
Menstrual Bleeding: What’s Normal and What’s Not?

Abnormal menstrual bleeding, termed menometrorrhagia, is any vaginal bleeding that varies from your normal menstrual cycle. It may be heavy, long, or irregular. A typical period lasts about 5-7 days and occurs every 21-35 days. Any bleeding that occurs outside of that cycle, bleeding that goes on longer than seven days, or bleeding that’s heavier than usual may be a sign of menometrorrhagia.
Our team of experienced physicians at Women's Health Specialists, PLLC in Murfreesboro, Tennessee, wants to reassure women that abnormal bleeding is a common occurrence, but that doesn’t mean you should just accept it. An underlying cause may need to be treated to resolve the situation and give you back a healthy reproductive system.
Menorrhagia and menometrorrhagia
It’s important to understand the difference between menorrhagia and menometrorrhagia. Menorrhagia refers to heavy menstrual bleeding and means you bleed too much during your normal menstrual cycle.
Menometrorrhagia, on the other hand, is abnormal, unpredictable, or irregular uterine bleeding that may take place at any time, not just during menstruation.
It’s estimated that some 10%-35% of women may have abnormal uterine bleeding, but since many women don’t report the problem, the numbers may actually be higher. It’s most common during perimenopause, the years leading up to menopause, but it’s also common when you initially get your period (around age 12).
Causes of abnormal menstrual bleeding
One of the most common causes of abnormal bleeding is an imbalance in hormone levels, since hormones are what trigger menstruation in the first place. Disruptions to normal levels may be caused by:
- Anovulation (irregular periods)
- Thyroid disease
- Polycystic ovary syndrome (PCOS)
- Obesity
- Stress
Noncancerous growths are another common reason for abnormal bleeding, either because they create blockages or because they bleed themselves. Examples include polyps, fibroids, adenomyosis, endometriosis, and precancerous or cancerous lesions.
Sexually transmitted infections (STIs) such as trichomoniasis, pelvic inflammatory disease (PID), chlamydia, and gonorrhea; and other systemic infections, such as endometritis, vaginitis, and cervicitis, can cause irregular bleeding.
If you’re postmenopausal and are bleeding, contact Women’s Health Specialists PLLC as soon as possible; bleeding after menopause is never normal. You should also contact us if you’re bleeding during pregnancy, as this may be serious and require medical attention.
Are there complications of menometrorrhagia?
Abnormal uterine bleeding isn’t a life-threatening condition, but it can lead to anemia, where you don’t have enough healthy red blood cells. It can make you feel weak and sluggish since your red cells aren’t providing enough oxygen to the tissues.
Irregular bleeding can also be a sign of other medical conditions. Because you don’t know what’s causing the irregular bleeding, you should always set up an appointment to come into the office for an evaluation.
Diagnosing and treating abnormal menstrual bleeding
Your doctor will probably do some blood tests to determine hormone levels and may perform a pelvic ultrasound to see if there are any growths or other structural problems with your uterus and related structures.
Medication is often the first line of treatment. Some of the most common drugs prescribed include:
- Birth control pills
- Progestin (shot, implant, or IUD)
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Gonadotropin-releasing hormone (GnRH) agonists and antagonists to reduce bleeding or shrink fibroids
- Tranexamic acid to treat heavy menstrual bleeding
- Antibiotics if the underlying cause is an infection
- Iron supplements if you have anemia
Surgical options also are available to treat abnormal uterine bleeding:
- A hysteroscopy removes atypical structures in the uterus, like fibroids and polyps.
- Uterine artery embolization prevents blood flow to fibroids, so they shrink.
- A myomectomy removes fibroids while keeping the uterus intact, if you want to have children.
- Endometrial ablation destroys the uterine lining using a laser, heat, electricity, microwave energy, or freezing. This procedure can affect fertility.
- Dilation and curettage (D&C) is a diagnostic tool and a treatment for abnormal bleeding. It examines and removes tissue from your uterus, and the sample is sent to a lab for analysis.
- A hysterectomy permanently removes the uterus and is used to treat cancer or cancerous changes in your endometrium.
If you’re experiencing heavy or irregular periods, it’s time to come into Women’s Health Specialists PLLC for an evaluation and possible treatment. Call our office at 615-907-2040, or book your appointment online with us today.
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