Menorrhagia (Heavy Bleeding)

Menorrhagia is menstrual bleeding that lasts longer than seven days or bleeding that is much heavier than usual, possibly with large clots. If you have unusually heavy bleeding for multiple menstrual periods, you should talk to your healthcare provider about it.

There are many possible causes of menorrhagia, including:

  • Hormone imbalance, the most common cause (the imbalance is sometimes caused by improper use of hormone medication)
  • Polyps, which are growths on the cervix (the opening of the uterus) or inside the uterus; polyps are usually noncancerous.
  • Fibroids, which are noncancerous growths in the uterus
  • Endometriosis (uterine tissue growing outside the uterus)
  • A cyst (a sac full of fluid or blood) on the ovary
  • Use of an IUD (intrauterine device) or birth control pills
  • Cancer of the uterus or ovary and sometimes cancer of the cervix or vagina
  • Chronic medical problems (for example, thyroid problems, diabetes, and blood-clotting problems)
  • Some medications, such as blood thinners
  • Stress

To diagnose menorrhagia, your healthcare provider will ask about your medical history and menstrual cycles.  Your provider may ask you to keep a diary of bleeding and non bleeding days, including notes about how heavy the bleeding was.  You will also have a physical exam.

You may need a blood test or procedure, such as:

  • Endometrial biopsy: Your healthcare provider takes a sample of tissue from the inside of the uterus.  The sample is examined under a microscope.
  • Ultrasound scan: Sound waves are used to get pictures of the uterus, ovaries, and pelvis.  The ultrasound probe may be placed on your lower abdomen or into your vagina.
  • Sonohysterogram: An ultrasound scan done after fluid is injected through a tube into your uterus.  This test allows your provider to look for problems with the lining of the uterus, such as fibroids.
  • Hysteroscopy: Your healthcare provider inserts a thing metal tube with a light and time camera through the vagina and cervix and into the uterus.  This allows your provider to see the inside of the uterus.
  • Laparoscopy: Your healthcare provider inserts a thin metal tube with a light and tiny camera into your abdomen and pelvis through a small cut in or just below your bellybutton.  Your provider uses the scope to look at your uterus and other pelvic organs.

If you are experiencing unusual heavy bleeding during multiple menstrual cycles, we invite you to make an appointment to discuss your options with your physician.