Heavy Menstrual Bleeding (HMB)
Are my periods too heavy?
Heavy menstrual bleeding, also known as menorrhagia, is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Heavy menstrual bleeding is common but not normal.
How do I tell if my periods are too heavy? Menstrual bleeding is considered heavy if the bleeding lasts more than 7 days or soaks through one or more tampons/pads every hour or needing to wear more than one pad a time. Some other signs include changing pads or tampons during the night or menstrual flow with quarter-sized blood clots.
What are the causes of heavy menstrual bleeding? There are several causes of heavy menstrual bleeding. The most common of these causes are hormone imbalance, dysfunction of the ovaries, fibroids or polyps. It is important for women who are post menopausal and have had an abnormal pap smear in the past to get checked for uterine and cervical cancer. Inherited bleeding disorders and certain IUD’s can also cause heavy menstrual bleeding.
How will your doctor diagnose the cause of heavy menstrual bleeding? Seeing an OB/GYN is important if these symptoms arise. You doctor can order certain diagnostic tests to find the cause of the heavy menstrual bleeding including ultrasound, hysteroscopy (a procedure that looks inside the uterus), endometrial biopsy or MRI.
How is heavy menstrual bleeding treated? Treatment options include hormone therapy, tranexamic acid (treats the excessive blood loss) and NSAIDs, like ibuprofen. Endometrial ablation, myomectomy, hysterectomy are some of the surgical procedures that can also be used as treatment. Endometrial ablation removes the inner layer of the uterus while a myomectomy is a procedure that removes the fibroids. Hysterectomy is removal of the uterus.
Why do we care? Prolonged heavy menstrual bleeding can cause anemia. It could also be a sign of a more serious problem such as anovulation, hyperplasia or cancer.