Menorrhagia: Abnormal menstrual bleeding


Menorrhagia, also called hypermenorrhea, is abnormal menstrual bleeding (excessive or prolonged), or bleeding between periods. Around 40ml of menstrual fluid is passed during the average period. For some women, the bleeding is excessively heavy (more than 80ml).

The menstrual cycle is regulated by the hypothalamus, a portion of the brain that also controls body temperature, appetite and blood pressure. The hypothalamus stimulates the pituitary gland (located near the base of the brain) to release hormones that regulate female reproductive cycling. In order for a woman to have regular menstrual cycles, her hypothalamus and pituitary gland must be functioning properly. Her cervix and vagina must also be anatomically normal to allow the passage of menstrual flow.

A problem with any of these parts of the body may cause problems in your monthly period.

Symptoms of abnormal menstrual bleeding include:

  • Menstrual flows that soaks through one or more sanitary pads or tampons every hour for several consecutive hours
  • Need to change sanitary protection during the night
  • Menstrual period that lasts longer than 7 days
  • Menstrual flow that includes large blood clots
  • Bleeding or spotting between periods
  • Cramping and pain in the lower abdomen during menstrual period
  • Irregular menstrual periods
  • Tiredness, fatigue or shortness of breath

In most cases, the cause of abnormal menstrual bleeding is unknown. But a number of the known conditions may include:

  • Hormonal imbalance (such as hypothyroidism (low levels of thyroxine)
  • Uterine fibroids and polyps
  • Infection (such as chlamydia or pelvic inflammatory disease (PID)
  • Ovarian cysts
  • Endometriosis (i.e., the cells lining the uterus - endometrial cells - migrate to other areas of the body)
  • Dysfunction of the ovaries
  • Intrauterine Device (IUD)
  • Pregnancy complications (i.e., ectopic pregnancy)
  • Abortion (either spontaneous –miscarriage - or induced)
  • Bleeding disorders (i.e., leukemia and Von Willebrand's disease)
  • Cancer (i.e., uterine cancer, ovarian cancer or cervical cancer)
  • Medications (i.e., hormonal contraceptives, anticoagulants and anti-inflammatory medications)
  • Other medical conditions (i.e., thyroid problems, lupus, liver or kidney disease, some uncommon blood disorders, and chemotherapy)

Here are some suggestions on managing abnormal menstrual bleeding :

  • Get plenty of rest.
  • Avoid anticoagulants that may contribute to excessive bleeding (i.e., aspirin).
  • Eat a well balanced diet.
  • Take iron supplements to prevent anemia.
  • Consult with your health care provider, which may recommend medication, dilatation and curettage, change of contraception, surgery, treatment of underlying disorders, or hysterectomy.


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