Excessive Menstrual Bleeding


Menorrhagia or excessive menstrual bleeding affects millions of American women. You may suffer from menorrhagia if you carry a change of clothing, avoid social activities or need to wake up several times nightly to change tampons and pads.

Normal menstrual cycles are regulated by a precise hormonal cycle during the reproductive years. During adolescence and perimenopause these hormones often do not cycle appropriately and result in lack of menses, irregular menses or excessive flow. Other causes for this type of excessive bleeding include polycystic ovarian syndrome and thyroid disorders.

In addition to hormonal causes for excessive bleeding, there may also be structural problems within the uterus itself. These include conditions such as some fibroids, polyps or adenomyosis. Polyps within the uterine cavity should be removed surgically. On the other hand, fibroids and adenomyosis will often respond to medical therapy or office procedures designed to reduce bleeding. Only rarely do any of these conditions require hysterectomy.

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The most common option chosen by women with menorrhagia is hormonal therapy. Birth control pills, patches or vaginal rings are very good at inducing predictable and lighter menstrual periods. Some brands even allow you to menstruate only every three months.

A way to introduce hormonal control to the uterus is with the progestin releasing intrauterine device. A small flexible device is inserted into the uterine cavity during an office visit and slowly releases hormones within the uterus which over time results in very scant to no menstrual flow at all. This device may be left in place for up to five years, but may be removed at any time to allow for pregnancy as desired. This is an ideal option for women who may not be able to tolerate other hormonal therapies.

Another excellent and completely non-hormonal method to achieve reduction in menstrual flow is endometrial ablation. This is the name of a group of procedures that essentially destroy the lining of the uterus. The result is a reduction or elimination of menstrual bleeding. It is important to be finished with child bearing before choosing this method. The procedure can usually be completed in the office with only local anesthetic.

In the occasional patient the conservative measures fail or there are coexisting problems that require hysterectomy. Hysterectomy today can often be performed laparoscopically, vaginally, or robotically with minimal down time. If you suffer from excessive menstruation limiting your activities as a result of your bleeding, speak to your doctor about your options. There are so many options today that make the choice to treat menorrhagia an easy one. Your gyn provider at Lexington Women's Health can review your symptoms and recommend which options may be best for you.