Menometrorrhagia is a condition marked by abnormally heavy, prolonged, and irregular uterine bleeding. Women with this condition usually bleed more than 80 ml, or 3 ounces, during a menstrual cycle. The bleeding is also unexpected and frequent. For example, you’ll likely experience bleeding outside of when you’d expect your menstrual period to occur.
Menometrorrhagia is actually a combination of two menstrual disorders:
- menorrhagia, which is heavy uterine bleeding that occurs at regular intervals
- metrorrhagia, which is irregular bleeding
It’s important to seek medical help if you’re experiencing menstrual irregularity. Unexpected or abnormal menstrual bleeding can have health consequences that shouldn’t be ignored.
There’s no concrete medical definition of “abnormal” uterine bleeding. For the average woman, menstruation occurs every 28 days, though having a period every 21-35 days is considered normal. The average length of a menstrual cycle is about 5 days. Most women will lose less than 80 ml, or 3 ounces, of blood overall.
Most experts agree that any bleeding that’s so excessive and severe that it interferes with your physical, social, and emotional life is abnormal. Some clues your bleeding is out of the ordinary and you might be experiencing menometrorrhagia include:
- soaking through tampons or sanitary pads every hour for several hours
- bleeding longer than eight days
- bleeding outside your usual menstrual cycle
- passing large blood clots
- having back and abdominal pain during menstruation
- feeling tired, weak, or short of breath, which may be signs that the excessive bleeding has reduced the amount of iron in your blood, leading to anemia
The causes for menometrorrhagia are not well understood, but it may be caused by any of the following:
A hormonal imbalance
Having too much of the female hormone estrogen can cause the uterine lining to grow thicker than expected. When that thicker lining begins to shed, it can lead to increased blood loss and clots.
An estrogen imbalance can occur for a variety of reasons, including stress and obesity.
Tumors, such as uterine polyps and fibroids, can cause excessive bleeding due to the pressure they place on the uterus, as well as the blood vessels these growths contain. These types of tumors are usually benign, or noncancerous.
This is a condition in which the uterine lining grows into the muscular wall of the uterus. It acts as the normal uterine lining does, growing and shedding each month, but it can produce heavy bleeding. The cause of adenomyosis isn’t well known, but it’s often seen in women who have reached menopause.
Endometriosis occurs when the uterine lining grows outside the uterus, usually in the fallopian tubes, ovaries, and pelvis. When this lining sheds, the bleeding can be substantial.
Lack of ovulation
Ovulation refers to the release of an egg from the ovary. If you don’t ovulate, or have what’s known as an anovulatory cycle, the uterine lining can continue to grow until it’s forced to shed.
Blood clotting disorders
When blood cannot coagulate properly, bleeding is more prolonged.
How common is menometrorrhagia?
Approximately 11.4 to 13.2 percent of women have this disorder. Menometrorrhagia is more commonly seen in woman age 40 and older, with an estimated 24 percent of woman experiencing this condition between the ages of 40 and 50.
Excessive menstrual bleeding can have a significant impact on your health and quality of life. The significant loss of blood can lead to anemia. Anemia is a condition in which your blood is lacking oxygen-carrying red blood cells. Without oxygen-rich blood, you may feel weak and tired.
Excessive menstrual bleeding can also be a symptom of some reproductive cancers and conditions that affect fertility. It’s important to get medical attention when you experience any excessive bleeding.
Your doctor will test for disorders that can cause menometrorrhagia. For example, a blood test will be used to test for pregnancy. That’s because miscarriage, even when it occurs before you know you’re pregnant, can cause heavy bleeding. You can still test positive for pregnancy up to 35 days after a miscarriage.
Your doctor will also take a Pap smear. Pap smears can test for cervical cancer. Your doctor may also do a hysteroscopy. During this procedure, your doctor will use a thin, lighted, telescopic tube to see into the uterus. This test can help your doctor diagnose things like endometriosis. Other tests may include ultrasound and MRI.
Treatment for menometrorrhagia depends on the cause. For example, surgery to remove fibroids may be recommended. A hysterectomy, or surgical removal of the uterus, may be an option for women who don’t want children or are past their childbearing years.
When there is no known cause of menometrorrhagia, the first line of treatment is usually pharmaceutical. Some common options include:
- Birth control pills to regulate hormone levels.
- Progestin therapy. Progestin is a synthetic version of the naturally occurring hormone progesterone. Your doctor my recommend taking progestin in the form of a pill for 21 consecutive days and then stop for 7 or using a levonorgestrel-releasing intrauterine device (IUD). Levonorgestrel is also a progestin. Progestin helps thin the uterine lining and thus reduce menstrual blood flow.
- Nonsteroidal anti-inflammatories (NSAIDs). Besides relieving the pain associated with menometrorrhagia, these drugs help to coagulate blood and limit its flow.
Heavy periods can be difficult to live with, but being prepared is the best way to protect against accidents.
- Use menstrual products designed for heavy flow. That means using super-absorbent tampons and sanitary pads.
- Double up. Wear two pads at a time or a pad and a tampon.
- Try a menstrual cup. It can hold more blood flow than a tampon or pad.
- Place towels or a bed pad underneath you at night to protect your sheets.
- Wear dark clothing on your heaviest days to camouflage any leaks.
- Stash extra menstrual products and underwear in your purse, car, and office desk.
When it comes to menstruation, there’s a wide range of normal. Bleeding that’s so profuse or frequent that it affects your physical and psychological health is never normal.
A gynecologist, which is a doctor who specializes in women’s reproductive health, can help diagnose menometrorrhagia and recommend effective treatment. In many cases, the condition can be readily managed. Some of the underlying causes of the menometrorrhagia can affect fertility, but many women can go on to get pregnant and successfully deliver babies following treatment for this condition.
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