The term “menorrhagia” refers to unusually heavy menstrual bleeding. Typically, a woman’s period consists of anywhere from one to three days of heavier bleeding with an additional two to three days of lighter flow. Women suffering menorrhagia, however, may bleed heavily for five days, rarely more, and the amount of blood they lose exceeds the typical amount. Is there anything women should know about the prevention of menorrhagia?

Much of the time, menorrhagia resolves on its own and presents no cause for concern. However, depending upon her age and sexual activity, menorrhagia may indicate a more serious underlying disorder. Severe menorrhagia can lead to anemia and other negative health effects, so women who experience unusually heavy periods should make an appointment for a pelvic exam.

What Is Menorrhagia and How Is It Diagnosed?

Most women go through nearly a full box of regular-sized tampons with each menstrual cycle. This number assumes a woman bleeds for six days and changes her tampon or cup every six hours. While some women do use pads, the majority choose tampons or menstrual cups for the convenience factor.

Women suffering menorrhagia, on the other hand, may soak through a regular tampon in two hours or less. They may also pass large clots that cause considerable pain and cramping. Many women who experience menorrhagia use a combination of tampons and pads to stem the flow, but still experience spotting on their clothing. Some use a combination of tampons and special underwear designed for women on their periods.

Most women carry on business as usual during their periods and need nothing more than Motrin or a hot water bottle to alleviate the worst cramps. However, those suffering from menorrhagia may find themselves unable to attend work or participate in social activities on their heaviest days due to the severity of the pain. Those whose blood iron stores fall too low may lack the energy to get out of bed.

Doctors diagnose menorrhagia using several methods, the first of which is a woman’s own reporting of her average flow. It’s important to use regular tampons and pads to measure this, which may mean calling in sick when bleeding is severe. Doctors then perform a routine pelvic exam and may order an ultrasound or a biopsy of the endometrial tissue, which lines the uterus, to rule out certain possible causes.

What Conditions Cause Unusual Bleeding?

Several factors and conditions can impact whether a woman develops menorrhagia, such as:

1. Age: Teen girls experience fluctuating hormonal levels and sometimes fail to ovulate, which can lead to unusually heavy bleeding some months and relatively little in others. Women approaching perimenopause, the years before true menopause occurs, likewise endure hormonal changes that can increase their monthly flow. Even when age is suspected as a factor, women who are sexually active should see the gynecologist to rule out the possibility of a sexually transmitted disease.
2. Birth control method: Women who cease using birth control pills to conceive often experience heavier than normal periods their first few cycles. Indeed, many doctors prescribe birth control as a first-line treatment for the prevention of menorrhagia. Women with copper IUDs typically experiencing heavier bleeding, too, though those using hormonal IUDs such as Mirena usually see a reduction in flow.
3. Uterine fibroids: In women over 40, uterine fibroids often cause menorrhagia. Fibroids are growths of tissue inside the uterus that can cause heavy bleeding and painful clots. As uterine fibroids may lead to infertility from scarring of endometrial tissue, women of all ages benefit from discussing the possibility with their doctor.
4. Endocrine disorders: Women suffering from hypothyroidism, a condition where the thyroid produces too little hormone, often experience heavier-than-normal periods. Women with high levels of prostaglandin, the hormone that makes the uterus contract during menstruation and labor, often experience menorrhagia as well.
5. Unknown pregnancy: Most women who are sexually active experience one or more spontaneous abortions in their lifetimes without ever knowing they had conceived. An isolated experience of heavy menstrual bleeding, especially if it comes a day or two later than usual, can indicate this cause.
6. Cancer: While relatively rare, uterine or cervical cancer sometimes creates an increase in period flow. All women of childbearing age benefit from an annual pap smear. Cervical cancer is more common than uterine, and this test can detect cellular changes in the earliest stages for the best treatment outcome.

What Women Can Do for the Prevention of Menorrhagia

Assuming no underlying hormonal imbalance or disease exists, women have many options for the prevention of menorrhagia. Women who are overweight or obese tend to have heavier periods, so those carrying a few extra pounds may find the condition improves when they shed them. Following a healthy diet and exercise plan improves overall health, so try to resist the temptation to binge on junk and skip the gym.

Iron supplementation can help resolve anemia and restore energy. Many doctors recommend women with the condition take a daily iron pill for at least a year to reverse this symptom.

Women who don’t wish to become pregnant can regulate heavy bleeding by using birth control pills. For women trying to conceive, certain other medications can help on heavy bleeding days. Some can make menorrhagia worse, and discussing alternative treatments with a physician can bring relief in certain cases.

When symptoms become severe enough to interfere with a woman’s day-to-day life, she may consider surgery. Procedures such as dilation and curettage (D&C) and ultrasound ablation can stop the flow while leaving fertility intact. Women who have completed their families may consider a hysterectomy if symptoms grow too much to bear.

Hope for Women with Menorrhagia

Heavy bleeding can seem scary, but keep in mind it is usually harmless. Even when the disorder stems from an underlying disease, treatment options can aid in the prevention of menorrhagia. With the right care, women can stem the heavy flow.