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Categories > Menstrual Health > Menstrual cycle

Period problems?

Periods can be a pain, for sure. But that monthly discomfort is compounded for women who suffer from heavy menstrual bleeding, or menorrhagia.

Women with normal periods lose about two to three tablespoons of blood over the course of four to five days. Those who have menorrhagia may lose six tablespoons or more (enough to require that you change your sanitary pads or tampons every hour for several hours in a row) and have periods—and constant pelvic pain—lasting more than a week.

The condition can affect women of any age, although adolescents, women nearing menopause and women who have hereditary bleeding disorders are at highest risk.

What’s behind menorrhagia?

An imbalance of the hormones estrogen and progesterone is one of the most common causes of menorrhagia. This imbalance results in the lining of the uterus growing too thick so that it causes heavy menstrual bleeding when it’s shed.

An imbalance may be caused by such factors as age, thyroid disease, medications or lack of ovulation. Polyps, uterine fibroids (noncancerous tumors), pregnancy complications, cancer, anticoagulants and medical conditions such as pelvic inflammatory disease, liver or kidney disease are other possible causes.

Left untreated, menorrhagia can lead to iron deficiency anemia.

Lessening the flow

Your healthcare provider will diagnose the condition using a variety of tests, including blood tests, a Pap test, an endometrial biopsy and ultrasound imaging.

Based on test results, your provider may recommend iron supplements, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or hormone treatment.

Surgical options include removing or destroying the uterine lining, removing polyps and surgical removal of the uterus and cervix, a procedure called a hysterectomy.

Your healthcare provider may also recommend getting plenty of rest and avoiding aspirin, which interferes with blood clotting.