Finding out if a woman has heavy menstrual bleeding often is not easy because each person might think of “heavy bleeding” in a different way. Usually, menstrual bleeding lasts about 4 to 5 days and the amount of blood lost is small (2 to 3 tablespoons). However, women who have menorrhagia usually bleed for more than 7 days and lose twice as much blood.
If you have bleeding that lasts longer than 7 days per period, or is so heavy that you have to change your pad or tampon nearly every hour, you need to talk with your doctor.
Questions a Doctor May Ask
To find out if you have menorrhagia, your doctor will ask you about your medical history and menstrual cycles.
- He or she may ask you questions like the following:
- How old were you when you got your first period?
- How long is your menstrual cycle?
- How many days does your period usually last?
- How many days do you consider your period to be heavy?
- How do your periods affect your quality of life?
Your doctor may also ask if any of your family members have had heavy menstrual bleeding.
Your doctor might tell you that one or more of the following tests will help find out if you have a bleeding problem:
Blood test: In this test, your blood will be taken using a needle. It will then be looked at to check for anemia, problems with the thyroid, or problems with the way the blood clots.
Pap test: For this test, cells from your cervix are removed and then looked at to find out if you have an infection, inflammation, or changes in your cells that might be cancer or might cause cancer.
Endometrial biopsy: Tissue samples are taken from the inside lining of your uterus or “endometrium” to find out if you have cancer or other abnormal cells. You might feel as if you were having a bad menstrual cramp while this test is being done. But it does not take long, and the pain usually goes away when the test ends.
Ultrasound: This is a painless test using sound waves and a computer to show what your blood vessels, tissues, and organs look like. Your doctor then can see how they are working and check your blood flow.
Using the results of these first tests, the doctor might recommend more tests, including,
Sono hysterogram: This ultrasound scan is done after fluid is injected through a tube into the uterus by way of your vagina and cervix. This lets your doctor look for problems in the lining of your uterus. Mild to moderate cramping or pressure can be felt during this procedure.
Hysteroscopy: This is a procedure to look at the inside of the uterus using a tiny tool to see if you have fibroids, polyps, or other problems that might be causing bleeding. You might be given drugs to put you to sleep (this is known as “general anesthesia) or drugs simply to numb the area being looked at (this is called “local anesthesia”).
Dilation and Curettage (D&C). This is a procedure (or test) that can be used to find and treat the cause of bleeding. During a D&C, the inside lining of your uterus is scraped and looked at to see what might be causing the bleeding. A D&C is a simple procedure. Most often it is done in an operating room, but you will not have to stay in the hospital afterwards.
You might be given drugs to make you sleep during the procedure, or you might be given something that will numb only the area to be worked on.