What is Menorrhagia?

Heavy menstrual flow is a common disorder in most women. It is medically termed menorrhagia. Heavy menstrual flow can be so much that you just have to change a pad or replace menstrual cup every 2 hours and may last for over 7 days. It can be so bad that sleep is lose. It is usually accompanied with weakness and inability to perform ones daily activity for living. There is thereore need to contact a medical provider for management options as soon as possible in severe cases.

What are the signs and symptoms ?

Signs of menorrhagia may include some of the followings:

  • Having to replace sanitary pads every hour or less for many consecutive hours
  • Menstrual periods that last over 7 days
  • Menstrual period that keeps you from performing activities of daily living
  • Constant lower abdominal pain
  • Weakness and shortness of breath
  • Doubling sanitary pads in order to prevent menstrual overflow
  • Changing pads or tampons during night time
  • Passing larger blood clots


Possible causes fall into the following three areas:

  • Growths or tumors in the uterus, that are called uterine fibroids or polyps.
  • Cancer of the uterus or cervix
  • Intra-uterine devices
  • Bleeding-related disorders such as platelet function disorder
  • Other medical conditions such as thyroid disease or pelvic inflammatory disease
  • Some drugs such as aspirin, can cause increased bleeding
  • The menopause transitions
  • Hormonal imbalance
  • Dysfunction of the ovaries
  • Pregnancy complications such as ectopic pregnancy
  • Inherited bleeding disorders
  • Medications such as anti-coagulants and vasodilators

Diagnosis of Menorrhagia

For menorrhagia to be diagnosed by your doctor, s/he would ask you some questions about your past and present medical history and menstrual cycles, and run some investigations on you.

  1. Comprehensive history taking
  • Your menarche. That is, the age you started menstruation
  • Typical length of your menstrual cycle
  • Usual number of days your period lasts
  • Number of days your period is heavy
  • Quality of life during your period
  • History of heavy menstrual bleeding in the family
  • Your stress patterns
  • Any problem with gain. Such as weight gain or loss
  • Current use of any drug
  1. Physical examination
  • Blood test to rule out anemia and thyroid problems
  • Pap test to test for infection, inflammation or cancerous changes
  • Endometrial tissue biopsy to examine uterine tissue for any form of pathology
  • Pelvic ultrasound to detect any abnormality with the pelvic organs
  • Hysteroscopy


Specific management of menorrhagia is dependent on several factors which include a comprehensive history taking, assessment and investigations.


Pharmacotherapy for menorrhagia may include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): they help by reducing menstrual blood loss and relieving painful menstrual cramps
  • Tranexamic acid.
  • Oral contraceptives.
  • Oral progesterone: this may be needed to correct hormone imbalance and reduce menorrhagia. However, if menorrhagia is hormone-induced, there is a need to speak with one’s medical provider about changing or stopping it.
  • Hormonal IUD. It releases levonorgestrel, which thins the uterine lining and decreases menstrual blood flow and cramping.
  • Iron supplement may be prescribed to reduce the chances of anemia

Complications of Menorrhagia

Excessive or prolonged menstrual bleeding can lead to other medical conditions such as

  • Anemia: Severe bleeding decreases iron levels. This increases the risk of iron deficiency anemia.
  • Severe pain: painful menstrual cramps usually accompany menorrhagia. This may require urgent medical attention

You can consult with a doctor today at eDokita . eDokita is a health technology organization that provides health services to you at your own convenience. Download eDokita app today andconsult with a doctor at your convenience.

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