Menstrual periods - heavy, prolonged, or irregular

Diagnostic tests that may be performed include:

Pap smear
Endometrial biopsy
Pelvic ultrasound
Lab tests such as thyroid function tests, CBC, pregnancy test

Ibuprofen or another prostaglandin inhibitor is often prescribed. Ibuprofen is also available in lower dosages (Advil, Nuprin) without prescription.

In some cases of heavy bleeding, dilation and curettage, "D and C", may be required.

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If a tumor is found, surgery (a hysterectomy ) will sometimes be needed. "Fibroid" tumors (uterine fibroids ) are common and are not related to cancer.

Fibroids may stop growing by themselves, and surgery may not be needed depending on the amount of bleeding, the location of the fibroid, and the response to various treatment attempts. Fibroids often stop growing at menopause, so an operation can be avoided by waiting. However, if there has been rapid growth of the fibroid tumor or if your Pap smear is abnormal, surgery or another type of therapy may be necessary.

If the heavy bleeding is related to hormonal abnormalities, treatment of the specific abnormality will correct the bleeding. Female hormones (birth control pills or progestins) are commonly used to regulate menses.

References:

Osei J, Critchley H. Menorrhagia, mechanisms and targeted therapies. Curr Opin Obstet Gynecol. 2005; 17(4): 411-418.

James AH. More than menorrhagia: a review of the obstetric and gynaecological manifestations of bleeding disorders. Haemophilia. 2005; 11(4): 295-307.

Warner PE, Critchley HO, Lumsden MA, Campbell-Brown M, Douglas A, Murray GD. Menorrhagia I: measured blood loss, clinical features, and outcome in women with heavy periods: a survey with follow-up data. Am J Obstet Gynecol. 2005; 192(6): 2093-2095.