What causes heavy menstrual bleeding and what should I do about it?

Symptom Database

Heavy menstrual bleeding, also known as menorrhagia, is a common condition that affects many women. It is characterized by excessive menstrual bleeding, heavy periods, and a heavy flow during menstruation. This condition can be distressing and disruptive to a woman’s daily life. In this article, we will explore the causes of heavy menstrual bleeding and discuss what you can do about it.

Understanding Heavy Menstrual Bleeding

Menstrual disorders, including heavy bleeding during periods, can be caused by various factors. It is essential to understand the underlying causes to determine the appropriate course of action. Here are some common causes of heavy menstrual bleeding:

Hormonal Imbalances

Hormonal imbalances, such as an excess of estrogen or a deficiency of progesterone, can lead to heavy menstrual flow. These imbalances can disrupt the normal menstrual cycle and cause excessive bleeding.

Uterine Fibroids

Uterine fibroids are noncancerous growths that develop in the uterus. They can cause heavy periods and prolonged bleeding. Fibroids can vary in size and number, and their presence can contribute to heavy menstrual flow.


Uterine polyps are small, benign growths that form on the inner lining of the uterus. They can cause heavy bleeding during periods and may lead to irregular menstrual cycles.


Adenomyosis is a condition in which the tissue that lines the uterus grows into the muscular wall of the uterus. This can cause heavy and prolonged menstrual bleeding, as well as severe cramping.


Endometriosis is a condition in which the tissue that normally lines the uterus grows outside of it. This can cause heavy periods, severe pain, and fertility issues.

Medical Conditions

Certain medical conditions, such as thyroid disorders, blood clotting disorders, and liver or kidney diseases, can contribute to heavy menstrual bleeding. It is important to identify and address these underlying conditions to manage the symptoms effectively.

Recognizing Heavy Bleeding Symptoms

It is crucial to recognize the symptoms of heavy menstrual bleeding to seek appropriate medical attention. Here are some common signs of heavy bleeding during periods:

  • Menstrual periods lasting longer than seven days
  • Changing sanitary pads or tampons every hour or more frequently
  • Passing blood clots larger than a quarter
  • Experiencing fatigue and shortness of breath due to excessive blood loss
  • Feeling lightheaded or dizzy during menstruation

If you experience any of these symptoms, it is essential to consult a healthcare professional for a proper diagnosis and treatment plan.

Managing Heavy Menstrual Bleeding

Fortunately, there are several options available to manage heavy menstrual bleeding. The appropriate treatment will depend on the underlying cause and individual circumstances. Here are some strategies that may help:

Hormonal Birth Control

Hormonal birth control methods, such as birth control pills, patches, or hormonal intrauterine devices (IUDs), can help regulate the menstrual cycle and reduce heavy bleeding. These methods work by balancing hormone levels and thinning the uterine lining.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Over-the-counter NSAIDs, such as ibuprofen or naproxen, can help reduce menstrual pain and decrease blood flow. These medications work by inhibiting prostaglandins, which are responsible for uterine contractions and inflammation.

Tranexamic Acid

Tranexamic acid is a medication that helps reduce heavy menstrual bleeding by preventing blood clots from breaking down. It is typically taken during the heaviest days of the menstrual cycle.

Surgical Interventions

In some cases, surgical interventions may be necessary to manage heavy menstrual bleeding. Procedures such as endometrial ablation, myomectomy (removal of fibroids), or hysterectomy (removal of the uterus) may be considered depending on the severity of the condition and the individual’s reproductive goals.

When to Seek Medical Attention

While occasional heavy periods may not be a cause for concern, it is important to seek medical attention if you experience any of the following:

  • Heavy bleeding that disrupts your daily activities
  • Bleeding between periods
  • Severe pelvic pain
  • Signs of anemia, such as fatigue, weakness, or pale skin

Your healthcare provider can evaluate your symptoms, perform necessary tests, and recommend appropriate treatment options.


Heavy menstrual bleeding can significantly impact a woman’s quality of life. Understanding the causes and recognizing the symptoms is crucial for seeking appropriate medical attention. With the help of healthcare professionals, various treatment options are available to manage heavy periods and improve overall well-being. Remember, it is essential to consult a healthcare provider for an accurate diagnosis and personalized treatment plan.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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