Heavy period, also known as menorrhagia, is excessive and prolonged menstrual bleeding. Although the condition is considered very common among women, it can disrupt your daily life and be quite distressing.
Here’s more information on heavy periods, including signs, causes, diagnosis, and treatments.
When is menstrual bleeding considered “heavy”?
You may have heavy periods if you:
- have periods that last more than seven days
- have excessive bleeding that soaks one or more pads or tampons every hour for several hours in a row
- need to use two sanitary pads or two different sanitary products to control your menstrual flow
- pass blood clots larger than 2.5cm or the size of a quarter
- bleed through your clothes or bedding
- experience constant pain in the lower part of your stomach during periods
- avoid daily activities such as exercise, or workout
- feel tired, lack energy, or are short of breath
How can heavy periods affect my health?
Heavy periods may indicate an underlying health problem that requires treatment. Additionally, it can lead to iron deficiency such as anaemia, which, if severe, can cause shortness of breath and increase the risk of heart problems.
What causes heavy menstrual bleeding?
Many factors can contribute to heavy menstrual bleeding. Some of the causes are the following:
- Non-cancerous uterus growth called fibroids(forms in the uterus muscle) and polyps(abnormal tissue growth that grows inside the organ)
- Irregular ovulation. If you do not ovulate regularly, areas of the endometrium (uterine lining) can become too thick. This is a common condition during puberty and perimenopause, as well as in women with polycystic ovary syndrome (PCOD).
- Certain types of birth control, such as an intrauterine device (IUD)
- Bleeding disorders – when the blood doesn’t clot properly
- Adenomyosis – A condition in which the tissue that normally lines the uterus grows in the uterine muscle wall
- Endometriosis – A disorder in which uterine tissue is found outside the uterus, usually on the ovaries, fallopian tubes, and other pelvic structures.
- Pregnancy complications, such as miscarriage or ectopic pregnancy(when a baby develops outside the uterus)
- Endometrial, uterusor cervix cancer
- Certain medications like blood thinners and aspirin
How is the heavy period diagnosed?
When you see your doctor for heavy period bleeding, you may be asked about:
- Past and present diseases and surgical procedures
- Pregnancy history
- Medications, including over-the-counter drugs
- Your birth control method
- Your menstrual cycle – Your doctor may ask you about your menstrual cycle, such as when you first got your period, how long it lasts, how much blood flow you have (light, medium, heavy, or spotting), and how it affects the quality of your life.
You can use a calendar or period calculator on your smartphone to track your period dates and associated symptoms before your visitso that you can give the doctor as much information as possible.
What tests can be used to diagnose heavy menstrual bleeding?
Your doctor may recommend one or more of the following tests to determine if you have a bleeding problem:
- Blood test – Your blood sample will be tested for anaemia, thyroid problems, and blood clotting issues during this test.
- Ultrasound exam – Use sound waves to create a picture of your pelvic organs and to check your blood flow.
- Hysteroscopy involves inserting a thin, lighted scope into the uterus through the cervix opening. It enables your doctor to see inside your uterus.
- Sonohysterogram– A thin tube injects fluid into the uterus while the uterus’s ultrasound images are taken to provide a better view of the uterine lining.
- Magnetic resonance imaging (MRI) – This test uses a strong magnetic field and sound waves to view internal organs and structures.
- An endometrial biopsy involves taking samples from your endometrium to check for abnormal or cancerous cells.
What are the treatments for heavy periods?
Heavy periods do not always require treatment. However, if they are interfering with your daily life, some treatments that can help are:
Drug therapy
- Iron supplements if you see any signs of anaemia
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen may help control heavy bleeding and relieve menstrual pain and cramps.
- Birth control pills reduce heavy bleeding caused by problems associated with ovulation, endometriosis, and fibroids.
- Hormone therapy uses drugs containing oestrogen and/or progesterone to treat heavy bleeding, which is common during perimenopause.
- Antifibrinolytic medications (tranexamic acid, aminocaproic acid) reduce bleeding by preventing clots from breaking down.
Surgical treatment
- Dilation and Curettage (D&C) involves the removal of the top layer of the uterine lining to reduce heavy bleeding.
- Operative hysteroscopy is a surgical procedure to correct uterine abnormalities and remove polyps, fibroids, and uterine lining to manage the heavy menstrual flow.
- Endometrial ablation or resection destroys the uterine lining. It reduces or stops menstrual bleeding.
- Hysterectomy involves surgical removal of the uterus. This procedure is used to treat fibroids, adenomyosis, and, in some cases, endometrial cancer.
Heavy periods are considered common but certainly not normal. If you notice any of the above signs and symptoms during your period, consult your doctor and seek treatment.