Heavy Menstrual Bleeding

Your healthcare provider will ask a series of questions about your medical history and menstrual cycle to diagnose menorrhagia. They’ll also perform a physical exam and a pelvic exam.

Your provider may ask about:

• Your age when you got your first period.
• The number of days your period lasts.
• The number of days your period is heavy.
• Family members with a history of heavy menstrual bleeding.
• Your pregnancy history and current birth control methods.
• Current medications you’re taking, including over-the-counter (OTC) ones.

Come prepared to talk about your quality of life, too. Your provider needs to know if you’ve been doubling up on menstrual products, avoiding activities or placing restrictions on your life in any way because of heavy periods.

What tests will be done to diagnose menorrhagia?

A pelvic ultrasound is the most common way healthcare providers diagnose menorrhagia. You may have other tests, depending on your age and how severe your symptoms are. Other tests may include:

• A blood test to check for signs of anemia, clotting issues or thyroid disease.
• Transvaginal ultrasound to check the appearance of the organs and tissues in your pelvis.
• Magnetic resonance imaging (MRI) to check for abnormal structures inside your uterus when an ultrasound doesn’t provide enough information.
• A Pap smear to study cells from your cervix for changes that may indicate cancer.
• A cervical culture to test for infection.
• An endometrial biopsy to check uterine tissue for cancer cells or other irregularities.

Other procedures that can help your provider diagnose what’s causing your bleeding include:

• A sonohysterogram (saline-infusion sonography) to check for problems in the lining of your uterus. A sonohysterogram allows your provider to see the inside of your uterus while it’s filled with saline.
• A hysteroscopy to check for polyps, fibroids or other irregular tissue in your uterus. Hysteroscopy allows your provider to inspect your vagina, cervix and uterus. Your provider can remove growths that may be causing your bleeding, like fibroids or polyps, during a hysteroscopy.