Healthy New Jersey

Periods (menstruation)

Heavy periods (menorrhagia)

The medical term for periods with abnormally heavy or prolonged bleed is menorrhagia. Although heavy bleeding is a common concern, most women don't experience blood loss severe enough to be defined as menorrhagia.

Heavy bleeding could keep you from performing your usual activities because you have so much blood loss and cramping. There are effective treatments for heavy bleeding. Speak with your health care provider about your condition.  


Heavy bleeding symptoms could include:

  • Changing your pad or tampon every hour 
  • Bleeding for longer than a week
  • Increased use or doubling of period products
  • Changing your period products during the night
  • Passing blood clots larger than a quarter
  • Limited participate in daily activities 
  • Tiredness, fatigue, or shortness of breath

When to see a health care provider

Seek medical advice if you experience:

  • Frequent changing of period products every hour for more than two hours
  • Bleeding between periods or that affects your daily activities 
  • Irregular bleeding
  • Any bleeding after menopause

Causes of heavy bleeding

Many conditions could cause heavy bleeding. Common causes include:

Hormone imbalance

Estrogen and progesterone are hormones that work together to regulate the lining of the uterus (endometrium) during your period. When there is an imbalance in these hormones, the uterus can become too thick and result in heavy bleeding. Conditions such as polycystic ovary syndrome (PCOS), obesity, insulin resistance, and thyroid problems could cause hormone imbalances. 

Dysfunction of the ovaries

If the ovaries do not release an egg during a menstrual cycle, the body does not produce enough progesterone. This leads to a hormone imbalance and may cause heavy bleeding.

Uterine fibroids

Uterine fibroids are noncancerous growths that appear in the uterus. They can cause heavier or prolonged bleeding.


Polyps are small, benign growths on the lining of the uterus and can cause heavy or prolonged bleeding.


This condition occurs when the glands from the uterus become embedded in the uterine muscle. It often leads to heavy bleeding and painful periods.

Intrauterine device (IUD)

Heavy bleeding can be a side effect of using a nonhormonal IUD for birth control. 

Pregnancy complications

A single, heavy, later period may be due to a miscarriage. Unusual placenta locations, such as low-lying placenta (placenta praevia), can also cause heavy bleeding during pregnancy.


Uterine cancer and cervical cancer can result in excessive bleeding, particularly if you are postmenopausal or have had an abnormal Pap test in the past.

Inherited bleeding disorders

Certain bleeding disorders like von Willebrand's disease, which affects blood-clotting, can lead to abnormal bleeding.

Certain medications

Some medications, such as anti-inflammatory drugs, hormonal medications like estrogen and progestins, and anticoagulants like warfarin or enoxaparin, can contribute to heavy or prolonged bleeding.

Other medical conditions

Conditions like liver or kidney disease may be associated with heavy bleeding.

These are just some of the common causes of heavy bleeding. It's important to consult with a health care professional for proper diagnosis and treatment.


Excessive or prolonged bleeding can lead to other health issues, such as:


Heavy bleeding can cause anemia due to the loss of red blood cells. Red blood cells carry oxygen, and when their numbers decrease, it can lead to anemia. One type of anemia related to heavy bleeding is iron deficiency anemia. When you experience heavy bleeding, your body tries to compensate for the loss of red blood cells by using your iron stores to produce more hemoglobin, which can carry oxygen. Heavy bleeding can lower iron levels enough to increase the risk of iron deficiency anemia.

Symptoms of anemia include pale skin, weakness, and fatigue. While diet can affect iron deficiency anemia, heavy periods can complicate the problem.

Severe pain

Heavy bleeding can cause intense cramps. Sometimes these cramps can be severe enough to require a medical evaluation.


Diagnosis for heavy bleeding requires a physical exam which may include one or more tests and procedures such as:

Blood tests

A sample of your blood may be tested for iron deficiency (anemia) and other conditions, like thyroid disorders or blood-clotting abnormalities.

Pap smear test

Cells from your cervix are collected and tested for infections, inflammation or changes that may be cancerous or may lead to cancer.

Endometrial biopsy

The health care provider may take a sample tissue from the inside of your uterus for examination by a pathologist


This imaging method uses sound waves to produce images of your uterus, ovaries, and pelvis.

Based on the results of your initial tests, the health care provider may recommend further testing.


Treatments are based on many factors, including:

  • Your overall health and medical history.
  • The cause and severity of your condition.
  • Your tolerance for certain medications, procedures, or therapies.
  • The likelihood of your periods becoming less heavy in the future.
  • Your plans for having children in the future.
  • How the condition affects your lifestyle.
  • Your opinion or preferences.


Certain medications can be used to treat heavy bleeding, including:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These include drugs like ibuprofen or naproxen sodium. They not only reduce menstrual blood loss but also provide relief from menstrual cramps.

Tranexamic acid

This medication helps reduce the amount of blood lost during your period. It only needs to be taken when you're experiencing heavy bleeding.

Oral contraceptives

Birth control pills can regulate your periods and decrease episodes of excessive or prolonged bleeding.

Oral progesterone

Progesterone hormone supplements can help correct hormonal imbalances and reduce heavy bleeding.

Intrauterine Device (IUD)

Hormonal IUD devices release a progestin hormone called levonorgestrel, which makes the lining of the uterus thinner. This leads to decreased period blood flow and cramping.

Your heavy periods may be caused by hormone medication. Talk with your health care provider about your options.

If you have anemia due to heavy periods, your health care provider may recommend regular iron supplements. Even if you're not anemic yet but have low iron levels, you might be advised to start taking iron supplements to prevent anemia from developing.

Speak with a health care provider before taking any medications. 

to top