Managing Heavy Menstrual Bleeding: Home Remedies & When to See a Doctor

Heavy Menstrual Bleeding (Menorrhagia): Self-Care & Medical Guidance

Menorrhagia = bleeding >80 mL/cycle or >7 days, or impacting quality of life.

Self-Care Strategies

• Hydration: Water, electrolyte drinks combat dehydration from blood loss
• NSAIDs (Ibuprofen/Naproxen): Reduce prostaglandins → less bleeding & cramping (start 1-2 days before period)
• Heat therapy: Heating pad/hot water bottle on lower abdomen for cramps
• Rest: Adequate sleep, reduce overexertion
• Iron-rich foods: Red meat, spinach, lentils, fortified cereals + vitamin C for absorption
• Avoid: Alcohol, excess caffeine (worsen bloating, mood)
• Complementary: Some evidence for acupuncture, yoga, magnesium, vitamin B1

Medical Treatments (Discuss with Provider)

• Hormonal: Combined OCPs, progestin-only (pill, IUD, implant, injection)
• Tranexamic acid: Non-hormonal, taken during period only
• NSAIDs prescription-strength
• Procedures: Endometrial ablation, uterine artery embolization, myomectomy, hysterectomy (definitive)

When to Seek Care

• Soaking through pad/tampon every 1-2 hours
• Passing clots >1 inch (quarter size)
• Bleeding >7 days
• Symptoms of anemia (fatigue, shortness of breath, pallor, dizziness)
• Bleeding between periods or after sex
• Postmenopausal bleeding
• Impact on daily activities

Heavy bleeding is not normal. Evaluation identifies cause (fibroids, adenomyosis, polyps, coagulopathy, hormonal) and guides treatment.