Menometrorrhagia: Understanding and Managing Abnormal Uterine Bleeding

What Is Menometrorrhagia?

Menometrorrhagia, or abnormal uterine bleeding, happens when your periods are heavier, longer, or come at unexpected times. It could mean bleeding between periods, a period that lasts too long, or a flow so heavy that it disrupts your daily life.

A typical menstrual cycle usually lasts about five days and comes every 21 to 35 days. If your bleeding doesn’t follow this pattern—or if it’s heavier or more frequent—you could be dealing with menometrorrhagia.

This kind of unpredictable bleeding can be stressful. It might make you cancel plans, stay home, or even worry about your health. The good news is, you don’t have to live with it. Talking to a doctor is the first step toward finding out what’s causing the problem and getting the right treatment.

Menorrhagia vs. Menometrorrhagia

While both involve unusual bleeding, there is a difference:

• Menorrhagia is very heavy bleeding during your period.
• Menometrorrhagia is bleeding that’s heavy, irregular, or happens when you’re not on your period.

How Common Is It?

Abnormal bleeding is more common than many think. Around 10% to 35% of women experience it, though the actual number might be higher. It’s especially common during the early teenage years when periods begin or during perimenopause—the time leading up to menopause.

Signs You Might Have Menometrorrhagia

You might have abnormal uterine bleeding if:

• Your periods are extremely heavy (you soak through pads or tampons every hour).
• You bleed or spot between periods.
• Your periods last more than seven days.
• Your cycle is unpredictable—less than 21 days or more than 35 days apart.
• You skip periods for months.
• You bleed after menopause.
• You feel weak or tired, possibly from anemia due to blood loss.

What Causes It?

Several things can cause abnormal uterine bleeding:

Hormonal Changes

Hormone imbalances are a common cause—especially if you’re just starting your period or approaching menopause. Reasons for hormonal imbalance include:

• Anovulation (when your ovaries don’t release an egg)
• Thyroid issues
• Polycystic Ovary Syndrome (PCOS)
• Obesity
• Stress

Non-Cancerous Growths

Growths in your uterus, like fibroids, polyps, or conditions like adenomyosis and endometriosis, can also lead to heavy or irregular bleeding.

Cancer (Though Rare)

In some rare cases, abnormal bleeding might be due to cancer in the uterus, cervix, vagina, or ovaries. Endometrial hyperplasia (a thickened uterine lining) can also be a sign of concern.

Infections

Infections—both sexually transmitted and others—can lead to irregular bleeding. These include:

• Trichomoniasis
• Cervicitis
• Pelvic Inflammatory Disease (PID)
• Chlamydia
• Gonorrhea
• Endometritis
• Vaginitis

Other Health Conditions

Issues with the liver and kidneys, blood clotting disorders like Von Willebrand disease, or even pregnancy complications like miscarriage or ectopic pregnancy can also be factors.

Medications

Some medications, including blood thinners, certain birth control methods, hormone treatments, and drugs like Tamoxifen (used for breast cancer), can affect your menstrual cycle. Even leaving an intrauterine device (IUD) in too long can lead to infections and bleeding.

Who Can Be Affected?

Anyone with a uterus can experience abnormal uterine bleeding—whether they’re in their reproductive years, pregnant, or postmenopausal. If you’ve already gone through menopause and begin bleeding again, it’s important to speak to a doctor right away.

Are There Any Complications?

Abnormal uterine bleeding isn’t usually dangerous, but it can cause anemia, a condition where you don’t have enough red blood cells. This can leave you feeling tired, dizzy, or short of breath.

Irregular bleeding can also point to more serious health issues. That’s why it’s important to talk to a doctor if you notice any changes in your menstrual cycle.

How Is It Diagnosed?

To find out what’s causing the bleeding, your doctor will ask questions like:

• When does the bleeding happen?
• How long does it last?
• How heavy is it?
• How often does it occur?
• Are you tracking your periods?
• Could you be pregnant?

It helps to keep a record of your bleeding before your appointment—note the days you bleed, how heavy it is, and any symptoms you notice.

Your doctor might also perform:

• A pelvic exam
• A Pap smear
• A pregnancy test
• Blood tests (to check hormone levels or look for anemia)
• Ultrasound to check for growths or problems inside the uterus
• A hysteroscopy to look inside the uterus
• An endometrial biopsy to check for abnormal or cancerous cells

How Is It Treated?

The treatment you receive will depend on what’s causing your abnormal uterine bleeding.

Medications

Common options include:

• Birth control pills to regulate hormones
• Progestin, given as a pill, shot, implant, or IUD
• NSAIDs like ibuprofen to reduce bleeding
• GnRH agonists to reduce bleeding and shrink fibroids
• Tranexamic acid for heavy bleeding
• Antibiotics, if an infection is the reason behind the bleeding.
• Iron supplements if you’re anemic

Surgical Options

If medicine doesn’t help or if there’s a growth, surgery might be necessary:

• Hysteroscopy to remove fibroids or polyps
• Uterine artery embolization to shrink fibroids
• Myomectomy to remove fibroids while preserving fertility
• Endometrial ablation to destroy the uterine lining (not for those planning pregnancy)
• Dilation and curettage (D&C) to remove tissue from the uterus
• Hysterectomy, the complete removal of the uterus (for severe cases of cancer)

Always talk to your gynecologist about the pros and cons of each treatment, especially if you plan to get pregnant in the future.

Can It Be Prevented?

You can’t always prevent abnormal uterine bleeding, but there are things you can do to lower the risk. Maintaining a healthy weight helps regulate hormones, and practicing safe sex can lower the chances of infections that may lead to bleeding.

What Should You Expect?

Treating menometrorrhagia depends on the cause. It might take time to find answers, or it could be resolved quickly. Most cases are treatable with the right approach. What matters most is staying in touch with your doctor and letting them know if something isn’t working.

When to See a Doctor

It’s time to speak to a doctor if you:

• Have very short, long, or unpredictable periods
• Need to change pads or tampons every hour for several hours
• Bleed between periods, even just spotting
• Feel weak, tired, or short of breath

If bleeding affects your life, don’t ignore it. You shouldn’t have to plan your day around your period. You deserve to feel comfortable and in control of your body.

Questions to Ask Your Doctor

• Is my bleeding normal?
• What could be causing it?
• Am I at risk for anemia or other health problems?
• What treatment options do I have if I want to get pregnant in the future?
• Will you be handling my treatment, or will others be involved?
• What’s your experience treating this kind of bleeding?
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Final Thoughts

You know your body better than anyone else. If your period isn’t normal for you—whether it’s longer, heavier, or happening at strange times—don’t brush it off. Irregular bleeding can be treated. You don’t have to just live with it.

Dr. Mustafa Aldam is here to help you find a treatment that suits your needs and restores balance to your health. You don’t have to face this alone.