Menstrual periods - heavy, prolonged, or irregular

Alternative Names

Irregular menstruation; Heavy, prolonged, or irregular periods; Menorrhagia; Polymenorrhea; Metrorrhagia and other menstrual conditions; Abnormal menstrual periods; Abnormal vaginal bleeding

Considerations

The menstrual cycle is not the same for every woman. On average, menstrual flow occurs every 28 days (with most women having cycles between 24 and 34 days), and lasts about 4-7 days.

However, there is a wide variation in timing and duration that is still considered normal, especially if your periods began within the last few years.

A small percentage of women have periods more often than every 21 days or less often than every 35 days. These variations may be normal.

Some examples of abnormal bleeding include:

Often, if you are bleeding from the rectum or there is blood in your urine, you may think the blood is coming from the vagina. To know for certain, insert a tampon into the vagina to confirm that it's the source of your bleeding.

Causes

A change in hormone levels is a common cause of abnormal menstrual bleeding. This is called dysfunctional uterine bleeding.

Other causes of abnormal menstrual bleeding include:

Home Care

Keep a record of your menstrual cycles and any other bleeding, including:

Tampons should be changed at least twice a day to avoid infection.

Because aspirin may prolong bleeding, it should be avoided. Ibuprofen is usually more effective than aspirin for relieving menstrual cramps. It also may reduce the amount of blood you lose during a period.

If you think you are or could be pregnant, talk to your doctor.

When to Contact a Medical Professional

Call your doctor if:

What to Expect at Your Office Visit

Your doctor will perform a physical examination, including a pelvic exam. Your doctor will ask questions like the following to determine the history of this symptom:

Diagnostic tests that may be performed include:

For information about treatment, see:

References

Apgar BS, Kaufman AH, George-Nwogu U, Kittendorf A. Treatment of menorrhagia. Am Fam Physician. 2007;75:1813-1819.

Lobo RA. Abnormal uterine bleeding: Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 37.


Review Date: 9/2/2009
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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