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Alternative names Return to top
Periods - heavy, prolonged, or irregular; Menorrhagia; Menstrual periods - abnormal; Abnormal menstruation; Menstruation - irregular; Irregular menstrual periodsConsiderations Return to top
The menstrual cycle is not the same for every woman. On average, menstrual flow occurs every 28 days and lasts about 4 days. However, there is wide variation in timing and duration that is still considered normal, especially if your periods began within the last two years.
If you soak through a sanitary pad or tampon every hour for 6 consecutive hours, this is considered a very heavy period. A prolonged period is one that lasts longer than 7 days. Irregular periods happen more often than every 21 days or less often than every 35 days.
These variations may be normal and are less concerning than bleeding, pain, or discharge between periods.
Bleeding may be something to worry about if you are over age 50, especially if you have already gone through menopause. The risk of cancer increases with age.
Often, if you are bleeding from the rectum or in your urine, you think it is coming from the vagina. To know for certain, insert a tampon into the vagina to confirm that it's the source of your bleeding.
Common Causes Return to top
Home Care Return to top
Keep a record of your menstrual cycles, including when menstruation begins and ends, how much flow you have (count numbers of pads and tampons used, noting whether they are soaked), and any other symptoms you experience. Tampons should be changed at least twice a day to avoid infection.
Bed rest may be recommended if bleeding is heavy.
Because aspirin may prolong bleeding, it should be avoided. Ibuprofen is usually more effective than aspirin for relieving menstrual cramps.
PREVENTION
Call your health care provider if Return to top
Call your doctor if:
What to expect at your health care provider's office Return to top
Your doctor will perform a physical examination, including a pelvic exam. Your doctor will ask questions like the following to determine the history of this symptom:
Diagnostic tests that may be performed include:
Ibuprofen or another prostaglandin inhibitor is often prescribed. Ibuprofen is also available in lower dosages (Advil, Nuprin) without prescription.
In some cases of heavy bleeding, dilation and curettage, "D and C", may be required.
If a tumor is found, surgery (a hysterectomy) will sometimes be needed, but the common "fibroid" tumor (uterine fibroids) may stop growing by itself, and surgery may not be needed depending on the amount of bleeding and the response to various treatment attempts. Such tumors often grow slowly and stop growing at menopause, so an operation can be avoided by waiting. However, if there has been rapid growth of the fibroid tumor or if your Pap smear is abnormal, surgery or another type of therapy may be necessary.
If the heavy bleeding is related to hormonal abnormalities, treatment of the specific abnormality will correct the bleeding. Female hormones (birth control pills or progestins) are commonly used to regulate menses.
Update Date: 10/13/2003 Updated by: Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma., and Senior Medical Editor, A.D.A.M., Inc. Previously reviewed by Peter Chen, M.D., Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network (1/14/2002).
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Page last updated: 28 October 2004 |