Normal vs. heavy periods
Heavy period bleeding, also called menorrhagia, is a common condition experienced by menstruating women. About 1 in 5 women will experience heavy periods. If your periods are heavier than usual and it is affecting the quality of your life, you may need medical treatment.
Here’s what you need to know.
The amount of normal menstrual bleeding can vary from woman to woman. Period bleeding usually lasts from 4 to 5 days, and the amount of blood lost is typically about 2 to 3 tablespoons.
You can think of your periods as being heavy if they last longer than 7 days or if you lose a lot more blood than you normally do. You may have to change your pad or tampon every hour for hours at a time. Clots may be as large as a quarter or even larger.
If you have to wear more than one pad at a time to manage the blood flow or you have to change your pads during the night, you may be having heavy periods.
Another sign that your periods are heavy is a feeling of constant pain in the lower part of your abdomen. Particularly heavy periods may cause you to take time off from work and skip activities that you enjoy.
Is having heavy periods a serious medical condition?
Heavy periods can be serious if the amount of blood loss you experience causes anemia. When a person has anemia, they don’t have enough red blood cells to carry oxygen to all the tissues in the body. That can make you feel tired, and you may have problems breathing. Anemia can cause other health problems and can sometimes even cause death without treatment.
Additionally, sometimes, heavy periods can be a sign of another serious health condition.
Why are my periods so heavy?
Heavy period bleeding can have several medical causes. Sometimes, you can even have heavy periods because of stress.
Your body makes hormones called estrogen and progesterone that regulate your menstrual cycle and how much bleeding you have. Sometimes, you may have medical conditions that affect hormone levels. That can cause heavy bleeding.
Sometimes, you may have growths in your uterus called uterine fibroids or polyps that can cause heavy bleeding. Alternatively, you may have cancer in your uterus or cervix.
Sexually transmitted diseases (STIs) like trichomoniasis, gonorrhea, and chlamydia can also cause heavy period bleeding.
Some medicines can cause you to have heavy periods. Blood-thinning medications, aspirin, hormone replacement therapy, birth control pills and injections, and a breast cancer drug called Tamoxifen are some examples.
You can experience heavy period bleeding because of pregnancy complications like a miscarriage or an ectopic pregnancy, which occurs when the baby grows outside the uterus.
Heavy bleeding can also be caused by the placenta being in an unusual location. The placenta is a large organ that develops during pregnancy to give oxygen and nutrition to the growing baby.
Some types of birth control, like the intrauterine device (IUD), can cause heavy periods.
Other medical conditions
Sometimes, your heavy periods can be caused by other medical conditions.
- Blood disorders like von Willebrand disease (VWD) or platelet function disorder
- Liver, kidney, or thyroid disease
- Pelvic inflammatory disease (PID)
Your doctor or OB-GYN will ask you general questions about your menstrual cycle, like the length of a normal cycle and how much bleeding you normally experience. An OB-GYN is a doctor who specializes in female health. They’ll want to know about your medical history and ask you questions about family history to rule out blood disorders.
Writing a period diary or using a period tracker app can help you give accurate information about your periods to your OB-GYN. Note how many pads or tampons you use and how often you change them.
Sometimes, your OB-GYN may conduct a pelvic examination. Your doctor will take a look at some parts of your body like your vulva, uterus, cervix, fallopian tubes, ovaries, bladder, and rectum. It’s usually not painful and is finished in as little as 10 minutes.
Your OB-GYN may also order other tests for more information if necessary, such as a:
- Blood test, where samples of your blood are examined in a lab
- Pap test, where cells of the cervix are examined for abnormalities
- Endometrial biopsy, where a small amount of tissue from the endometrium (the lining of the uterus) is taken for examination
- Ultrasound, where sound waves are used to see the inside of the pelvic organs
- Hysteroscopy, where the doctor will look at the inside of your cervix and uterus using a small, thin tube called a hysteroscope
- Sonohysterography, where sound waves are used to see the picture of the inside of the uterus
- Magnetic resonance imaging (MRI), where a magnetic field and radio waves are used to inspect the interior of your body
- Dilation and Curettage (D&C), where the inside of your uterus is scraped for a sample to find out why you’re bleeding. A D&C is carried out in the operating theatre, but it’s a simple procedure that doesn’t require you to stay in the hospital afterward.
Treatment can depend on the cause of your heavy periods and the seriousness of your condition. Your doctor will check your medical history and your current state of health. They will also discuss any questions or concerns you have before deciding on the right type of treatment for you.
Some treatments can be taken a single time. Sometimes, though, you may need to keep taking treatments for a while. Treatments can include iron supplements, painkillers, nasal sprays for blood disorders, hormone therapy, or antifibrinolytics, a class of drugs that helps promote blood clotting and reduces bleeding.
Your OB-GYN may sometimes recommend birth control as that can help to make your cycles more regular and reduce bleeding. Surgery may be recommended in some cases.
Heavy period bleeding is a condition that many women face. Talk to your doctor openly about your concerns, though, so you get the right treatment. Early treatment can help you manage or resolve other medical conditions that may be causing heavy bleeding. Your doctor can help you get relief so your heavy bleeding doesn’t get in the way of living a normal life.
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ACOG: "Heavy Menstrual Bleeding."
Centers for Disease Control and Prevention: "Heavy Menstrual Bleeding."
Cleveland Clinic: "Heavy Menstrual Bleeding (Menorrhagia)."
Mayo Clinic: "Anemia," "Menorrhagia (heavy menstrual bleeding)."
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