“Heavy menstrual bleeding affects
about one in five women and is a common problem
in the 30-50-year-old age group”.1

Umbrella
What may the Periods and Heavy Bleeding Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Dysfunctional Uterine Bleeding
  • Heavy Bleeding
  • Heavy Menstrual Bleeding
  • Heavy Periods
  • Heavy Uterine Bleeding
  • Menorrhagia

Heavy Menstrual Bleeding

What is heavy menstrual bleeding?

DotS the definition of heavy menstrual bleeding may vary. The (Australian) Jean Hailes for Women’s Health’s (JH) definition is:

“Heavy menstrual bleeding (also known as menorrhagia) is excessive and/or prolonged menstrual bleeding. The amount varies from woman to woman and can change at different stages in your life; for example, in teenage years or approaching menopause. It is defined as blood loss greater than 80ml (equal to one-third of a cup) per cycle, or periods lasting more than seven to eight days”.2

Menorrhagia

What is menorrhagia?

DotS the definition of menorrhagia may vary. The (United States) Mayo Clinic’s definition is:

“Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern, most women don’t experience blood loss severe enough to be defined as menorrhagia”.3

The (United States) Centers for Disease Control’s (CDC) definition is:

Menorrhagia is menstrual bleeding that lasts more than 7 days. It can also be bleeding that is very heavy”.4

Heavy or Not

How heavy is heavy menstrual bleeding?

In Bleeding Disorders In Women: Heavy Menstrual Bleeding the CDC explain:

“How do you know if you have heavy bleeding? If you need to change your tampon or pad after less than 2 hours or you pass clots the size of a quarter or larger, that is heavy bleeding. If you have this type of bleeding, you should see a doctor”.5

In Heavy Bleeding: How Do You Know If Your Bleeding Is Too Heavy? the JH note:

“It is very difficult to determine whether your bleeding is too heavy. The best guide is to decide whether your period is having an impact on your quality of life – if it is causing you to be housebound, interrupting your daily activities, or causing you stress and anxiety. The following signs might indicate you are experiencing heavy bleeding:

  • Bleeding or ‘flooding’ not contained within a pad/tampon (especially when wearing the largest size)
  • Changing a pad/tampon every hour or less
  • Changing a pad overnight
  • Clots greater than a 50-cent piece in size
  • Bleeding for more than seven to eight days”.6

Cause

What causes heavy menstrual bleeding?

In Heavy Periods: Causes of Heavy Periods the (United Kingdom) NHS elaborate on:

“It can be normal to have heavy periods.

They can sometimes be heavy at different times, like when you first start your periods, after pregnancy or during menopause.

Sometimes, they can be caused by:

  • Conditions affecting your womb, ovaries or hormones, such as polycystic ovary syndrome, fibroids, endometriosis and pelvic inflammatory disease
  • Some medicines and treatments, including some anticoagulant medicines and chemotherapy medicines
  • Stress and depression

Rarely, heavy periods can be a sign of womb cancer”.7

In Menorrhagia (Heavy Menstrual Bleeding): Symptoms & Causes – Causes the Mayo Clinic elaborate on:

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

  • Hormone imbalance…
  • Dysfunction of the ovaries…
  • Uterine fibroids…
  • Polyps…
  • Adenomyosis…
  • Intrauterine device (IUD)…
  • Pregnancy complications…
  • Cancer…
  • Inherited bleeding disorders…
  • Medications…
  • Other medical conditions…”.8

Common or Not

How common is heavy menstrual bleeding?

According to the JH:

Periods and Heavy Bleeding
“Heavy menstrual bleeding affects about one in five women and is a common problem in the 30-50-year-old age group”.9

Perimenopause

Is there an association between perimenopause and heavy bleeding?

In Perimenopause: Symptoms & Causes – Complications the Mayo Clinic explain:

“Irregular periods are a hallmark of perimenopause. Most of the time this is normal and nothing to be concerned about. However, see your doctor if:

  • Bleeding is extremely heavy — you’re changing tampons or pads every hour or two for two or more hours
  • Bleeding lasts longer than seven days
  • Bleeding occurs between periods
  • Periods regularly occur less than 21 days apart.

Signs such as these may mean there’s a problem with your reproductive system that requires diagnosis and treatment”.10

Treatment

What are treatment options for heavy menstrual bleeding?

In Heavy Periods: Treatment the (British) Women’s Health Concern elaborate on:

“Treatment options depend on the type and duration of abnormal bleeding, the presence of specific disease or condition, your age, and desire for further pregnancies. Treatment can be medical or surgical”.11

In Bleeding Disorders In Women: Heavy Menstrual Bleeding: Treatment the CDC elaborate on different types of treatment and note:

“The type of treatment you get will depend on the cause of your bleeding and how serious it is. Your doctor also will look at things such as your age, general health, and medical history; how well you respond to certain medicines, procedures, or therapies; and your wants and needs”.12

Health Care Provider

What if I have heavy menstrual bleeding?

If you have heavy menstrual bleeding, it may be in your best interest to choose to talk to your health care provider about this. In Heavy Menstrual Bleeding (Menorrhagia): Living With – When Do You Call Your Healthcare Provider If You Suspect Heavy Period Bleeding? the (United States) Cleveland Clinic explain:

“You should call your provider if you’re experiencing the symptoms of heavy menstrual bleeding or anemia, or if your period bleeding has become abnormal. Tracking your periods using a calendar or app can help you identify if your periods are heavier and longer-lasting than usual. Share these notes with your provider.

You should also schedule an appointment if you notice that you’re having to double-up on menstrual products or if you’re skipping activities you enjoy because of heavy bleeding”.13

The Mayo Clinic also note:

“Seek medical help before your next scheduled exam if you experience:

  • Vaginal bleeding so heavy it soaks at least one pad or tampon an hour for more than two hours
  • Bleeding between periods or irregular vaginal bleeding
  • Any vaginal bleeding after menopause”.14

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Sources

Where may I find the Sources quoted?

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Sources

  1. Heavy Bleeding: What Is Heavy Bleeding? Last Updated: 16 August 2022 | Last Reviewed: 10 July 2018. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/periods/heavy-bleeding Accessed: 09 September 2022
  2. Heavy Bleeding: What Is Heavy Bleeding? Last Updated: 16 August 2022 | Last Reviewed: 10 July 2018. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/periods/heavy-bleeding Accessed: 09 September 2022
  3. Menorrhagia (Heavy Menstrual Bleeding): Symptoms & Causes – Overview. 25 June 2022. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829 Accessed: 09 September 2022
  4. Bleeding Disorders In Women: Heavy Menstrual Bleeding. Page Last Reviewed: 17 August 2022. Centers for Disease Control and Prevention https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html Accessed: 09 September 2022
  5. Bleeding Disorders In Women: Heavy Menstrual Bleeding. Page Last Reviewed: 17 August 2022. Centers for Disease Control and Prevention https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html Accessed: 09 September 2022
  6. Heavy Bleeding: How Do You Know If Your Bleeding Is Too Heavy? Last Updated: 16 August 2022 | Last Reviewed: 10 July 2018. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/periods/heavy-bleeding Accessed: 09 September 2022
  7. Heavy Periods: Causes of Heavy Periods. Page Last Reviewed: 03 November 2021. NHS https://www.nhs.uk/conditions/heavy-periods/#what-causes-heavy-periods Accessed: 09 September 2022
  8. Menorrhagia (Heavy Menstrual Bleeding): Symptoms & Causes – Causes. 25 July 2022. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829 Accessed: 09 September 2022
  9. Heavy Bleeding: What Is Heavy Bleeding? Last Updated: 16 August 2022 | Last Reviewed: 10 July 2018. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/periods/heavy-bleeding Accessed: 09 September 2022
  10. Perimenopause: Symptoms & Causes – Complications. 07 August 2021. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 Accessed: 09 September 2022
  11. Heavy Bleeding: Treatment. Reviewed: November 2019. British Women’s Health Concern https://www.womens-health-concern.org/help-and-advice/factsheets/heavy-periods/ Accessed: 09 September 2022
  12. Bleeding Disorders In Women: Heavy Menstrual Bleeding: Treatment. Page Last Reviewed: 17 August 2022. Centers for Disease Control and Prevention https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html Accessed: 09 September 2022
  13. Heavy Menstrual Bleeding (Menorrhagia): Living With – When Do You Call Your Healthcare Provider If You Suspect Heavy Period Bleeding? Last Reviewed: 11 November 2021. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17734-menorrhagia-heavy-menstrual-bleeding Accessed: 09 September 2022
  14. Menorrhagia (Heavy Menstrual Bleeding): Symptoms & Causes – Symptoms: When To See A Doctor. 25 June 2022. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829 Accessed: 09 September 2022
Topic Last Updated: 06 November 2022 – Topic Last Reviewed: 09 September 2022

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