Heavy Bleeding (Menorrhagia)

Heavy menstrual bleeding, also called menorrhagia, is more than just a “heavy period.” It’s a common but often overlooked condition that can interfere with daily life, cause fatigue, and even lead to chronic anemia if left untreated.

If your period is consistently heavy, longer than normal, or difficult to manage, it’s time to talk to your provider. Effective, individualized treatment is available.

What Is Considered Heavy Menstrual Bleeding?

Your period may be classified as “heavy” if you experience one or more of the following:

  • Bleeding that lasts longer than 7 days
  • Needing to change a pad or tampon every 1–2 hours
  • Passing large blood clots (larger than a quarter)
  • Waking at night to change protection
  • Bleeding that soaks through multiple layers of clothing or bedding
  • Symptoms of anemia, such as fatigue, shortness of breath, or dizziness

Common Causes of Heavy Bleeding

Heavy periods can result from several conditions or imbalances. Your provider will help identify the cause based on your symptoms, medical history, and test results.

Hormonal causes:

  • Polycystic ovary syndrome (PCOS)
  • Thyroid dysfunction
  • Perimenopause or irregular ovulation

Structural causes:

Other contributing factors:

  • Blood clotting disorders
  • Certain medications (such as blood thinners)
  • Use or recent removal of certain types of IUDs
  • Pregnancy complications (miscarriage, ectopic pregnancy)

Understanding the root cause is the first step toward lasting relief.

When to Seek Medical Care

It’s time to see a provider if:

  • You experience heavy bleeding month after month
  • You’re changing pads/tampons more often than every 1–2 hours
  • You pass multiple or large clots (larger than a quarter) or have to double up on menstrual protection
  • You experience pain, fatigue, dizziness, or lightheadedness
  • Bleeding impacts your work, sleep, or social life
  • You’re concerned about fertility or planning pregnancy

Diagnosis

We’ll begin with a review of your menstrual history, symptoms, and general health. Diagnostic tools may include:

  • Pelvic exam
  • Blood tests (to check for anemia, thyroid function, clotting issues)
  • Pelvic ultrasound (to detect fibroids, polyps, or structural changes)
  • Endometrial biopsy (if needed to evaluate the uterine lining)
  • Hysteroscopy (a detailed look inside the uterus, if indicated)

These tools help us understand what’s causing your symptoms and guide treatment planning.

Treatment Options

Your treatment plan will depend on the cause of your heavy bleeding, your age, and whether you plan to become pregnant in the future.

Nonsurgical treatments may include:

  • Hormonal birth control (pills, patch, ring, IUD) to regulate or reduce bleeding
  • Tranexamic acid or NSAIDs to reduce blood loss during periods
  • Thyroid or other hormonal therapies
  • Iron supplements and/or nutritional adjustments to treat or prevent anemia

Minimally invasive procedures include:

  • In-office polyp or fibroid removal
  • Endometrial ablation (removes the uterine lining to reduce or stop periods)
  • Uterine artery embolization (shrinks fibroids by blocking blood flow)

Surgical options:

  • Myomectomy (fibroid removal while preserving the uterus)
  • Hysterectomy (removal of the uterus—typically considered if other treatments fail and childbearing is complete)

Take Control of Your Menstrual Health

Heavy bleeding is common, but it’s not normal if it interferes with your life. You don’t have to struggle with discomfort, fatigue, or uncertainty any longer.

Schedule an appointment today to evaluate your symptoms and explore treatment options that work for you.