Heavy menstrual bleeding (formerly known as menorrhagia) is a common disorder among people who menstruate. It refers to bleeding lasting longer than seven days and involves more blood flow than is typical during menstruation. Talk to your provider about treatment options if you’re experiencing disruption to your everyday life because of heavy period bleeding.
Heavy menstrual bleeding (formerly called menorrhagia) is when your periods are extremely heavy or prolonged. "Heavy" means that your period lasts longer than seven days or that you lose more blood than is typical during menstruation. You may bleed so much that you have to change your tampon or pad every hour for several hours back-to-back. You may pass blood clots the size of a quarter or even larger.
Menstrual bleeding that's so heavy that it interferes with your daily life is never normal. Your provider can recommend treatments to manage heavy blood flow.
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Heavy period bleeding is common, affecting anywhere from 27% to 54% of people who menstruate.
Heavy menstrual bleeding can be serious if you lose so much blood that you show signs of anemia. Anemia is a condition arising from having too little iron in your body. Anemia can be life-threatening without treatment.
Also, some of the conditions that can cause heavy period bleeding, like cancer, require early medical intervention. Speak with your healthcare provider to discuss any risks related to your period bleeding.
Signs of heavy menstrual bleeding include:
With anemia, you may also notice signs of a condition called pica. Pica symptoms include hair loss, pale skin, and the urge to eat non-food items (paper, hair, dirt, etc.). See your provider if have these symptoms.
Heavy menstrual bleeding interferes with your quality of life. Many people with heavy periods assume that periods are supposed to be inconvenient and uncomfortable. They may have watched people in their families live with heavy periods without seeking care and followed their example. But periods should never cause you to restrict activities or accept inconvenience.
During your period, you should be able to:
If your periods are disrupting your life, it's time to see your provider.
Heavy menstrual bleeding is a period that lasts longer than seven days. How long you bleed depends on what's causing your bleeding.
Heavy menstrual bleeding can have many causes, ranging from hormone-related issues to various medical conditions and even stress.
The hormones that your body produces, like estrogen and progesterone, help regulate your menstrual cycle, including how heavy your periods are. Having a condition that causes your hormones to become imbalanced can lead to heavy period bleeding. Causes include:
Weighing more than your ideal body weight can interfere with your body's hormone production and lead to heavy menstrual bleeding, too.
Benign growths in your uterus and conditions that cause cells in your uterus to grow improperly can cause heavy menstrual bleeding, too. Causes include:
Conditions that increase your risk of getting cancer, including endometrial hyperplasia, as well as cancers that affect your reproductive system, can cause heavy menstrual bleeding. These include:
Infections, including sexually transmitted infections (STIs) can cause heavy bleeding. These include:
Heavy bleeding can be a warning sign of pregnancy complications, such as:
Heavy menstrual bleeding is a symptom associated with various conditions, including bleeding disorders and non-bleeding disorders. Some common medical conditions that can lead to heavy bleeding are:
Certain medicines can cause heavy menstrual bleeding, too. These include:
Failing to remove contraceptive devices when needed can also cause abnormal uterine bleeding.
Your healthcare provider will ask a series of questions about your medical history and menstrual cycle to diagnose heavy menstrual bleeding.
Your provider may ask about:
Come prepared to talk about your quality of life, too. Your provider needs to know if you've been doubling up on menstrual products, avoiding activities or placing restrictions on your life in any way because of heavy periods.
Your provider will do a physical exam and a pelvic exam. Many non-invasive procedures are available that can help your provider diagnose what's causing your bleeding, such as:
You may have other tests, depending on your age and how severe your symptoms are. Other tests may include:
Treatment depends on what's causing your bleeding, how severe your bleeding is, your health, age and medical history. Also, treatment depends on your response to certain medicines and your preferences. For instance, you may not want to have a period at all, or you may want to reduce your bleeding. In addition, your plans to get pregnant will affect your treatment options.
Talk with your provider about your health concerns and your goals for treatment.
Hysteroscopy is often used to diagnose and treat heavy period bleeding. With an operative hysteroscopy, your provider inserts a thin, lighted tube into your vagina that allows them to inspect your uterine cavity. The hysteroscope acts as a precise surgical instrument, too, and can help your provider remove any growths that may be causing your bleeding.
Other procedures include:
Treatment may begin with medication and then progress to minor procedures and surgical options. Speak with your provider to decide which options work best for your health and your goals for treatment.
You can't prevent all causes of heavy period bleeding. But talking with your healthcare provider to get diagnosed and treated can help you manage your bleeding so that it doesn't interfere with your quality of life.
Left untreated, heavy periods can interfere with your life. In addition, heavy menstrual bleeding can cause anemia and leave you feeling tired and weak. Other health problems can also arise if you don't get help. With proper treatment and assistance from your provider, you can manage heavy periods without compromising your well-being.
You should call your provider if you're experiencing the symptoms of heavy menstrual bleeding or anemia, or if your period bleeding has become abnormal. Tracking your periods using a calendar or app can help you identify if your periods are heavier and longer-lasting than usual. Share these notes with your provider.
You should also schedule an appointment if you notice that you're having to double-up on menstrual products or if you're skipping activities you enjoy because of heavy bleeding.
Heavy periods aren’t usually life-threatening, but they can be if you lose too much blood. Bleeding through two or more tampons or pads each hour for two hours in a row is a sign that you should see your provider or seek emergency care immediately.
A note from Cleveland Clinic
Just because heavy periods are common doesn't mean that you have to learn to live with the discomfort they cause. If managing your blood flow is getting in the way of your emotional and physical well-being, speak with your provider. They can provide a care path that will provide relief.
Last reviewed by a Cleveland Clinic medical professional on 11/11/2021.
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