Why Is My Period Heavy? Heavy Menstrual Bleeding (Menorrhagia) |
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Why Is My Period Heavy? Heavy Menstrual Bleeding (Menorrhagia)
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When Should I Be Concerned About a Heavy Period? If you experience any of these signs and symptoms of a heavy period, you may want to schedule an appointment with your primary care doctor or gynecologist. Your period lasts more than seven days.You soak through one or more tampons or pads an hour for several hours in a row.You need to double up on sanitary protection.You wake up during the night to change your sanitary products.You experience painful menstrual cramps.You pass menstrual blood clots that are larger than the size of a quarter.You lose so much blood that you feel tired, fatigued, or short of breath, which are signs of anemia, or low iron in the blood.You cancel or scale back activities due to heavy menstrual flow.Why Is My Period So Heavy?There are many causes of heavy menstrual bleeding, such as: Adenomyosis, which occurs when endometrial tissue grows and becomes embedded in the uterine muscleCancer, such as uterine or cervical cancer, particularly in postmenopausal women or those who have had an abnormal Pap testHormonal imbalances, which can occur if estrogen or progesterone levels are off, which in turn can interfere with your body’s ability to regulate the buildup of the uterine lining, or endometrium, that’s shed during your periodIntrauterine devices (IUDs) — heavy menstrual bleeding can be a side effect of using a nonhormonal IUD for birth controlMedications, such as anti-inflammatory drugs, hormone medications, and blood thinnersMenopause: As you near menopause and begin to skip periods, the flow may be heavier than normal when you do bleed, but women of any age can experience heavy menstrual bleedingIrregular ovulation, which can lead to hormone imbalances and affect your flowUterine fibroids, which are noncancerous growths that can appear in uterine tissue during childbearing yearsUterine polyps, or small, noncancerous growths that can develop in the lining of the uterusVon Willebrand disease, which is an inherited bleeding disorder marked by impaired blood-clotting abilityOther disorders, such as issues with the liver or kidneys, thyroid disease, insulin resistance, obesity, polycystic ovary syndrome, endometriosis, or pelvic inflammatory diseaseWork with your doctor to determine the root cause of your heavy menstrual bleeding, which can help inform the best possible course of treatment. Your doctor will perform an evaluation and likely ask you a variety of questions about your menstrual cycle and how it affects your quality of life. Consider keeping a period log for multiple cycles that notes how many days of bleeding you experienced, how heavy your flow was, and how many sanitary products you needed to control it, and then share this log with your doctor. From there, to determine the cause of your heavy menstrual bleeding, your doctor may order one or more of these tests: Blood test to screen for anemia, thyroid disorders, and blood-clotting issuesEndometrial biopsy to assess the uterine tissue for abnormalities or growthsPap test to evaluate cells from the cervix for infection, inflammation, or cancerUltrasound to evaluate the structure of the uterus, ovaries, and pelvisDepending on what these initial tests find, your doctor may order additional tests or procedures: Sonohysterography to look for problems in the uterine liningHysteroscopy to take a closer look inside the uterusDilation and curettage (D&C) to find what’s causing the excessive bleedingHow Can I Stop Heavy Periods?If your doctor determines that an underlying condition is contributing to your heavy menstrual bleeding, treating that condition often helps lighten your periods. But heavy menstrual bleeding can also be effectively treated even if there isn’t an underlying medical condition causing it. The exact treatment plan your doctor recommends will depend on a host of factors, including: The underlying cause of the bleedingThe severity of the condition and the bleedingHow well you respond to certain treatmentsYour medical historyYour general healthYour ageYour future childbearing plansYour quality of lifeYour personal preferencesFrom there, your doctor may recommend various treatment options: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, which are available over the counter and can help reduce blood loss and relieve crampingAntifibrinolytic medication, such as tranexamic acid or aminocaproic acid, which are used to improve blood clotting and control bleedingOral contraceptives, such as low-dose birth control pills, to help regulate your menstrual cycle and reduce menstrual bleedingHormone therapy, such as estrogen or progesterone, to address any underlying hormonal imbalance that may contribute to heavy menstrual bleedingHormonal IUDs, which release hormones to help thin the uterine lining and decrease menstrual bleeding and crampingIron supplements to address any underlying anemiaNasal sprays to address bleeding disorders such as von Willebrand disease or mild hemophiliaIf these treatments aren’t doing the trick, your doctor may recommend one of these surgical interventions: D&C, which can be used as both a diagnostic and treatment tool, though the procedure may need to be repeated over timeOperative hysteroscopy, which is used to remove polyps and fibroids, fix abnormalities in the uterus, and remove some of the uterine lining to help reduce menstrual flowUterine artery embolization or focused ultrasound surgery, which are two types of procedures used to shrink uterine fibroids in an effort to decrease blood flowMyomectomy, which removes uterine fibroids altogetherEndometrial ablation or resection — two different approaches that are used to destroy or remove some of the uterine lining to lighten periodsHysterectomy, which surgically removes your entire uterus to end menstruation altogetherTalking openly with your doctor can help you get the answers you need and find the right treatment to manage your heavy periods. |
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