What is Menorrhagia?

Menorrhagia is a condition characterised by abnormally heavy or extended menstrual bleeding. With menorrhagia, you may have excessive blood loss and pain that disturbs your normal activities.

Symptoms of Menorrhagia

The most common symptoms of menorrhagia are:

  • Menstrual flow that soaks one or more pads per hour for several consecutive hours
  • Need to use double sanitary protection to control the flow of blood
  • Need to change your pad frequently during the night
  • Menstrual period that lasts longer than seven days
  • Menstrual flow that includes large blood clots
  • Heavy menstrual flow that affects daily routine activities
  • Fatigue, weakness or shortness of breath (symptoms of anaemia)

Causes of Menorrhagia

The cause of menorrhagia is not known in some cases; however, several conditions that may cause menorrhagia include:

  • Hormonal imbalance
  • Dysfunction of the ovaries
  • Uterine fibroids (noncancerous or benign tumours of the uterus
  • Uterine polyps
  • Adenomyosis (where endometrial glands are found in the muscular wall of the uterus)
  • Intrauterine devices (IUDs)
  • Pregnancy complications
  • Cancer
  • Inherited blood disorders
  • Certain medications (anti-inflammatory medications and anticoagulants)
  • Other medical conditions such as:
    • Pelvic inflammatory disease (PID)
    • Thyroid problems
    • Endometriosis
    • Liver or kidney disease

Diagnosis of Menorrhagia?

Your doctor will perform a pelvic examination and may recommend other tests or procedures such as a pelvic ultrasound scan or a biopsy of the lining of the womb if you are over 40 years of age. Biopsy is a technique of removing a piece of tissue from the inner lining of the uterus, which is examined under a microscope. This is performed to ensure that the cells are growing normally.

Your doctor may also recommend an examination called hysteroscopy, which involves placing a tiny tube with a light through your cervix to obtain a direct view of the lining of the womb.

Treatment of Menorrhagia

Treatment options will depend on the cause and severity of menorrhagia, and your overall health. Some common treatments include:

  • Iron supplements may be started if your iron levels are low.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) may help reduce menstrual blood flow as well as cramping.
  • Oral contraceptives may be given to help reduce bleeding and make menstrual cycles more regular.
  • Oral progesterone may be given to help correct hormonal imbalance and reduce menorrhagia.
  • Mirena, a type of intrauterine device, releases progestin in the womb that thins the uterine lining and reduces the blood flow.

Surgery may be needed if medication is not successful. The surgical procedures include:

  • Endometrial ablation: It is a procedure that permanently destroys the entire lining of your uterus (endometrium), resulting in little or no menstrual flow.
  • Dilation and curettage (D&C): It is a procedure in which the cervix is dilated, and the lining of the uterus is scraped to reduce menstrual bleeding. You may need additional D&C procedures if menorrhagia recurs.
  • Hysterectomy: It is the surgical removal of the uterus and the cervix that leads to infertility, and the cessation of menstrual periods.
  • Hysteroscopy: This procedure involves the use of a hysteroscope, a tiny tube with a light, to view your uterine cavity and remove abnormalities such as polyps that may be causing heavy menstrual bleeding.
  • Endometrial resection: It is a surgical procedure that uses an electrosurgical wire loop to remove the lining of the uterus.

Hysterectomy, endometrial ablation and endometrial resection may reduce your ability to become pregnant. Therefore, discuss with your doctor about the treatment options if you plan to become pregnant in the future.


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