Heavy menstrual bleeding (also known as menorrhagia) is a common disorder among menstruating women. This refers to bleeding lasting more than seven days and involving more blood flow than is typical during menstruation. Menstrual bleeding that is so heavy that it interferes with daily life is not normal. Heavy menstrual bleeding is common, affecting 27% to 54% of menstruating women. Heavy menstrual bleeding can be serious if the blood loss leads to anemia. Anemia is a condition resulting from the presence of low levels of serum iron in the body. Anemia can be life-threatening without treatment. Also, some of the conditions that can cause heavy bleeding, such as cancer, require early medical intervention. Signs of heavy menstrual bleeding include: Abdominal pain; Menstruation lasting more than seven days; Passage of blood clots that are the size of a quarter of the palm of your hand or larger. The blood may appear red, pink, brown, or even rusty; Bleeding through 1 or more pads or pads every hour for more than two consecutive hours; Loss of more than 80 milliliters of blood during menstruation, from what is typical (35-40 milliliters); Symptoms of anemia, such as feeling exhausted, tired, or short of breath. Heavy menstrual bleeding is a period that lasts more than seven days. How long the bleeding lasts depends on what’s causing it. Heavy menstrual bleeding can have many causes, ranging from hormone-related issues to various medical conditions and even stress. Hormonal Imbalance The hormones the body produces, such as estrogen and progesterone, help regulate the menstrual cycle, including how heavy the period is. Having a condition that causes an imbalance in hormones can lead to heavy bleeding. Causes include: Anovulation; Thyroid disease; Polycystic ovary syndrome. Non-cancerous growths in the uterus Benign growths in the uterus and conditions that cause cells in the uterus to develop incorrectly can also cause heavy menstrual bleeding. Causes include: Polyps; Fibroids; Adenomyosis. Cancers in the uterus Conditions that increase the risk of getting cancer, including endometrial hyperplasia, as well as cancers that affect the reproductive system, can cause heavy menstrual bleeding. These include: Cancer of the uterus; Cervical cancer. Infection Infections, including sexually transmitted infections, can cause heavy bleeding. These include: Trichomoniasis; Gonorrhea; Chlamydia; Chronic endometritis. Pregnancy complications Heavy bleeding can be a warning sign of pregnancy complications, such as: Miscarriage; Ectopic pregnancy; A large number of C-sections can lead to a scar that creates a pocket in the uterus. This pocket can collect blood,which then looks like heavy menstrual bleeding. References: 1. Bradley LD, Gueye NA. The medical management of abnormal uterine bleeding in reproductive-aged women. Am J Obstet Gynecol. 2. Davies J, Kadir RA. Heavy menstrual bleeding: An update on management (https://pubmed.ncbi.nlm.nih.gov/28262240/). Thromb Res. 3. Duckitt K, Collins S. Menorrhagia. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907973/) BMJ Clin Evid. 4. Iyer V, Farquhar C, Jepson R. Oral contraceptive pills for heavy menstrual bleeding. (https://pubmed.ncbi.nlm.nih.gov/10796696/) Cochrane Database Syst Rev.