Symptoms may include:

• Menstrual flow that soaks through one or more sanitary pads or tampons every hour for several consecutive hours or days
• The need to use double sanitary protection to control your menstrual flow
• The need to change sanitary protection during the night
• Menstrual periods lasting longer than seven days
• Menstrual flow that includes large blood clots
• Heavy menstrual flow that interferes with your regular lifestyle
• Tiredness, fatigue or shortness of breath (symptoms of anemia)
• Spotting or bleeding between menstrual periods
• Spotting or bleeding during pregnancy

There are several possible causes of menorrhagia, including the following:

• hormonal (particularly estrogen and progesterone) imbalance (especially seen in adolescents who are experiencing their menstrual period for the first time and in women approaching menopause)
• pelvic inflammatory disease (PID) 
• uterine fibroids
• abnormal pregnancy (i.e., miscarriage, ectopic)
• infection, tumors, or polyps in the pelvic cavity
• certain birth control devices (i.e., intrauterine devices, or IUDs)
• bleeding or platelet disorders
• high levels of prostaglandins (chemical substances which help to control the muscle contractions of the uterus)
• high levels of endothelins (chemical substances which help the blood vessels in the body dilate)
• liver, kidney, or thyroid disease

Treatments may include:

• Iron supplements
• Oral contraceptives
• Oral progesterone
• Dilation and curettage (D and C)
• Hysteroscopy
• Endometrial resection
• Endometrial ablation
• Hysterectomy

Specific treatment for menorrhagia is based on a number of factors, including:

• Overall health and medical history
• The cause and severity of the condition
• Your tolerance for specific medications, procedures or therapies
• The likelihood that your periods will become less heavy before long
• Your future childbearing plans
• Effects of the condition on your lifestyle
• Your opinion or personal preference