When is menstrual bleeding too heavy

Hysteroscopy —A thin, lighted scope is inserted into the uterus through the opening of the cervix. It allows your ob-gyn to see the inside of the uterus. Endometrial biopsy —A sample of the endometrium is removed and looked at under a microscope. Sometimes hysteroscopy is used to guide this test. Sonohysterography —Fluid is placed in the uterus through a thin tube while ultrasound images are made of the uterus.

Magnetic resonance imaging MRI —This test views internal organs and structures using a strong magnetic field and sound waves. Heavy bleeding caused by problems with ovulation, endometriosis, PCOS, and fibroids often can be managed with certain hormonal birth control methods.

Depending on the type, these methods can lighten menstrual flow, help make periods more regular, or even stop bleeding completely. Hormone therapy can be helpful for heavy menstrual bleeding that occurs during perimenopause. Before deciding to use hormone therapy, it is important to weigh the benefits and risks increased risk of heart attack, stroke, and cancer.

Gonadotropin-releasing hormone GnRH agonists stop the menstrual cycle and reduce the size of fibroids. They are used only for short periods less than 6 months. Their effect on fibroids is temporary. Once you stop taking a GnRH agonist, fibroids usually return to their original size. Tranexamic acid is a prescription medication that treats heavy menstrual bleeding.

It comes in a tablet and is taken each month at the start of the menstrual period. Nonsteroidal anti-inflammatory drugs NSAIDs , such as ibuprofen, also may help control heavy bleeding and relieve menstrual cramps. If you have a bleeding disorder, your treatment may include special medications to help your blood clot.

Endometrial ablation destroys the lining of the uterus. It stops or reduces menstrual bleeding. Pregnancy is not likely after ablation, but it can happen.

If it does, the risk of serious complications is greatly increased. You will need to use a birth control method until after menopause following endometrial ablation. Sterilization permanent birth control may be a good option to prevent pregnancy for women having ablation.

Endometrial ablation should be considered only after medication or other therapies have not worked. Uterine artery embolization UAE is used to treat fibroids. In UAE, the blood vessels to the uterus are blocked, which stops the blood flow that allows fibroids to grow. Myomectomy is surgery to remove fibroids without removing the uterus. Hysteroscopy can be used to remove fibroids or stop bleeding caused by fibroids in some cases. Hysterectomy is surgical removal of the uterus. Hysterectomy is used to treat fibroids and adenomyosis when other types of treatment have failed or are not an option.

It also is used to treat endometrial cancer. After the uterus is removed, a woman will no longer have periods and can no longer get pregnant. Adenomyosis: A condition in which the tissue that normally lines the uterus begins to grow in the muscle wall of the uterus. Cells: The smallest units of a structure in the body. Cells are the building blocks for all parts of the body. Complications: Diseases or conditions that happen as a result of another disease or condition. An example is pneumonia that occurs as a result of the flu.

A complication also can occur as a result of a condition, such as pregnancy. An example of a pregnancy complication is preterm labor. Ectopic Pregnancy: A pregnancy in a place other than the uterus, usually in one of the fallopian tubes. Endometrial Ablation: A minor surgical procedure in which the lining of the uterus is destroyed to stop or reduce menstrual bleeding. Endometrial Biopsy: A procedure in which a small amount of the tissue lining the uterus is removed and examined under a microscope.

Endometriosis: A condition in which tissue that lines the uterus is found outside of the uterus, usually on the ovaries, fallopian tubes, and other pelvic structures. Fibroids: Growths that form in the muscle of the uterus. Treatment of small polyps is unnecessary unless you're at risk of uterine cancer.

If you are, your healthcare provider might recommend a polypectomy , in which the polyp would be removed for microscopic examination. Large polyps are routinely removed and examined as a precaution. Uterine adenomyosis is a condition in which the endometrial uterine cells grow into the muscular wall of the uterus, causing uterine enlargement and painful, heavy bleeding.

Hormonal birth control methods can help control the condition, and the definitive treatment for adenomyosis is a hysterectomy. PID is most often caused by an untreated sexually transmitted infection STI , however, it can sometimes occur following childbirth, abortion, or other gynecological procedures.

The recommended treatment for PID is antibiotic therapy. Cervical cancer , which can be caused by human papillomavirus HPV an asymptomatic STI , can invade other parts of the body. While the cause of endometrial cancer is unknown, the most common age for diagnosis is the mid 60's.

Early diagnosis is key to the effective treatment of cancer. In addition to regular Pap screening for cervical cancer, the American Cancer Society recommends that women at high risk of endometrial cancer have an annual endometrial biopsy. While there are several types of bleeding disorders, the most common type in women is von Willebrand disease VWD.

Other bleeding issues that can lead to heavy menstrual bleeding include having a low platelet count platelets are involved in the clotting process and are produced in the bone marrow or taking a blood thinner like aspirin or Coumadin warfarin sodium.

It's important that you get a diagnosis for the cause of your heavy menstrual bleeding. Before your appointment, try to jot down your period pattern in the last few months.

For instance, how many days did you bleed each month? How many pads or tampons do you go through on the days of your heaviest menstrual flow? Make sure you have a list of all your medications, including hormonal birth control, hormone therapy, and any vitamins or over-the-counter supplements. You might have diagnostic tests, such as:. Your healthcare provider may also do a hysteroscopy which is a diagnostic procedure that is used to visualize the inside of your uterus.

They may also do an endometrial biopsy to sample your uterine tissue for microscopic examination. Getting to the bottom of your heavy menstrual bleeding is important for your quality of life and for your overall health. Heavy blood loss, regardless of the cause, can cause iron-deficiency anemia , which can make you short of breath, tired, and dizzy.

Once both the bleeding and the root cause of your bleeding are addressed and treated, you can move forward and feel well—you deserve it. If bleeding is hormonal in nature, prostaglandin inhibitors non-inflammatory drugs , birth control pills , and progesterone may help. For issues involving the endometrium , treatment options include ablation , resection removal of the uterine lining, or hysterectomy.

In May , the Food and Drug Administration FDA approved Oriahnn elagolix, estradiol, and norethindrone acetate capsules; elagolix capsules for heavy bleeding due to fibroids. There are no Food and Drug Administration-approved natural remedies for heavy periods, but a number have been studied. Among those that show promise are:. In studies, women who had anemia due to menorrhagia experienced a number of positive benefits from taking iron supplements : more energy and physical activity, a more robust social life, and less anxiety and depression.

See your healthcare provider to find out if you're anemic and if they think iron supplements may help. A number of measures may be taken depending on the cause, the amount of blood loss, and any complications, such as:.

Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. American College of Obstetricians and Gynecologists. ACOG committee opinion no.

Obstet Gynecol. Khrouf M, Terras K. J Obstet Gynaecol India. Uterine fibroids: burden and unmet medical need. Semin Reprod Med. Johns Hopkins Medicine. Endometrial ablation. Uterine fibroids: diagnosis and treatment. Am Fam Physician. The pathogenesis of endometrial polyps: a systematic semi-quantitative review. Eur J Gynaecol Oncol.

Adenomyosis: a systematic review of medical treatment. Gynecol Endocrinol. Women who do experience abnormally heavy menstrual bleeding may have a condition called menorrhagia. This condition causes flows so heavy you need to change your tampon or pad every hour. You may also use more than six or seven tampons a day. This condition can cause anemia and severe cramps.

You may also pass blood clots larger than a quarter during your period. Because measuring your total blood loss is impractical, the best way to know if your period is unusually heavy is to talk with your doctor. Several conditions or issues can cause heavy periods. These heavy periods may occur frequently, or they may be more sporadic. The signs and symptoms of an ectopic pregnancy may be confused with a heavy menstrual period.

It can cause severe health issues, including heavy bleeding and severe cramping. Left untreated, an ectopic pregnancy is life threatening.

During and surrounding a miscarriage, heavy bleeding is common and may be mistaken for a very heavy period. Heavy menstrual bleeding is a common side effect of a non-hormonal IUD. After a few months with your IUD, you may find that bleeding becomes less severe.

Many women experience heavier bleeding on the first day of a period and lighter bleeding on the last days. A heavy flow that might get in the way of your normal activities is unusual. If you recently stopped using hormonal birth control, your periods may be very heavy in the first days as your cycle adjusts to the hormone changes. Like birth control, medications you take may interfere with your cycle and lead to heavy bleeding on the first day of your period.

If every period is heavy, painful, and difficult to work around, you may have underlying, long-term issues. Your body typically balances progesterone and estrogen, the two hormones that play the biggest roles in menstruation. Too much estrogen, however, can lead to a thickened uterine lining. This can cause heavy bleeding as the lining is eliminated during your period.

An underactive thyroid gland hypothyroidism may also cause heavy or irregular menstrual bleeding. Roughly 10 to 30 percent of women with heavy periods have a bleeding disorder, such as von Willebrand disease. These disorders can make it difficult to stop your bleeding.