Abnormal bleeding most often shows itself in the form of heavy periods, or bleeding at unexpected times such as before or after one’s normal menstrual cycle, according to George Washington (GW) University Hospital. The medical term is "menorrhagia".

Common causes of menorrhagia include hormonal imbalance, uterine fibroids, polyps, or an intrauterine device (IUD). Other causes can be inherited bleeding disorders such as von Willebrand's disease; and rarely uterine, ovarian or cervical cancer.

However the most common cause is dysfunctional uterine bleeding (DUB). This condition refers to heavy bleeding with no apparent reason.

Treatment options for heavy periods range from observation and reassurance to drug therapy, or if necessary, surgical intervention.

Drug therapy for menorrhagia includes oral contraceptives which can help regulate menstrual cycles and reduce excessive or prolonged menstrual bleeding. And if oral progesterone is taken for 10 days or more of each menstrual cycle, it can help correct hormonal imbalance and reduce menorrhagia.

An IUD with progesterone can typically reduce bleeding by up to 80 percent in women with menorrhagia. Progesterone-containing IUDs are best for women who still want to get pregnant, advised GW Hospital.

If menorrhagia is caused by a hormone medication, a doctor may be able to combat it by changing or stopping that medication.

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen are painkillers that are often used to treat both menstrual symptoms and heavy periods.

Surgical intervention may be necessary if drug therapy is unsuccessful in treating menorrhagia.

With dilation and curettage (D&C), a doctor scrapes or suctions tissue from the uterine lining to reduce menstrual bleeding. Although this procedure is common and is often successful in treating menorrhagia, additional D&C procedures may be needed if menorrhagia recurs.

Operative hysteroscopy is an option if fibroids or polyps are causing menorrhagia. Doctors can remove these through the abdominal cavity or vagina. Since the womb is not removed during this procedure, women are usually able to still get pregnant.

Endometrial ablation utilizes lighted viewing instruments, along with methods such as a laser, heat, electricity and freezing, to destroy the uterine lining. However, since the absence of functional endometrial tissue reduces or prevents future uterine bleeding, pregnancy is unlikely.

Hysterectomy is another option women can choose. This is the surgical removal of the uterus and cervix. It is a permanent procedure that causes both cessation of menstrual periods and sterility.

Sources:

Cornforth, Tracee. "Top Ten Causes of Heavy Menstrual Bleeding." About.com Women's Health. N.p., n.d. Web. 11 Jan. 2014.
http://womenshealth.about.com/od/abnormalbleeding/a/causemenorrhagi.htm

"Heavy periods (menorrhagia)." Netdoctor. N.p., n.d. Web. 11 Jan. 2014.
http://www.netdoctor.co.uk/health_advice/facts/menstruationheavy.htm

"Menorrhagia (heavy menstrual bleeding)." Definition. N.p., n.d. Web. 11 Jan. 2014.
http://www.mayoclinic.org/diseases-conditions/menorrhagia/basics/definition/con-20021959

"Treatment for Heavy Periods." Washington D.C. N.p., n.d. Web. 11 Jan. 2014.
http://www.gwhospital.com/hospital-services/womens-services/treatment-for-heavy-periods

"Treatment options for heavy periods." Treatment options for heavy periods. U.S. National Library of Medicine, 10 Apr. 2013. N.p., n.d. Web. 11 Jan. 2014.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0005201

"Women's Health." Heavy Periods (Menorrhagia): Causes and Treatments. N.p., n.d. Web. 11 Jan. 2014.
http://women.webmd.com/guide/heavy-period-causes-treatments?ecd=wnl_wmh_103113&ctr=wnl-wmh-103113_hdln_3&mb=

Reviewed January 16, 2014
by Michele Blacksberg RN
Edited by Jody Smith