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Bleeding is normal during menstruation. Once in a while, there might be a little more blood than usual and that is normal. However, where heavy bleeding including clots recur, there is a bleeding disorder and urgent medical help is pertinent.

Menorrhagia is the medical term for unusually heavy and prolonged bleeding during menstruation especially one that interrupts a woman’s routine. It involves losing up to 80 millimeters of blood or 6 tablespoons (as against the normal 30 to 40 millimeters or 2 to 3 tablespoons) over a period 7 or more days (instead of the usual 4 to 5 days).

Menorrhagia is so serious that the woman may need to change tampons or pads every two hours. It is not common but when it occurs, it is important to attend to it immediately.


Anovulation: Here, menstruation occurs without ovulation. It is common in females who have either just begun menstruating or are approaching menopause.

Pelvic Inflammatory Disease: PID is an infection of the reproductive organs that causes severe complications including heavy bleeding.

Ovarian dysfunction: A situation where no egg or progesterone is produced, hence a hormonal imbalance.

Hormonal imbalance: Changes in the progesterone and estrogen levels could cause the endometrium to overbuild thus causing a large volume during shedding (menstruation).

Inherited Bleeding disorders: Like Von Willebrand’s disease or a platelet function disorder.

Adenomyosis: A condition where glands from the endometrium get into the muscles of the uterus.

Uterine Fibroids: The growth of non-cancerous tumors in the uterus. When they lead to higher hormonal levels, then it has grown to Uterine Polyps.

Non-hormonal Intrauterine Device (IUD): Using such a birth control device can cause heavier bleeding.

Medications: Anti-inflammatory and Anticoagulant drugs.

Cancer: Cancers in any of the reproductive organs can cause heavy bleeding.

Health challenges: Liver or Kidney disease, Endometriosis (painful menstruation), etc.


Anemia, heavy bleeding, blood clots the size of a quarter or more, fatigue, short breath, constant pelvic or abdominal pain, lengthy periods, etc.


Menorrhagia shares common symptoms with other blood disorders, some tests are pertinent for a correct diagnosis. The tests include:

  • Pap test – Cells are collected from the patient’s cervix and tested for infection, inflammation or cancerous changes.
  • Ultrasound – The use of sound waves to produce images of the patient’s uterus, pelvis and ovaries to detect any anomalies.
  • Blood tests – As the name implies, samples of the patient’s blood are collected and evaluated for anemia, thyroid disorders or other blood-clotting abnormalities.
  • Endometrial biopsy – It involves obtaining a tissue sample from the patient’s uterus for pathological examination and evaluation.

Depending on the results of the test, further tests may be recommended. They are:

  • Hysteroscopy – A thin, lighted instrument is inserted in the patient’s vagina and cervix up to the uterus, so that the doctor can examine the uterus.
  • Sonohysterography – Through the vagina and cervix, a fluid is injected into the uterus to enable the doctor to examine the lining of the uterus through an ultrasound.

Doctors must ensure that the patient is not suffering from any other menstrual disorder before settling on menorrhagia.


Self-medication is wrong. Visit us at Progressive Women’s Health, PLLC for the right treatment. Treatment ranges from Drug therapy to surgery, depending on the underlying cause.

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