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Gynecology

Excessive Menstrual Flow

05/17/2010

Question:

I have gone from no period to a forceful rushing menstrual river. I am 48 and have had a vanishing cycle for the last 4 years. My gynecologist wanted to regulate it with birth control pills but I declined as I really don’t miss the menstrual flow and do not like the pills, but this onsloghout is unnerving. My mother is almost 70 and is still having this kind of issue. When should the menopause become meno-gone? I have been taking Aleve to help with foot pain. Could that have triggered the bleeding?

Answer:

Menorrhagia is the term used to describe excessively heavy period flow.  Although "heavy" may mean different things to different women, flow so heavy that it is soaking through to clothing or causing symptoms of anemia, or just increasing enough to be bothersome, is considered abnormal. 

Such a condition may be caused by tumors in the uterus, such as fibroids, excessive growth of glandular tissue in the uterus (eg adenomyosis or hyperplasia), clotting abnormalities (eg being on a blood thinner), or sometimes no specific cause is found.

The condition can be treated with medication such as birth control pills or progesterone hormones that shrink the uterine glands, a progesterone intra-uterine device, endometrial ablation (surgery that scars the lining of the uterus) or hysterectomy.  Anti-inflammatory medications such as Aleve (naproxen) may be helpful in reducing flow as well.

The average age of menopause is 51.  Bleeding leading up to this event can be unpredictable, but excessive flow is something that requires an evaluation to look for the sorts of problems mentioned above.

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Response by:

Jonathan  A Schaffir, MD Jonathan A Schaffir, MD
Clnical Associate Professor of Obstetrics & Gynecology
College of Medicine
The Ohio State University