Learn About Heavy Periods

The first thing to know about heavy periods is you’re not alone if you have them – one in five women suffer from periods that keep them from living life to the fullest.1 The medical term for heavy periods is abnormal uterine bleeding (AUB), and it’s usually defined as excessively long or heavy bleeding during your menstrual cycle.1

There are several common causes of heavy periods, including fibroids, polyps and hormonal imbalances.1 Fibroids are noncancerous tissue growths in the muscle walls of the uterus, while polyps in the uterus are small, protruding bits of tissue that grow on the lining of the uterus. Visit our page on fibroids for more information on this common cause of heavy periods.

Hormonal imbalances of estrogen or progesterone can also lead to heavy periods. These hormones can build up the endometrium, which is shed during your period, and a thicker lining can result in heavier blood flow.2

Other causes of heavy bleeding include pelvic inflammatory disease (PID), thyroid disease, liver or kidney disease, or bleeding disorders like von Willebrand disease (characterized by an impaired ability of the blood to clot).1 Rarely, heavy bleeding is possibly related to cancer of the uterus or cervix.1 The risk is greater for women who are overweight, as this can lead to hormone imbalances.2

So what exactly is considered normal vs. abnormal bleeding? And when is it time to talk to your doctor about It?  Here are a few distinctions that should clue you into whether or not you may be experiencing abnormal uterine bleeding:

Normal period1

  • Blood lost: 2-3 tablespoons
  • Bleeding lasts 4-5 days for most women

Heavy period1

  • Bleeding lasts longer than 7 days
  • Your period affects your daily activities
  • You need to change your tampon/pad frequently
  • You pass clots the size of a quarter or larger

We also know that heavy periods mean more than just heavy bleeding. Suffering from heavy periods can affect you in a number of ways:3

Physically

  • Feeling tired and nauseated
  • Bad cramps
  • Headaches

Socially

  • Missing social or athletic events
  • Avoiding sex
  • Missing work

Emotionally

  • Depression or moodiness
  • Feeling anxious
  • A lack of confidence during your period

The blood loss resulting from heavy bleeding can also cause iron-deficiency anemia, which means the iron levels in the body are low. Weakness and fatigue are common symptoms of mild anemia; more severe anemia can also cause shortness of breath, rapid heart rate, lightheadedness and headaches.1

While what characterizes a “normal” period can vary, experts agree:  If you think your period is a problem, you should talk with a doctor about evaluation and treatment.

Heavy Period Treatment Options

Unfortunately, due to the stigma that prevents open and honest conversations around uterine health, many women don’t know that solutions exist to treat heavy periods. As a result, millions of women suffer in silence for several years before seeking treatment for their heavy periods. Informing yourself of the options can help you change your cycle for the better.

MINIMALLY INVASIVE PROCEDURES

Minor procedures that treat heavy bleeding can take anywhere from 5 to 45 minutes, and may be performed in the operating room or the doctor’s office. Depending on the procedure, patients usually recover in a few hours or days. Minor procedures include:

Dilation and curettage (D&C): This procedure, which involves scraping away the top layer of the uterine lining, is typically performed to determine the cause of heavy bleeding but can also serve as a treatment. D&C may lighten your period, but typically only for a couple of cycles. It is also normal to experience vaginal bleeding and/or cramps for several days following a D&C.

Myomectomy and polypectomy: A myomectomy is a procedure that removes intrauterine fibroids (a polypectomy removes polyps). To learn more about the different kinds of myomectomies and other treatments for fibroids, visit our page on fibroids.

Endometrial ablation: Women who are finished childbearing can consider endometrial ablation to treat their heavy periods. The procedure is characterized by the removal of the uterine lining by using a laser, radiofrequency or heat. Endometrial ablations may reduce or eliminate your period entirely.

The NovaSure® procedure is an endometrial ablation procedure that takes 5 minutes to perform and can be completed in your doctor’s office. Most women who receive the NovaSure procedure can resume normal activities within a day or so.

Learn more about the risks and benefits for endometrial ablation and the NovaSure procedure:

We Hate Heavy Periods

MAJOR SURGERY

Hysterectomy: Hysterectomy is a permanent solution for women who don’t respond to other treatments. A hysterectomy is a major surgery involving the removal of the entire uterus and should be considered a last resort. The procedure requires a hospital stay, and recovery takes several weeks. After a hysterectomy, you can no longer become pregnant and you will stop having your period.

If your ovaries are removed (a separate procedure, sometimes done at the same time as the hysterectomy), you will likely also experience menopausal symptoms.

LIFESTYLE CHANGES

Some experts believe that eating foods with vitamin K may help manage heavy periods because this vitamin supports the blood’s ability to clot. Vitamin K-rich foods include:

  • Oats
  • Leafy green vegetables
  • Green peas
  • Whole wheat
  • Green beans

Increasing the amount of iron and vitamin C in your diet is also recommended to help prevent anemia. (Consult your doctor before consuming large amounts of iron.)

Foods that contain iron include:

  • Various types of meat, fish and shellfish
  • Dried beans and peas
  • Dark green, leafy vegetables
  • Dried fruits, nuts, seeds

Some women have also found that yoga, exercise, and acupuncture can help reduce heavy periods.

Be sure to talk to your doctor before changing your diet or starting an exercise program.

DRUG THERAPY

If you want children in the future, drug therapy could be an option to treat your heavy bleeding. These solutions often treat the symptoms – not the underlying causes – of heavy periods.

NSAIDs (non-steroidal anti-inflammatory drugs, like ibuprofen): Over-the-counter NSAIDs can be taken as directed while you have your period. Sometimes, your doctor may prescribe certain NSAIDs to help you manage your symptoms. Of course, it's important to note that NSAIDs are not a permanent solution, and your heavy period symptoms will return when you stop taking them.

Tranexamic acid (Lysteda®): This oral medication can be taken during your period to slow the breakdown of blood clots, helping to prevent prolonged bleeding.

Oral contraceptives: Hormone-based contraceptives stabilize the body’s estrogen and progestin levels. As a result, bleeding may become lighter and more controlled while you’re on birth control.

There are many brands of birth control pills that contain different hormone levels. Ask your doctor which would be best for you.

Progesterone hormone therapy (progestins and natural progesterone): Progestins act as a replacement for progesterone, a hormone that a woman’s body naturally produces. This is an option for women who are producing too much estrogen and not enough progesterone.

Progestin is available in several forms: oral progestin pills, an implant under your skin (Implanon®), or as an IUD (intrauterine device). These treatments thin the lining of the uterus, which can help to reduce blood flow.

REFERENCES

  1. Centers for Disease Control and Prevention. Heavy menstrual bleeding. https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html. Accessed February 19, 2019.
  2. Mayo Clinic. Menorrhagia (heavy menstrual bleeding). https://www.mayoclinic.org/diseases-conditions/menorrhagia/symptoms-causes/syc-20352829.  Accessed February 19, 2019.
  3. Hologic, Inc. Data on File; AUB Patient Journey Research, conducted January 2017. Survey of 1,003 women who self-identified as currently or recently experiencing heavy bleeding with need to change feminine hygiene product every hour or more.
  4. Winchester Hospital (Lahey Health System). Health Library: Vitamin K. http://www.winchesterhospital.org/health-library/article?id=21883. Accessed February 19, 2019.
  5. Mayo Clinic. Iron deficiency anemia. https://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/symptoms-causes/syc-20355034. Accessed February 19, 2019.
  6. NovaSure Instructions for Use.
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