Excessive menstrual bleeding is an important health issue for women. At least one in five women bleed so heavily during their periods they have to put their normal lives on hold. The medical term for this condition is "menorrhagia," meaning periods that are too heavy or that go on longer than the typical seven-day menstrual cycle. It is more common in women over 35 as hormonal levels shift during the perimenopausal phase. However, heavy menstrual bleeding can occur at any age.
Heavy menstrual bleeding is more than an inconvenience. It is also the most common cause of iron-related deficiency in women, and, if it's heavy enough, can even require hospitalization and blood transfusions.
If you experience heavy bleeding during your periods, your health care professional will conduct tests to rule out underlying problems like fibroids, uterine cancer, an infection or endometriosis. If you don't have any of these conditions, then your bleeding is likely caused by hormonal imbalances.
There are several treatments available for heavy menstrual bleeding, ranging from over-the-counter nonsteroidal anti-inflammatory medications, oral contraceptives and minimally invasive surgery that preserve the uterus, to hysterectomy, that removes the uterus.
Talk with your health care professional about heavy menstrual bleeding. Here is a list of questions to ask at your next office visit.
1) Do you consider the amount of menstrual bleeding I'm experiencing abnormal?
2) What tests do you need to conduct to diagnose symptoms and why are you doing them?
3) Is this heavy bleeding affecting my iron level? What can you do about that?
4) Why are you recommending this particular treatment option for my heavy bleeding? If that doesn't work, what do you recommend next?
5) What are the disadvantages and risks associated with each recommended treatment?
6) Even if you find a problem like fibroids or endometriosis causing my abnormal uterine bleeding, is it possible to avoid a hysterectomy?
7) Am I a candidate for endometrial ablation? What is the success rate for the technique you use? What kind of complications have you encountered?