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Heavy Menstrual Bleeding

During reproductive period of life many women experience heavy menstrual bleeding or prolonged heavy menstrual period but how to know when menstrual bleeding is abnormal. Doctors recommend just taking notes of how often you need to change your menstrual pad or tampon – if you are forced to change them every one or two hours, it means you have heavy menstrual bleeding (sometimes called “menorrhagia”).

It is not easy to define exactly what is heavy menstrual bleeding because the amount of blood that is lost during menstrual period can vary considerably between women. Sometimes gynecologists can measure blood loss during menstrual period and heavy menstrual bleeding is considered to be 60-80ml or more in each cycle. The average amount of blood that is lost during normal healthy menstruation is 30-40ml.

Heavy menstrual bleeding does not necessarily mean that woman has any serious problem, but intensive bleeding could affect a women’s everyday life – physically, emotionally and socially.

Heavy menstrual bleeding – risk factors

Females with menstrual cycle without ovulation are at high risk of heavy menstrual bleeding. In most cases it is adolescent girls who just started menstruation (during first year of menstrual cycle) or women after 40 who are approaching premenopause and menopause. Mentioned two periods of reproductive life are known as periods of dramatic hormonal disturbances – absence of ovulation and insufficient progesterone production. These hormonal dysfunctions could trigger heavy menstrual bleeding.

Heavy Menstrual Bleeding

Heavy Menstrual Bleeding – causes

Female Hormones

Hormonal imbalance during adolescence or premenopause is the most common cause of heavy menstrual bleeding. Hormonal imbalance of main female hormones (estrogen and progesterone) trigger inadequate development of endometrium (internal uterine lining) – excessive (thick) grow of endometrium and shedding of extra tissue. And finally during mentioned periods the fluctuation of hormones leads to excessive heavy monthly uterine bleeding.


Uterine fibroids can easily trigger heavy menstrual bleeding. It is well known that uterine fibroids are estrogen-dependent and excessive estrogen production can lead to heavy menstrual bleeding. In these cases treatment could be hormonal or surgical.


Polyps could be cervical or uterine.
The cause of cervical polyps could be infection and abnormal response to increased levels of main female hormone estrogen. Sometimes the cause of cervical polyp could be the congestion of the blood vessels located in the cervix.

Endometrial polyps are growing fromthe lining of the uterus. The grow of uterine polyps often associated with an excess levels of estrogen in women blood which could be a result of ovarian tumors or hormonal therapy or hormonal contraception.


Adenomyosis is a very specific rare health condition which results from the lining cells of the uterus growing directly into the muscle wall of the uterus (into myometrium) – actually the endometrial tissue, which normally lines the uterus from inside, start growing into the muscular walls of the uterus.
Adenomyosis can often cause heavy menstrual bleeding and painful periods.


Lupus is a chronic inflammatory autoimmune disease that affects several parts of the body, particularly the skin, joints, blood and kidneys. This complicated genetically predisposed disease could be triggers by several factors including infections, certain types of antibiotics, UV light, severe stress, hormones and some other drugs.


Medical professionals noted heavy menstrual bleeding during treatments with following medications – acetaminophen, steroids, antimalarials, cytoxic or immunosuppressive drugs, and anticoagulants.

Pelvic Inflammatory Diseases (PID)

Pelvic inflammatory disease (PID) is an infection of one or more reproductive organs (uterus, fallopian tubes, and cervix). Very often PID is developed because of sexually transmitted diseases (STDs) but sometimes it could be triggered by other types of infections after childbirth, abortion, gynecological procedures or operations. Women with PID often suffer from heavy menstrual bleeding.


Cervical cancer and endometrial cancer could be a serious cause of heavy menstrual bleeding.
Cervical cancer is a type of cancer that occurs when cells in the cervix become abnormal, multiply out of control. It was observed that very often cervical cancer can be a result of human papillomavirus (HPV).
Endometrial cancer occurs when abnormal cells in the uterus or the endometrium (the lining of the uterus) multiply out of control. Most women with endometrial cancer have history of endometrial hyperplasia or many times used hormone replacement therapy (HRT).
Both types of cancer could be a cause of heavy menstrual bleeding.

Intrauterine Devices (IUDs)

Very often IUDs are used for contraception (very popular method). Heavy menstrual bleeding is recognized as a side effect of IUDs. Women who experience prolonged or heavy periods while using the IUD should have the device removed and choose an alternate method of birth control.

Congenital Blood Diseases

Inherited bleeding disorders (mainly blood coagulation disorders) — such as von Willebrand’s disease, are conditions in which important blood-clotting factors are deficient or impaired — can cause heavy menstrual bleeding.

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