Menorrhagia

What is menorrhagia?

Menorrhagia is defined as unusually heavy and/or long-lasting menstrual periods. If your period last a long time, or is so heavy that you need to change pads or tampons every 1 to 2 hours, then you may have menorrhagia.

Menorrhagia is more than just a problem with bleeding. It can have very disruptive effects on your family and social life, regular daily activities, and your mood.

Consider the following questions?

  1. Do your periods last a long time?
  2. Is your bleeding so heavy you need to change your pad or tampon every 1 or 2 hours?
  3. Do you often wear a tampon AND a pad for more protection?
  4. Do you need to change your pads at night, or do you stain your sheets?
  5. Do you pass many clots? Are your clots sometimes as large as a quarter?
  6. Are you tired all the time?
  7. Do you wear dark clothing because you worry about having menstrual accidents?
  8. Does your bleeding affect your work, social, athletic, or sexual activities?
  9. Would your life improve if you had less bleeding or no bleeding each month?
If you answered "yes" to any of these questions, then you may have menorrhagia.

How common is menorrhagia?

Menorrhagia occurs in 1 out of every 5 women. An estimated 10 million women suffer from heavy menstrual bleeding, yet only 2.5 million seek treatment each year. The reason for this is that many women are embarrassed to discuss their periods; they think their bleeding is normal because it has always been that way, or they are afraid of the treatment options.

Heavy bleeding is a problem for many women at different stages of their lives, including women who have had a tubal ligation (had their "tubes tied"), women who have been prescribed hormones and have stopped taking them, or women approaching menopause. These events may cause changes in a woman's bleeding. Your doctor can help you determine whether you may be suffering from menorrhagia. Talking with your doctor can bring you one step closer to relief.

What are the effects of menorrhagia?

Physical
The physical effects of menorrhagia may include:
  • Heavy periods that last more than a few days
  • Heavy bleeding that requires double protection or changing protection every 1 to 2 hours
  • Large blood clots
  • Bad cramping
  • Fatigue or extreme tiredness
  • Anemia
  • Headaches
  • Nausea
Social
Menorrhagia is more than just a physical condition; women are often forced to plan their lives around their heavy periods:
  • More than 60% have had to miss social or athletic events
  • About 80% avoid sexual activities
  • 33% have been forced to miss work
Emotional
Menorrhagia can disrupt the lives of women in other ways as well. Among women with heavy periods:
  • 77% have depression or moodiness
  • 75% feel anxious
  • 57% feel a lack of confidence
If you can identify with any of the symptoms, your doctor can help. Talking with your doctor will bring you one step closer to relief.

Treatment Options for Menorrhagia

NoveSure Endometrial Ablation Hormones Hormone-releasing IUD Dilation and curettage Hysterectomy
Description Quick, simple, safe, and effective procedure that removes the lining of the uterus in about 90 seconds Low doses of female hormones such as birth control pills Device placed in the uterus that releases a female hormone similar to progesterone Surgery to scrape and remove the lining of the uterus Surgery to remove the uterus
Advantages
  • More than 9 out of 10 women return to normal or lower than normal bleeding
  • Typically takes less than 5 minutes
  • Can be done in the office or an outpatient setting
  • Does not require general anesthesia
  • Can be done at any time during the cycle without hormonal pretreatment
  • Recovery in 1 to 2 days
  • Removes lining but leaves uterus intact
  • 97% of women had not needed a hysterectomy 5 years after procedure
  • Reduces bleeding in about half of women
  • Taken by mouth or injection
  • Reversible by stopping the pills or injections
  • Reduces bleeding for a short time
  • 39% efficacy after 5 years
  • Does not require taking pills
  • Inserted in-office
  • Fewer side effects than hormones taken orally
  • Reversible by removing IUD
Reduces bleeding for a short time Definitive treatment
Disadvantages
  • Only appropriate for women who are finished having children
  • Surgical risks associated with minimally invasive procedure
  • Cannot be reversed
  • May take up to 3 months before they start working
  • Possible hormonal side effects (eg, depression, acne, headache, weight gain, breast tenderness, increased risk of cervical cancer)
  • Ongoing cost
  • Must remember to take them
  • 77% of women eventually progress to a surgical solution
  • Women with some medical conditions cannot take hormones
  • May take up to 6 months before they start working
  • Can cause bleeding between periods
  • Possible hormonal side effects (eg, depression, acne, headache, weight gain)
  • Must be removed after 5 years
  • 42% of women require surgery within 5 years
  • May require general anesthesia
  • Reduced bleeding is temporary
  • Surgical risks associated with a minimally invasive procedure
  • Only appropriate for women who are finished having children
  • Risk of major surgery
  • Risks of general anesthesia
  • Recovery takes 2 to 8 weeks
  • Cannot be reversed