Menorrhagia Relief: Causes, Treatments & Top Products in Kenya

Date: 03 Oct 2025

What Is Menorrhagia (Heavy Menstrual Bleeding)?

Menorrhagia refers to menstrual bleeding that is abnormally heavy or prolonged—typically lasting more than 7 days, or involving passage of large blood clots or frequent changes of sanitary products (e.g. soaking through a pad every hour). This can lead to iron‑deficiency anemia, fatigue, reduced quality of life, and emotional distress.

Primary Causes of Heavy Bleeding

Common contributors to menorrhagia include:

• Uterine abnormalities: Such as fibroids, polyps, or adenomyosis, that increase blood loss.
• Hormonal imbalances: Particularly estrogen–progesterone dysfunction leading to excessive endometrial growth.
• Pelvic infections (PID): Untreated infections can disrupt the uterine lining and increase bleeding.
• Bleeding disorders: Conditions like von Willebrand disease may manifest as heavy menstrual flow.
   

Why Does Heavy Menstrual Bleeding Happen?

Heavy menstrual bleeding, or menorrhagia, often has multiple causes. It usually results from one or more of the following conditions:

1. Uterine Structural Abnormalities

Benign growths like fibroids, polyps, and adenomyosis, or conditions like endometrial hyperplasia, can increase bleeding by enlarging the uterine lining or distorting the uterus. These changes disrupt normal shedding and contraction, making periods heavier.

2. Hormonal Imbalance

When ovulation doesn't occur (anovulation), estrogen builds up the uterine lining without progesterone to balance it. This leads to excessive growth and heavy shedding. Common in PCOS, thyroid issues, obesity, and perimenopause.

3. Bleeding Disorders

Conditions like von Willebrand disease or platelet function defects impair clotting, causing prolonged bleeding. Many women discover these disorders only after experiencing menorrhagia.

4. Pelvic Infections

Chronic infections like PID or endometritis, often caused by STIs such as chlamydia or gonorrhea, can inflame the uterus and increase bleeding by damaging the lining.

5. Pregnancy-Related Issues

Heavy bleeding may signal complications like miscarriage, ectopic pregnancy, retained tissue, or molar pregnancy. These are not menstrual but require urgent care.

6. Systemic Conditions & Medications

Diseases like liver/kidney problems or blood cancers can affect clotting. Blood thinners and some IUDs may also worsen bleeding.

Key Insight: In many women, multiple factors contribute simultaneously (e.g. fibroid + hormonal imbalance + mild bleeding disorder). That’s why an individualized diagnostic approach is essential.

 

How Is Menorrhagia Evaluated? (Diagnostic Workup)

A comprehensive evaluation helps tailor treatment:

1. History & Symptom Tracking
   • Duration, volume, clot size, pain, intermenstrual bleeding
   • Family history of bleeding disorders
   • Medication use (anticoagulants, hormone therapies)
2. Laboratory Tests
   • CBC (hemoglobin, platelets), iron studies, ferritin
   • Coagulation profile, von Willebrand panel (if indicated)
   • Thyroid function, liver, kidney function
3. Imaging & Endometrial Assessment
   • Pelvic ultrasound (transvaginal or transabdominal) to detect fibroids or polyps
   • Hysterosonography or office hysteroscopy for intrauterine lesions
   • Endometrial biopsy (especially if over 40 or risk factors for hyperplasia)
   • Hysteroscopy + D&C may be used diagnostically and sometimes therapeutically.
4. Additional Tests
   • Imaging for liver or kidney disease if suspicion
   • Further hematologic evaluation if coagulopathy suspected

 

Evidence-Based Treatment Strategies by Underlying Cause

Treatment should aim to:

1. Address the underlying cause
2. Control bleeding
3. Correct or prevent anemia
4. Preserve fertility (when desired)

 

Medical / Pharmacologic Treatments

Effective management of menorrhagia depends on addressing the specific trigger:

1. Surgery to Remove Tumors or Fibroids

When fibroids or large polyps are identified, surgical removal—via hysteroscopy, myomectomy, or endometrial ablation—can drastically reduce bleeding. These interventions restore uterine integrity and often provide long-term relief for women experiencing structural causes of heavy periods.

2. Antibiotics for Pelvic Inflammatory Disease (PID)

If PID is diagnosed, a treatment course involving broad-spectrum antibiotics is prescribed. Prompt therapy not only resolves infection, but also helps stabilize menstrual cycles and reduce excessive bleeding caused by inflammation.

3. Hormone Therapy for Imbalance

Hormonal dysfunction is frequently corrected using combined oral contraceptives (COCs) or high-dose progestin therapy. These medications regulate the endometrial lining, slow its buildup, and stabilize bleeding. In some cases, intrauterine devices (IUDs) releasing levonorgestrel are used for continuous bleeding control.

4. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are commonly used to manage ovulatory menorrhagia. They work by reducing prostaglandin levels in the uterine lining—chemicals that contribute to both bleeding and cramping. By lowering these levels, NSAIDs help decrease menstrual blood loss and relieve pain. Clinical studies show that NSAIDs can reduce menstrual bleeding by 20% to 46%. 

 

Top Recommended Products from Pharmily Kenya

These pharmacy products offer supportive care during treatment of heavy bleeding:

1. Quest Liposomal Iron 15 mg Capsules (30s)

A highly absorbable, stomach-friendly iron supplement ideal for managing anemia due to menorrhagia. Its liposomal delivery ensures higher uptake with minimal gastrointestinal side effects.

• Why it stands out: Gentle on the stomach, convenient once-daily dosing, and enhanced with Vitamin C for optimal iron absorption.

2. Natures Aid Iron Bisglycinate Tablets (90s)

Iron bisglycinate is known for its superior absorbability and tolerability. Formulated with Vitamin C, B12, and folic acid, this supplement helps rebuild healthy blood levels and combat fatigue. Why it stands out: Specifically designed for iron deficiency and especially helpful for women with heavy menstrual bleeding.

3. Vitabiotics Feroglobin B12 Liquid Iron (200 ml)

This liquid iron formula is flavored and easy to take, ideal for those who dislike pills. Enriched with B vitamins and minerals, it supports red blood cell production and energy. Why it stands out: Delicious flavor, gentle on the stomach, and ideal for ongoing supplementation during treatment.
 

Integrating Treatment & Supplements

Here’s how you can combine medical treatment with supportive supplements:

• Begin antibiotic or surgical therapy as indicated by your provider.
• For hormonal therapy, take prescribed COCs or initiate progestin treatment as directed.
• Use tranexamic acid during heavy flow days, as prescribed, to directly reduce blood loss. 
• Supplement daily with an iron product—such as one of the top 3 above—to prevent anemia and restore vitality.
• Maintain a balanced diet rich in leafy greens, lean protein, vitamin C, and fluids to support recovery.
   

Lifestyle Strategies for Long-Term Support

• Track menstrual flow and symptoms to monitor treatment effectiveness.
• Include regular moderate exercise and relaxation techniques to enhance hormonal balance.
• Avoid excessive caffeine and alcohol intake, which can exacerbate bleeding and cramps.
• Attend routine medical follow-up to assess hemoglobin levels and uterine health.
   

When to Seek Further Medical Evaluation

Consult your healthcare provider if:

• Heavy bleeding continues despite treatment
• You experience severe pain or signs of infection (e.g., fever or foul-smelling discharge)
• You develop dizziness, fainting, or symptoms of severe anemia

FAQ

1. What counts as “heavy bleeding” in menorrhagia?
   Bleeding longer than 7 days, soaking through pads/tampons every hour for several hours, passing clots larger than a quarter, or significantly impacting daily life.
2. Can iron supplements stop heavy menstrual bleeding?
   No — they help manage the effects of heavy bleeding (i.e. iron deficiency). To reduce bleeding, medical or surgical treatments are needed (e.g. tranexamic acid, hormones, surgery).
3. Is tranexamic acid safe to use?
   Yes, when prescribed and monitored. It’s used during the heaviest days to reduce bleeding. But caution is needed in those with thrombosis risk. 
4. How quickly will I see benefits from iron supplementation?
   Hemoglobin may begin to improve in 4–6 weeks; full replenishment can take 3–6 months.