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Menorrhagia (Heavy Menstrual Bleeding)

Daniel R. Matta, DFPHM, FAAFP, MD and Thandi Walters, MD Reviewed 04/2024
 


BASICS

This article will focus on heavy menstrual bleeding in non-pregnant reproductive age women. 

DESCRIPTION

  • Heavy menstrual bleeding (HMB) is a form of abnormal uterine bleeding (AUB) and is an abno...

DIAGNOSIS

The first part of diagnosis involves a thorough history and physical exam. 

HISTORY

  • It is important to obtain a proper understanding of the patient's bleeding episode and to ask questions focu...

TREATMENT

MEDICATION

First Line

  • Acute bleeding

    • Conjugated equine estrogen 25 mg IV every 4-6 h for 24 h with IV antiemetic agents

    • Monophasic 35-mg estrogen-containing OCP 3 times daily for 7 days, then 1 ...

REFERENCES

1
Marnach ML, Laughlin-Tommaso SK. Evaluation and management of abnormal uterine bleeding. Mayo Clin Proc. 2019;94(2):326-335.
2
Cheong Y, Cameron IT, Critchley HO. Abnormal uterine bleeding. ...

ADDITIONAL READING

SEE ALSO

Bleeding Disorders in Women: Free Materials. Centers for Disease Control and prevention. Published August 17, 2022. Accessed June 1, 2023. https:/...

CODES

ICD10

  • N92.0 Excessive and frequent menstruation with regular cycle

  • N92.3 Ovulation bleeding

  • N92.2 Excessive menstruation at puberty

  • N92.1 Excessive and frequent menstruation with irregular cycle

SNOMED

CLINICAL PEARLS

  • Heavy menstrual bleeding is often associated with a structural uterine disorder.

  • A thorough history and physical examination is a key part of determining the cause of AUB.

  • The treatment ...

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