David Cook, M.D. Answers Questions On: Menorrhagia

Women should come in when they first notice heavy or prolonged bleeding, especially if it’s persistent. Some women wait a long time. They may deal with it for years and not know that there are options for treatment.

Once they’ve been evaluated with a history, physical exam, and an ultrasound or other imaging options, we can discuss treatment or management.

Some of the common causes are anovulatory cycles, perimenopause, uterine fibroids, adenomyosis, and endometrial polyps.

If the cause is anovulation or adenomyosis, the two main treatments I use are birth control pills or progesterone-releasing IUDs. Endometrial ablations may also be an option for certain patients. These choices have been very helpful in decreasing and controlling bleeding.

If the bleeding is caused by fibroids or polyps, we may remove them through a hysteroscope or with robot-assisted surgery.  And if conservative measures are unsuccessful or declined a hysterectomy may be required.

The menorrhagia itself is more of a significant nuisance that limits a patient’s daily functioning than a risk. However, it may cause marked anemia, which in certain compromised patients could be serious. Women should consult their physician for any heavy or prolonged bleeding.