Wellness Matters

Is it Too Much? 9 Causes of Excessive Menstrual Bleeding and How to Treat Them

February 03, 2017

woman with stomach pain
Many women have heavy bleeding during their menstrual period. But does yours interfere with your daily routine? If it does, you may have menorrhagia, where every period causes enough blood loss so that normal activities cannot be maintained.

The best way to know if you are experiencing menorrhagia is to keep track of the frequency with which you change your sanitary products. If you are having to replace them every one or two hours or your period lasts more than seven days, you may want to talk to your doctor.

Common causes for menorrhagia are:

  1. Hormones. During puberty and leading up to menopause, a hormonal imbalance may occur, which leads to excessive bleeding. This is often treatable with hormone therapy.
  2.  Fibroid tumors in the uterus. These benign (non-cancerous) tumors can occur in the uterus when a woman is in her thirties or forties. It is unclear why these estrogen-dependent tumors occur, but there are several surgical treatments available.
  3. Cervical polyps. These polyps are small growths on the surface of the cervix that protrude through the opening. They are often the result chronic inflammation or hormonal factors. A simple outpatient office procedure to remove the polyps is the solution.
  4. Endometrial polyps. These are usually non-cancerous growths that protrude from the lining of the uterus. These are sometimes associated with hormone treatment or ovarian tumors. Treatment is a hysteroscopy and a dilation and curettage. The polyps are tested for cancer after removal.
  5. Pelvic Inflammatory Disease. This is an infection that affects the uterus, fallopian tubes and cervix. It is most often a sexually transmitted infection, but can occur following childbirth, abortion or other gynecological procedures. It is typically treated with antibiotics.
  6. Cervical cancer. This is when cells in the cervix become abnormal and multiply out of control. The human papilloma virus (HPV) is the cause of most cervical cancer.
  7. Endometrial cancer. This is when cells in the uterus become abnormal and multiply out of control. The causes for this type of cancer are unknown. Women diagnosed with this are usually over 50, have endometrial hyperplasia or use hormone replacement therapy. Treatment is most often a hysterectomy and may be followed by chemotherapy or radiation treatments.
  8. IUD. This form of contraception may cause heavy bleeding or menorrhagia. Treatment is to use another form of birth control.
  9. Bleeding disorder. There are many types of bleeding disorders. The most common type that impacts women is von Willebrand Disease. Treatment involves releasing clotting agents in the blood, IV treatments or a prescribed nasal spray.

If you feel your menstrual bleeding is excessive, you should speak with your provider about possible causes and solutions.

Even if you don’t have menorrhagia, you should have annual exams and regular cervical cancer screenings. All women 30 and older should have the Pap test and the HPV test every five years, both of which greatly decrease the chances of dying from cervical cancer. Some women need more frequent Pap smears.

About the Author

Jill Jertson, MD

Jill Jertson, MD is a Gynecologist with the Greensboro Women's Health Care


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