Heavy Bleeding during Periods (MENORRHAGIA)

Menorrhagia is the medical term used for menstrual periods with the abnormally heavy or prolonged bleeding. Although abnormally heavy menstrual bleeding is a common concern, most women don’t experience significant blood loss to be defined as menorrhagia.

With menorrhagia, you can’t carry out your routine activities when you have your period because you have too much blood loss and cramping. If you are scared of your period because you have such heavy menstrual bleeding, talk with your gynaecologist. There are many effective treatments for heavy menstrual bleeding.


Signs and symptoms of menorrhagia may include:

  • Soaking through one or more sanitary napkins every hour for many consecutive hours
  • Need to use double sanitary protection to control your blood flow during periods
  • Need to wake up to change the sanitary protection during the night
  • Menstrual bleeding lasting for longer than a week
  • Passing blood clots during the periods
  • Need to restrict your daily activities due to heavy menstrual flow
  • Symptoms of anemia,(low haemoglobin) such as excessive tiredness, fatigue or shortness of breath

When to Consult A Doctor

Most women do not seek medical help before they experience severe symptoms. Consult your doctor when you experience:

  • Vaginal that is so heavy that it soaks at least one pad an hour for more than two hours bleeding
  • Vaginal bleeding between periods or irregular vaginal bleeding
  • Any vaginal bleeding after menopause (when your periods have stopped for one year)

Causes of Heavy Bleeding Periods during Menorrhagia

In some cases, the cause of the heavy menstrual bleeding is unknown, but a number of conditions may cause menorrhagia. Common causes include:

  • Hormone imbalance: In a normal menstrual cycle, there is a balance between the hormones estrogen and progesterone which regulates the formation of the lining of the uterus (endometrium), which is shed during menstruation. If a hormonal imbalance occurs, the endometrium develops in excess and eventually sheds by way of the heavy menstrual bleeding.

A number of conditions can cause hormonal imbalance, including polycystic ovary syndrome (PCOS), insulin resistance, obesity and thyroid problems.

  • Ovarian dysfunction: If your ovaries don’t release an egg (ovulate) during a menstrual cycle (anovulation), the hormone progesterone is not produced by your body, as it would produce during a normal menstrual cycle. This leads to the hormonal imbalance and may result in menorrhagia.
  • Uterine fibroids: These noncancerous (benign) tumours of the uterus appear during your childbearing age. Uterine fibroids may cause heavy or prolonged menstrual bleeding.
  • Polyps: These are small, benign growths in the lining of the uterus (uterine polyps) which may cause heavy or prolonged menstrual bleeding.
  • Adenomyosis: This condition occurs when glands from the lining of uterus become embedded in the uterine muscle. This often causes heavy bleeding and painful periods.
  • Intrauterine device (IUD): Heavy menstrual bleeding is a well-known side effect of using a nonhormonal intrauterine device for birth control. Your doctor will help you plan for alternative contraceptive options.
  • Cancer: Cancer of the Uterus and cervix can cause the heavy menstrual bleeding or irregular bleedings, especially if you are postmenopausal or have had an abnormal Pap test in the past.
  • Inherited bleeding disorders: Some bleeding diathesis— such as von Willebrand’s disease, a condition in which an important blood-clotting factor is deficient — can cause abnormal menstrual bleeding.
  • Medications: Certain medicines, including anti-inflammatory medications, hormonal medications such as oestrogen and progesterone, and anticoagulants such as warfarin or enoxaparin, can cause heavy or prolonged menstrual bleeding.
  • Other medical conditions: A number of other medical conditions, including liver or kidney disease, may be associated with menorrhagia.

Risk Factors

Risk factors for menorrhagia vary with age and depend on whether you have other medical conditions that may explain your menorrhagia. In a normal menstrual cycle, the release of one egg from the ovaries stimulates the body’s production of progesterone, the female hormone that is responsible for keeping flow during periods in check. When the egg is not released, insufficient production of progesterone can cause heavy menstrual bleeding.

Heavy bleeding in young adolescent girls is typically due to anovulation. Adolescent girls are more prone to anovulatory cycles in the first year after their first menstrual period (menarche).

Heavy bleeding in older reproductive-age women is typically due to uterine abnormalities, including fibroids, polyps and adenomyosis. However, other problems, such as uterine or cervical cancer, medication side effects, bleeding disorders and liver or kidney disease could be contributing causes.


Heavy or prolonged menstrual bleeding can lead to other medical problems, including:

  • Anaemia: Menorrhagia can cause iron deficiency anaemia by reducing the number of circulating red blood cells. The number of circulating red blood cells is measured by haemoglobin, a protein that enables red blood cells to carry oxygen to tissues.

Iron deficiency anaemia occurs as your body attempts to make up for the lost red blood cells by consuming your body’s iron stores to make more haemoglobin, which can then carry oxygen in red blood cells deficiency.

Signs and symptoms of anaemia include pale skin, weakness and fatigue. Although diet plays a role in iron deficiency anaemia, the problem is complicated by heavy bleeding during periods.

  • Severe pain: Along with heavy menstrual bleeding, you might experience painful menstrual cramps (dysmenorrhea). Sometimes the cramps associated with menorrhagia are severe enough to require medical attention.

Treatment of Heavy Bleeding During Periods of Menorrhagia of Menorrhagia

Treatment depends on the age of the patient and the underlying cause. These include medications like a combination of tranexamicacisnad NSAIDS, hormones like oestrogen, and progestins or combined oral contraceptive pills. Treatment may also include surgical options where medical options fail or are not indicated. This includes conservative surgeries like hysteroscopic ablation of endometrium or hysterectomy.

24 Hour Helpline at KJIVF

KJIVF and Laparoscopy Centre will provide you with the facility of a 24-hour helpline for your menorrhagia. The 24-hour helpline allows you to seek medical help as soon as you experience heavy bleeding during periods. As the menstrual cycle is a natural phenomenon and bleeding may start at any time of the day, the availability of a 24-hour helpline avoids unnecessary suffering. We have experienced staff at KJIVF that provide you with counselling as well as medical advice. They can also connect you to a specialist doctor whenever required.

For more queries, Call us at +9196507 25386, +91 011 3560 4368.