What can I do About Excessive Menstrual Bleeding?

Excessive menstrual bleeding refers to an abnormal amount of blood loss during menstruation. Also known as menorrhagia, excessive menstrual bleeding may cause anemia. Treatments for abnormal menstrual bleeding generally depend on the severity and cause of the condition, the patient's health, medical history, child planning desires, and age. There are many non-surgical and surgical treatments available to control it.

Typical non-surgical treatments for excessive menstrual bleeding include the use of non-steroidal anti-inflammatory medications, or NSAIDs. NSAIDs, may help decrease heavy menstrual bleeding and relieve painful cramps associated with heavy bleeding. Many times, iron supplementation may be recommended, especially when the condition is accompanied by anemia. Common symptoms of anemia are weakness, fatigue, and shortness of breath. Iron supplements may alleviate these symptoms.

Other common medications used in the treatment of excessive menstrual bleeding are oral contraceptives, or birth control pills. Oral contraceptives help regulate the menstrual cycle and may lessen the incidence of excessive or irregular menstrual bleeding. Oral contraceptives carry risks and side effects, which should be discussed with the physician prior to treatment.

Frequently, the physician will recommend a course of hormones such as oral progesterone. Typically, excessive menstrual bleeding is related to fluctuations in hormones. Hormone replacement therapy using oral progesterone throughout the month may alleviate these fluctuations and reduce the incidence of heavy menstrual bleeding. Usually, heavy menstrual bleeding responds quickly to progesterone supplementation.

Certain surgical procedures, such as a dilation and curettage (D&C), or scraping out the uterus, may be effective in curtailing excessive menstrual bleeding. The D&C treats heavy menstrual bleeding by scraping excess tissue from the endometrium, or uterine lining. Sometimes, a D&C may need to be repeated as uterine tissue regenerates or thickens.

Another common surgical intervention to relieve excessive menstrual bleeding is the endometrial ablation. During this procedure, the surgeon ablates or destroys the lining of the uterus. Typically, after this procedure patients will have a dramatic decrease in menstrual bleeding, or it may cease altogether. Endometrial ablation is not recommended if the patient wishes to preserve her fertility.

Often times, if other treatments are ineffective, the physician may recommend a hysterectomy, which involves removing the uterus and cervix. A hysterectomy may either be performed vaginally or abdominally, and may entail removal of ovaries as well. The hysterectomy will render the patient infertile, and if the ovaries are removed, she may experience symptoms of menopause, such as hot flashes, night sweats, and vaginal dryness.