Normal menstruation is familiar to most women:  it is the monthly result of the shedding of the lining of the uterus (endometrium) which is accompanied by a fairly predictable amount of vaginal bleeding for 3 to 5 days.  Some women experience excessive menstrual bleeding, also known as menorrhagia.  This is technically defined as blood loss of more than 80mL during a menstrual cycle.  Clinically, this translates into bleeding for more than seven days or needing to use more than 10 pads or tampons per day during the menstrual cycle.  Aside from being annoying and inconvenient, excessive menstrual bleeding is a common cause of iron deficiency anemia (a low blood count and low blood iron levels).  More than two-thirds (67 percent) of patients who have excessive menstrual bleeding also suffer from anemia.

Women describe the symptoms of excessive menstrual bleeding as unmanageable bleeding accompanied by a constant need to change soaked pads or tampons.  They often complain of fatigue and worry about embarrassing accidents.

The causes of excessive menstrual bleeding include:

• Hormonal imbalances -- cause dysfunctional uterine bleeding (DUB) and accounts for approximately 20 percent of hysterectomies.
• Fibroids and polyps -- cause structural uterine bleeding, and account for 30 percent of hysterectomies performed. 
• Infection or disease -- infection of the uterus or cervix and certain types of cancer, such as cancer of the uterus, cervix or vagina.

If you think your periods are excessive, too heavy, or last too long, try to do a pad or tampon count for each day during one cycle.  Write this down along with any other symptoms you may have (e.g. fatigue, headache, dizziness, weakness, cramping, etc.) and discuss it with your doctor at your next appointment. 

Created: 7/1/2003  -  Donnica Moore, M.D.