Hartford Hospital

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Menorrhagia (Heavy Bleeding)

You will be asked about:

  • Your family and medical history
  • Your lifestyle, eating, and exercise habits
  • Stress
  • Changes in body weight
  • Your menstrual periods
  • Birth control

Your doctor will also do a physical exam, including a pelvic exam.

You may have one or more of the following tests:

  • Blood tests—Your doctor will measure levels of hormones and other factors in the blood, as well as to check for pregnancy.
  • Endometrial biopsy —A small amount of tissue is scraped from the lining of your uterus and examined under a microscope.
  • Ultrasound—A device that uses sound waves to create an image of your pelvic organ is placed on your abdomen or inside of your vagina.
  • Laparoscopy —A thin tube with a tiny camera attached is inserted through a small incision below or through your navel, allowing the doctor to look inside your abdomen.
  • Hysteroscopy —A thin tube with a tiny camera attached is inserted into your vagina and up through your cervix, allowing your doctor to see inside your uterus.

It may be difficult for your doctor to diagnose the cause of your amenorrhea. Evaluation usually includes the following:

You will be asked about:

  • Your family and medical history
  • Your lifestyle, eating, and exercise habits
  • Stress
  • Changes in body weight
  • Your menstrual periods
  • Birth control

Your doctor will also perform a physical exam, including a pelvic exam.

The most common cause of secondary amenorrhea is pregnancy. If your menstrual period is at least 2-3 weeks overdue and you are sexually active, the first consideration is pregnancy.

Your doctor may recommend testing your blood for hormone levels:

  • Androgen excess
  • Estrogen deficiency
  • Problems with the endocrine system (hormone production)
  • Prolactin in the blood
  • Thyroid hormone

Other tests that may be done include:

  • Imaging of the brain to evaluate the pituitary gland—Sometimes a small, noncancerous growth can produce excess hormones that interfere with the normal menstrual cycle.
  • Ultrasound scans of your abdomen and pelvis
  • Chromosome studies
References

American Congress of Obstetricians and Gynecologists. Premenstrual syndrome. ACOG Practice Bulletin. 2000.

Menstruation and the menstrual cycle fact sheet. Womens Health.gov website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/menstruation.cfm. Updated October 21, 2009. Accessed August 20, 2012.

Last reviewed September 2013 by Andrea Chisholm, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.