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Menstrual periods - heavy, prolonged, or irregular
Alternative namesPeriods - heavy, prolonged, or irregular; Menorrhagia; Menstrual periods - abnormal; Abnormal menstruation; Menstruation - irregular; Irregular menstrual periods
Heavy or prolonged menstrual periods refer to profuse or extended menstrual bleeding. Irregular menstrual periods are those that occur at unusual or unexpected times. Collectively or individually, these may be called abnormal menstrual bleeding.
The menstrual cycle is not the same for every woman. On average, menstrual flow occurs every 28 days and lasts about 4 days. However, there is wide variation in timing and duration that is still considered normal, especially if your periods began within the last two years.
If you soak through a sanitary pad or tampon every hour for 6 consecutive hours, this is considered a very heavy period. A prolonged period is one that lasts longer than 7 days. Irregular periods happen more often than every 21 days or less often than every 35 days.
These variations may be normal and are less concerning than bleeding, pain, or discharge between periods.
Bleeding may be something to worry about if you are over age 50, especially if you have already gone through menopause. The risk of cancer increases with age.
Often, if you are bleeding from the rectum or in your urine, you think it 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.
Keep a record of your menstrual cycles, including when menstruation begins and ends, how much flow you have (count numbers of pads and tampons used, noting whether they are soaked), and any other symptoms you experience. Tampons should be changed at least twice a day to avoid infection.
Bed rest may be recommended if bleeding is heavy.
Because aspirin may prolong bleeding, it should be avoided. Ibuprofen is usually more effective than aspirin for relieving menstrual cramps .
Call your health care provider if
Call your doctor if:
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:
Ibuprofen or another prostaglandin inhibitor is often prescribed. Ibuprofen is also available in lower dosages (Advil, Nuprin) without prescription.
In some cases of heavy bleeding, dilation and curettage, "D and C", may be required.
If a tumor is found, surgery (a hysterectomy ) will sometimes be needed, but the common "fibroid" tumor ( uterine fibroids ) may stop growing by itself, and surgery may not be needed depending on the amount of bleeding and the response to various treatment attempts. Such tumors often grow slowly and stop growing at menopause , so an operation can be avoided by waiting. However, if there has been rapid growth of the fibroid tumor or if your Pap smear is abnormal, surgery or another type of therapy may be necessary.
If the heavy bleeding is related to hormonal abnormalities, treatment of the specific abnormality will correct the bleeding. Female hormones (birth control pills or progestins) are commonly used to regulate menses.
Update Date: 10/13/2003Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma., and Senior Medical Editor, A.D.A.M., Inc. Previously reviewed by Peter Chen, M.D., Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network (1/14/2002).
Last updated: Tue, 06 Jan 2009 00:20:03 GMT