Heavy Menstrual Bleeding (Menorrhagia) – Causes
Heavy menstrual bleeding, previously known as menorrhagia, can refer to any of the following among menstruating women:
- Losing more blood during regular 5 days menstrual cycle
- Periods lasting longer than 5 days.
Periods will be heavier than normal that changing tampons or sanitary pads every hour might be needed. This condition may be interfering with your day to day activities at home or at work. Heavy menstrual bleeding is a common condition that affects 50% of women at some time during their menstruating age. Very rarely heavy menstrual bleeding can lead to anemia but as that is a possible scenario, you need to consult a good gynecologist near you if you have heavier than normal periods.
Symptoms of heavy menstrual bleeding
- Severe abdominal cramps and pain in lower back
- Large clots of blood (larger than usual)
- Increase in frequency of changing tampons or pads or menstrual cups. You may probably end up changing one every hour.
- If you are losing more blood, symptoms of amnesia include fatigue, shortness of breath etc.
- Pica is also a symptom of amnesia caused due to heavy menstrual bleeding. Symptoms of Pica include hair loss, pale skin and urge to eat non-edible items such as sand, paper etc.

Hormone Imbalance
Two important hormones called estrogen and progesterone regulate the menstrual cycle of a woman. This includes building of the endometrial layer (inner lining of the uterus) and shedding it at the end of the cycle if the egg is not fertilized. When the balance of these hormones is disturbed (by any other condition including obesity, PCOS, insulin resistance, thyroid issues etc), that can result in heavy periods.
Improper functioning of the ovaries
Ovaries need to function well in order to release the egg on time and produce the hormones at required levels. When the ovaries fail to do their job due to any reason, that can lead to hormonal imbalance resulting in heavy periods.
Fibroids
Fibroids are non cancerous growth that can occur inside the uterus or outside of it. Different types of fibroids exist depending on where they are grown. Presence of fibroids can also lead to heavy periods.
Endometriosis
Endometriosis is a condition when the cells that form the endometrial layer inside the uterus also grow on the outside of it. The extra growth of endometrial tissues outside the uterus can lead to heavy bleeding and abdominal cramps during menstruation
Uterine Polyps
These are non cancerous growth of tissues on the inner lining of the uterus that can result in heavy periods.
Adenomyosis
In some women, the endometrial cells / tissues get embedded in the muscle around the uterus (uterine muscles) and start growing. Such growth of endometrial tissue in the uterine muscles is called Adenomyosis. These extra growths can also be a cause of heavy periods.
Usage of IUD
Non hormonal IUD such as copper based ones (called ‘Copper T’ in India) can lead to little heavy periods during the initial months while the body is adjusting to the foreign material. Periods should regularize after 3 to 6 months post insertion of IUD.
Cancer
Cancer of the cervix, which has become very common type of cancer in women and uterine cancer can also show heavy periods as a symptom. It is important to see a good gynecologist near you when you experience heavy periods continuously for a couple of months to make sure that there is no adverse condition that is developing inside the body.
Medications and other medical conditions
If you are taking any hormone related medication that can disturb the hormonal balance in the body can lead to heavy menstrual bleeding. You need to speak with your doctor immediately about the side effect and he/she can change the prescription or can tell you to wait until the body adjusts for the medication.
Other medical conditions such as problem with liver and kidneys can also show heavy periods as a symptom.