unwilling to take certain medications or who have tried medications without success in reducing their bleeding might be candidates for surgical treatment options.
“It’s important for women to understand that you don’t have to live with heavy bleeding,” says Dr. Journagin. “Women who believe they might have menorrhagia should talk to their OBGYN to determine the cause and discuss their multiple options for treatment.”