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Menstrual Flow  
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Definition  

Heavy menstrual bleeding (also called menorrhagia) is excessive menstrual blood loss that interferes with a woman's quality of life.

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Causes  

In some cases, the cause is not known. However, many conditions have been associated with menorrhagia, such as:

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Risk Factors  

Factors that may increase your chances of menorrhagia include:

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Symptoms  

Symptoms of menorrhagia include:

  • Menstrual bleeding lasting more than seven days
  • Unusually heavy bleeding (soaking through a sanitary napkin or tampon every hour)
  • Menstrual flow requiring change of sanitary protection during the night
  • Menstrual flow including large clots
  • Menstrual flow interfering with lifestyle
  • Fatigue and/or shortness of breath (symptoms of anemia )

When Should I Call My Doctor?  

Call your doctor if you have symptoms of menorrhagia.

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Diagnosis  

Your doctor will ask about your symptoms and medical history. A physical examination, including a pelvic exam, will be done. Tests may include:

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Treatment  

Treatment depends on the underlying cause of the heavy menstrual bleeding. Your doctor will work with you to create a treatment plan.

Medications  

Your doctor may recommend:

  • Hormonal therapy
  • An IUD that releases the hormone progesterone
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Iron supplement

Surgical Procedures  

In some cases, surgery may be needed, such as:

  • Dilation and curettage
  • Operative hysteroscopy—may be used along with other tools to remove a polyp
  • Removal of the lining of the uterus— endometrial ablation
  • Removal of the uterus— hysterectomy
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Prevention  

There are no current guidelines to prevent heavy menstrual bleeding.