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title: "Heavy Menstrual Flow (Menorrhagia) in Curitiba — Femi Saúde"
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Clínica Femi Saúde — Home
Clínica Femi Saúde — Home
Individualized Clinical Treatment
# Heavy Menstrual Flow (Menorrhagia)
Heavy periods: causes and treatment
Consulta
Acompanhamento periódico
## What it is
Menorrhagia is heavy or prolonged menstrual flow that requires frequent pad changes, comes with clots, and lasts more than seven days. It affects about one in four women of reproductive age and is more common after age 40, but it can occur at any stage. Besides the discomfort and the limits it places on daily activities, excessive bleeding leads to iron-deficiency anemia, with fatigue, weakness, and reduced performance. Causes range from hormonal imbalances to fibroids, polyps, adenomyosis, and bleeding disorders. The gynecology team at Femi Saúde investigates the source of the bleeding and proposes the appropriate treatment for each case.
## Most common symptoms
- Needing to change pads every one to two hours
- Periods lasting more than seven days
- Large clots, coin-sized or bigger
- Nighttime leaks and the need for double protection
- Fatigue, weakness, dizziness and shortness of breath
- Stronger cramps during heavy flow
## Causes and risk factors
- Anovulatory cycles and hormonal imbalances
- Fibroids, polyps and adenomyosis
- Bleeding disorders, such as von Willebrand disease
- Thyroid disorders
- Copper IUD use and anticoagulant medications
- Endometrial hyperplasia and, rarely, cancer
## How it is diagnosed
The evaluation starts with the menstrual history, estimating flow volume, duration, the presence of clots, and the impact on daily routine, along with medication use and any history of bleeding in other situations. The gynecological exam looks for changes in the cervix and uterus. A complete blood count and ferritin measure anemia and iron stores; thyroid hormones and coagulation tests are ordered as needed. Transvaginal ultrasound assesses fibroids, polyps, adenomyosis, and endometrial thickness. When a lesion inside the uterine cavity is suspected, hysteroscopy with endometrial biopsy completes the work-up.
## How we treat it at Femi Saúde
Treatment depends on the cause, age, and whether pregnancy is desired. For hormonal causes, the gynecology team at Femi Saúde may prescribe anti-inflammatories and antifibrinolytics during the flow, hormonal contraceptives, progestogens, or the hormonal IUD, which significantly reduces menstrual volume. Iron supplementation corrects the anemia. Polyps and fibroids inside the uterine cavity can be removed by surgical hysteroscopy; larger fibroids, by myomectomy. Endometrial ablation and hysterectomy are options for those who have completed their family planning. Bleeding disorders are treated jointly with hematology. The plan is individualized and reviewed during follow-up.
## When to see a gynecologist
See your gynecologist if your period requires changing pads every one to two hours, lasts more than seven days, comes with large clots or nighttime leaks, or if you feel tired, dizzy, or short of breath during your period. Bleeding that disrupts work, sleep, or social life should not be considered normal. Schedule an appointment to investigate the cause.
## What we offer
1
Investigation of the causes of the bleeding
2
Reduced flow and cramping
3
Treatment of associated anemia
4
Medical and surgical options depending on the case
5
Uterus preservation when pregnancy is desired
## Gynecology specialists
[Dra. Melissa Amoroso
Gynecologist](https://femisaude.com.br/en/doctors/dra-melissa-amoroso) [Dra. Vanessa Amoroso
Gynecologist and Mastologist](https://femisaude.com.br/en/doctors/dra-vanessa-amoroso) [Dra. Aline Matos
Gynecologist](https://femisaude.com.br/en/doctors/dra-aline-matos) [Dra. Andrea Novellino
Gynecologist](https://femisaude.com.br/en/doctors/dra-andrea-novellino) [Dra. Fabiane Sloboda
Gynecologist](https://femisaude.com.br/en/doctors/dra-fabiane-sloboda) [Dr. Igor Chiminacio
Gynecologist](https://femisaude.com.br/en/doctors/dr-igor-chiminacio) [Dra. Isadora Goetten
Gynecologist and Obstetrician](https://femisaude.com.br/en/doctors/dra-isadora-goetten) [Dra. Sabrina Oliveira
Gynecologist](https://femisaude.com.br/en/doctors/dra-sabrina-oliveira)
## Gynecology treatments at Femi Saúde
[CO2 Laser Rejuvenation and Lubrication
Skin Improvement and Lubrication](https://femisaude.com.br/en/treatment/laser-co2-rejuvenescimento-lubrificacao) [Implanon® — Hormonal Contraceptive Implant
Freedom and safety in a small implant](https://femisaude.com.br/en/treatment/implanon) [Menopause and Perimenopause
Care and hormone therapy when indicated](https://femisaude.com.br/en/treatment/menopausa-climaterio) [Family Planning
Preparing for a healthy pregnancy](https://femisaude.com.br/en/treatment/planejamento-pre-concepcional) [IUD — Intrauterine Device
Preventing pregnancy effectively](https://femisaude.com.br/en/treatment/diu) [Pap Smear
Cervical cancer screening](https://femisaude.com.br/en/treatment/papanicolau)
[See all Gynecology treatments ](https://femisaude.com.br/en/specialties/ginecologia)
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