Average menstrual blood loss is between 30 and 40 mL per cycle. An early population-based study concluded that the upper limit of normal menstrual blood loss was between 60 and 80 mL, with the upper limit subsequently adopted as the classic definition of menorrhagia. A greater prevalence of impaired iron status was noted with a loss of more than 60 mL.
In 34 percent of women, the subjective complaint of “heavy periods” appears to correlate with a significantly higher quantified average blood loss.5 Some women, however, do not consider heavy menstrual flow to be abnormal. Of women who rated their flow as very heavy, 25 percent had losses of less than 35 mL per cycle, and 25 percent of those who rated their periods as heavy had losses of more than 82 mL.
Where an underlying cause can be identified, treatment may be directed at this. Clearly heavy periods at menarche and menopause may settle spontaneously (the menarche being the start and menopause being the cessation of periods). If the degree of bleeding is mild, all that may be sought by the woman is the reassurance that there is no sinister underlying cause.
Major research on disease:
Microwave endometrial ablation after endometrial curettage for the management of heavy menstrual bleeding.Treatment options will depend on the cause of menorrhagia, the severity of menorrhagia and the overall health of the patient. Some common treatments include iron supplements, oral contraceptives, ibuprofen, and progesterone.