Millions of American women have menorrhagia, or heavy bleeding during their menstrual cycle. How do you know if you’re one of them? Read on to learn the signs and what to do.
Signs of Menorrhagia
Talk to your doctor if you deal with any of the issues below.
- Your period soaks through one or more pads (or tampons) every hour throughout the day.
- You double up on pads to manage your flow.
- You have to change your pads or tampons in the middle of the night.
- Your periods last more than 7 days.
- You have blood clots the size of a quarter or larger.
- Your period is so heavy, it keeps you from doing your daily activities.
- You have constant pain in your lower stomach during your cycle.
- You are tired, have low energy, and shortness of breath.
Causes
Abnormal heavy bleeding can have many causes.
- Hormone imbalance
- Problems with your uterus
- Precancer/cancer
- Infections
- Medications like aspirin, blood thinners, and certain birth control pills
- Foreign bodies like a forgotten IUD
- Other medical conditions such liver, kidney, or pelvic inflammatory disease
Before Your Appointment
Get the most out of your appointment by preparing a list of questions for your doctor. Talking about the following can help them pinpoint what might be wrong:
Your family and medical history. Any past surgeries, any women in your family with reproductive system issues
Your sexual history. The number of sexual partners, if they’re male or female, and if you use protection
Tell them about any unpleasant or possibly embarrassing symptoms, too. These include:
- Odor
- Pain during sex
- Low interest in sex
- Leaking pee
Diagnosing Menorrhagia: The Doctor Visit
Here are some questions your doctor might ask:
- What brings on your bleeding?
- What other symptoms do you have?
- Are you pregnant?
- When did your symptoms begin? (Try to get as close as possible to the date.)
- Are your symptoms constant or on and off?
- On a scale of 1 to 10, how painful or heavy are your periods?
- Does anything make your symptoms better?
- Does anything make your symptoms worse?
It may be helpful to get a notepad to jot down the answers to these questions before your appointment. Or you can type them in the notes section of your phone. If you’re worried you’ll forget, bring a family member or friend with you to your appointment who can help you remember the details.
The doctor will likely do the following to confirm you have menorrhagia:
A pelvic exam. Your doctor will use two gloved fingers to check the outside and inside of your vagina, checking the health of your uterus, ovaries, and cervix (cervical exam).
APapsmear. Your doctor will swab the inside of your cervix to collect cells to be reviewed in a lab.
In addition to physical exams, your doctor may order several tests to diagnose heavy bleeding. These include:
Pregnancy test. A miscarriage can cause heavy bleeding. You can test positive more than a month after a miscarriage. You might have light bleeding during the early stages of pregnancy. Call your doctor right away if your bleeding is heavy while you’re pregnant.
Blood tests. Your doctor can see if you have an issue with clotting or your overall blood count.
Thyroid test. A problem with your thyroid might show a problem with your ovaries – which could cause heavy bleeding.
Hormone levels. If your hormones are not balanced, it can cause bleeding. Or your hormone levels can provide clues of something else causing your bleeding.
Hysteroscopic exam/hysteroscopy. This surgery lets your doctor check the lining of your uterus. It can show fibroids, polyps, or signs of cancer.
Pelvic ultrasound. This imaging lets your doctor check for growths in your reproductive organs.
Sonohysterogram (saline or salt-infusion sonography). Your doctor will use a saltwater solution and soundwaves to see any abnormal areas in your uterus, like polyps or fibroids.
Biopsy. In this exam, your doctor can check tissue samples from the lining of your uterus to spot cancer or pre-cancer cells.
When to Go to the Emergency Room
If you’re pregnant, some vaginal bleeding is normal and some is serious, but it’s better to be safe than sorry. Call 911 or go to the ER right away. Do so even if you’re not pregnant, but you have heavy bleeding and the following:
- Shortness of breath
- High heart rate
- Feeling faint or dizzy
These symptoms may mean anemia (low red blood cells) or low oxygen and can be serious.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
CDC: “Heavy Menstrual Bleeding.”
Cleveland Clinic: “Abnormal Heavy Bleeding,” “Pap Smear.”
Mayo Clinic: “Heavy Menstrual Bleeding,” “Pelvic Exam,” “Vaginal Bleeding.”
Temple Health: “What Topics to Discuss with Your Gynecologist.”
John Hopkins Medicine: “Sonohysterography.”
