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Am Fam Physician. 2007;75(12):1820

See related article on menorrhagia.

What is menorrhagia?

Menorrhagia (men-or-RAY-jah) is periods that are heavier than normal or periods that last for seven days or more each month. Menorrhagia can cause stress for many women. It can also result in anemia, a condition in which you don't have enough red blood cells. Some women have heavy periods in the years when they first begin their periods or in the years right before menopause.

What causes menorrhagia?

There are many causes, including hormonal changes or problems with blood clotting. Fibroids or polyps in the uterus can also be a cause. The most serious cause of heavy bleeding is cancer of the uterus. Your doctor will try to help you find the cause, but many times it can't be found.

Your doctor may want to take tissue from your uterus to see if you have cells that may lead to cancer. Your doctor might also do an ultrasound or take a closer look inside the uterus with a special scope.

What are the treatments for menorrhagia?

There are many treatments available, including hormone pills and surgery. Women who prefer not to take pills can try an intrauterine device (IUD). It contains a hormone called progestin that thins the lining of the uterus to reduce bleeding. This device is placed inside the uterus in your doctor's office, can stay in your body for up to five years, and can be easily removed.

There are also surgeries to stop the bleeding. These only work for women who do not want to have any more children. These include procedures that freeze or heat the uterus, and hysterectomy (removing the uterus). Like any major surgery, hysterectomy has risks. Discuss all of the options with your doctor to decide which one is right for you.

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