Menorrhagia is defined as abnormally heavy or prolonged menstrual periods. The New York-Presbyterian Hospital (NYPH) says menorrhagia is the most common type of abnormal uterine bleeding.

The Mayo Clinic reports while heavy menstrual bleeding is a common concern among premenopausal women, most women do not experience blood loss severe enough to be defined as menorrhagia.

It is normal for some periods to be heavier on some days than others. But telltale signs of menorrhagia are soaking through at least one sanitary pad or tampon an hour for several hours in a row or periods lasting longer than seven days.

The Mayo Clinic lists other symptoms as passing large blood clots with menstrual flow and restriction of daily activities due to heavy menstrual flow. Women with menorrhagia also experience symptoms of anemia, such as tiredness, fatigue or shortness of breath.

It is important to note menorrhagia symptoms may resemble other menstrual conditions or medical problems.

KidsHealth.org says the most frequent cause of menorrhagia is an imbalance between the levels of estrogen and progesterone, which allows the uterine lining (endometrium) to keep building up. When the endometrium is finally shed during menstruation, the resulting bleeding is particularly heavy.

NYPH says other causes include pelvic inflammatory disease (PID), uterine fibroids, abnormal pregnancy (i.e., miscarriage, ectopic), infection, tumors, or polyps in the pelvic cavity, bleeding or platelet disorders, high levels of prostaglandins (chemical substances which help to control the muscle contractions of the uterus); high levels of endothelins (chemical substances which help the blood vessels in the body dilate); and liver, kidney, or thyroid disease.

The Mayo Clinic adds menorrhagia is a well-known side effect of using a non-hormonal intrauterine device (IUD) for birth control.

Heavy or prolonged bleeding can lead to iron deficiency anemia and severe pain due to painful menstrual cramps.

There are several effective treatments for menorrhagia. Drug therapy may include iron supplements for women with anemia, oral contraceptives, oral progesterone and the hormonal IUD.

The Mayo Clinic says non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, also help reduce menstrual blood loss and have an added benefit of relieving painful menstrual cramps.

NYPH says surgical procedures include endometrial ablation. This destroys the endometrium which leaves most women with a reduced menstrual flow. Another is endometrial resection which removes the endometrium. Both procedures reduce the ability to become pregnant.

The Mayo Clinic says other surgical procedures include dilation and curettage (D&C), operative hysteroscopy and hysterectomy.

Sources:

Menorrhagia (heavy menstrual bleeding) MayoClinic.com by Mayo Foundation for Medical Education and Research. Web 25 Sept 2011.
http://www.mayoclinic.com/health/menorrhagia/DS00394

Abnormal Bleeding Menorrhagia. About.com Women’s Health by the New York Times Company. Web 25 Sept 2011.
http://womenshealth.about.com/od/abnormalbleeding/Abnormal_Bleeding_Menorrhagia.htm

Menorrhagia. nyp.org by New York-Presbyterian Hospital. Web 25 Sept 2011.
http://nyp.org/health/gyneonc-menor.html

Menstrual Problems. Kids Health from the Nemours Foundation. Web 25 Sept 2011.
http://kidshealth.org/parent/growth/growing/menstrual_problems.html#

Reviewed September 26, 2011
by Michele Blacksberg RN
Edited by Jody Smith