Prolonged Menstruation or Excessive Menstrual Bleeding

The medical term for heavy vaginal bleeding (or heavy menstrual bleeding) is menorrhagia. This condition occurs when your period lasts longer than seven days and/or when the bleeding soaks more than five sanitary pads per day or requires you to change your pad multiple times at night.

Menorrhagia can have many causes, including:

• Irregular ovulation
• Uterine fibroids and polyps
• Hormonal imbalance of estrogen and progesterone
• Bleeding disorders
• Use of blood thinners, aspirin or the copper IUD
• Endometriosis
• Ectopic pregnancy or miscarriage
• Pelvic inflammatory disease
• Endometrial cancer

In addition, giving birth multiple times and smoking can also increase your risk for heavy vaginal bleeding.

Symptoms, Diagnosis and Outlook

The signs and symptoms of heavy vaginal bleeding are:

• Period that lasts longer than seven days
• Bleeding that requires changing your pad or tampon once or twice per hour for several hours in a row
• Bleeding that requires changing your pad multiple times at night
• Bleeding that requires wearing more than one pad at a time
• Bleeding with blood clots larger than a quarter
• Painful menstrual cramps (dysmenorrhea)

To diagnose the cause of your heavy menstrual bleeding, your obstetrician-gynecologist will review your medical history and perform a pelvic exam. Your doctor will need to learn about your menstrual cycle, contraceptive and medication use, sexual history and other lifestyle factors in order to make a diagnosis. Additional tests will then be done to narrow down the cause:

• A blood test may be done to check your hormone and iron levels and to test for bleeding disorders.
• A pregnancy test may be done to rule out ectopic pregnancy or miscarriage.
• Imaging tests may be performed to look for conditions that affect the uterus and other reproductive organs.
• An endometrial biopsy may be performed if your OB-GYN suspects your heavy bleeding is caused by a hormonal imbalance or endometrial cancer.
• A laparoscopy may be done if your doctor suspects you have endometriosis.

If you suffer from heavy vaginal bleeding, it’s important to talk to your OB-GYN about your symptoms. Blood loss from the condition may lead to iron-deficiency anemia. And some conditions that cause heavy menstrual bleeding also cause infertility. The right diagnosis and treatment will improve your quality of life and protect your reproductive and overall health.

Why Choose Penn State Health for Care

A Comprehensive, Multidisciplinary Team Approach

Because heavy vaginal bleeding can have many causes, it requires comprehensive treatment. Our team is made up of many different medical and surgical specialists, including physicians from obstetrics and gynecology, female pelvic medicine and reconstructive surgery, minimally invasive gynecologic surgery, and reproductive endocrinology and infertility. By working together, we can ensure an accurate diagnosis and thorough treatment plan that considers all options.

The Most Advanced Ultrasound Imaging

Our reproductive endocrinology doctors are able to perform advanced ultrasound imaging to examine the female reproductive system. Advanced imaging allows for the most precise, individualized treatment plan. These doctors are accredited by the American Institute of Ultrasound in Medicine.

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