Heavy Periods
Heavy menstrual bleeding can significantly impact a woman's quality of life, causing physical discomfort, social embarrassment, and emotional distress.
What is considered heavy?
Menorrhagia, or heavy periods, is defined as soaking through a pad or tampon every hour or needing to use double protection to control bleeding or if you bleed for more than 7 days (A normal period usually lasts 4 to 6 days). Bleeding that causes anemia (low blood counts) can also be considered abnormal.
What is the cause?
Heavy menstrual bleeding can be caused by a variety of factors:
Hormonal changes: Normally one of your ovaries releases an egg during your menstrual cycle. This is called ovulation. If you don't ovulate, the uterus does not receive the proper signals to regulate bleeding, which may cause your periods to stop, to become irregular or to become heavy.
Uterine fibroids: These are non-cancerous growths that can develop in or on the uterus, causing heavy or prolonged periods.
Polyps: These are small, non-cancerous growths that can develop in the lining of the uterus, leading to heavy menstrual bleeding.
Adenomyosis: This is a condition where the tissue lining the uterus grows into the muscle layer of the uterus, causing heavy and painful periods.
Blood disorders: Medical conditions that affect clotting or platelet function, such as Von Willebrand's disease, can cause heavy menstrual bleeding. Certain anticoagulant medications, such as coumadin, may also cause this.
Intrauterine devices (IUDs): The use of copper IUDs as a form of contraception can lead to heavier menstrual bleeding.
Certain medications, such as anticoagulants
Sometimes a cause can't be found.
When are heavy periods a cause for concern?
When you lose a lot of blood during your period, your iron levels can drop. This can cause anemia. Anemia can make you feel tired and weak. Call your doctor if you think you have anemia.
In rare cases, heavy periods may be a sign of a serious problem, such as an infection or cancer.
Call your doctor now or seek immediate medical care if:
You pass clots of blood and soak through your usual pads or tampons every hour for 2 or more hours.
You are dizzy or lightheaded, or you feel like you may faint.
How are heavy periods diagnosed?
Your doctor will ask about your menstrual periods and may perform a pelvic exam. During the exam, your doctor will check for signs of disease, infection, and abnormal growths.
If needed, your doctor may also do one or more tests to find out what's causing heavy periods. These tests may include:
A Pap test- This can look for signs of infection and changes in the cells of your cervix.
Blood tests- These can check for anemia, a bleeding disorder, or other problems.
A pelvic ultrasound- This test can look for problems with the ovaries or uterus
An endometrial biopsy- It can check for abnormal cell changes in the lining of the uterus (endometrium).
A hysteroscopy- This can check the lining of your uterus to look for the cause of bleeding, such as a polyp.
How are they treated?
Non-steroidal anti-inflammatory medications: If you have severe cramping during your periods, taking an NSAID such as ibuprofen or naproxen may help. An NSAID works best when you start taking it 1 to 2 days before you expect pain to start. If you don't know when your period will start next, take your first dose as soon as bleeding or cramping starts.
Iron supplementation: Heavy periods can make you feel weak and run-down and can lead to anemia. Your doctor may suggest that you take an iron supplement if your iron levels are low. You may be able to prevent anemia if you increase the amount of iron in your diet. Foods rich in iron include red meat, shellfish, eggs, spinach, and almonds.
Hormonal therapies:
Birth control pills, patch, or ring. These release two hormones, estrogen and progestin. They prevent pregnancy and also can reduce menstrual bleeding and pain.
Progestin-only birth control, such as mini-pills, implants, and shots. These types of birth control can reduce bleeding and cramping.
Progestin pills. These are progestin-only pills that help reduce bleeding but do not prevent pregnancy.
Hormonal IUD. This is a birth control device that your doctor places inside your uterus. It releases a type of progestin that can reduce bleeding and cramping.
Non-hormonal therapy- Tranexamic acid (Lysteda) is a non-hormonal medication that can be prescribed by medical professionals to help manage menorrhagia. Unlike hormonal therapies, this medication does not affect hormones or the menstrual cycle, but instead works by preventing the breakdown of blood clots or clumping of blood platelets, reducing heavy bleeding during menstruation.
Surgical treatment options:
You may want to think about surgery if medicines don't help or if there are certain structural changes, such as fibroids or a polyp. Your choice will depend partly on whether you want to get pregnant in the future. Surgery options include:
Hysteroscopy. This procedure can be done to diagnose heavy periods. But it can also treat some problems at the same time. For example, fibroids or polyps may be removed during this procedure.
Endometrial ablation: a procedure in which the lining of the uterus is destroyed or removed, reducing the amount of menstrual bleeding. This procedure can be performed minimally invasively by hysteroscopy, and can be done on an outpatient basis. This is not an option if you desire to become pregnant.
Hysterectomy: If other treatment options have not been effective, and when no future pregnancy is desired, medical professionals may recommend hysterectomy, the surgical removal of the uterus. Hysterectomy may also be recommended in cases where the uterus is enlarged or there is an underlying condition such as uterine fibroids, adenomyosis or endometriosis.
Our team of experts is equipped to provide an accurate diagnosis and tailored treatment plan to help alleviate heavy menstrual bleeding and improve your overall well-being. Don't let heavy bleeding control your life - we’re here to help.