Signs Your Period Is Too Heavy
Heavy periods, also known as menorrhagia, are characterized by an excessive or prolonged menstrual flow, often accompanied by discomfort and inconvenience. According to the American College of Obstetricians and Gynecologists (ACOG), about one in five women reports heavy menstrual bleeding. Adolescents, women approaching menopause, and those with certain underlying health conditions may be more susceptible to experiencing heavy periods.
While every woman's menstrual cycle is unique, the standard menstrual flow typically ranges from 30 to 40 milliliters over the entire duration of the period. Menorrhagia, on the other hand, involves a significantly higher volume of blood loss, often exceeding 80 milliliters per cycle. Here are a few reference points you can use to estimate how much blood loss you are experiencing during your period.
A fully saturated light tampon can hold up to 3 milliliters of fluid.
A fully saturated regular tampon can hold up to 5 milliliters of fluid.
A fully saturated super tampon can hold up to 12 milliliters of fluid.
A fully saturated regular daytime pad may hold around 5 milliliters of fluid.
A fully saturated overnight pad may hold 10 to 15 milliliters of fluid.
A smaller menstrual cup can hold around 25 to 27 milliliters of fluid.
A larger menstrual cup can hold around 30 milliliters of fluid.
Signs of a heavy period
It's important to recognize that some variability in menstrual flow is normal, and what constitutes a heavy period can differ from person to person. Here are common signs of a heavy period:
Needing to change your pad or tampon every 1-3 hours
Needing to change your sheets in the morning because you bled through your tampon or pad
Needing to double up on protection to keep from leaking
Noticing blood clots the size of a quarter or larger
Having low iron levels or iron-deficiency anemia
Periods lasting more than 7 days
What are some potential reasons for heavy bleeding during periods?
There are many different causes of heavy menstrual bleeding. Various factors can play a role in the development of menorrhagia. If you or someone you know is experiencing heavy periods, it is advisable to seek medical advice. A healthcare professional can help identify the underlying cause and recommend appropriate therapies tailored to your individual needs. Common causes of heavy periods include:
Hormonal imbalance - High estrogen or low progesterone can cause heavy periods. Estrogen dominance occurs when estrogen levels are disproportionately high compared to progesterone. Estrogen stimulates the growth of the endometrial lining in the uterus. If estrogen levels remain consistently high, the endometrium can become excessively thick. A thickened uterine lining is more prone to shedding during menstruation, leading to heavier bleeding. Estrogen and progesterone work in tandem to regulate the menstrual cycle. Progesterone stabilizes the uterine lining and prevents excessive growth. If there is a lack of progesterone relative to estrogen, the uterine lining may become unstable, leading to irregular and heavy menstrual bleeding.
Uterine fibroids - Although surgery is not always required, uterine fibroids are the most common reason to have a hysterectomy. Fibroids are benign tumors that grow within the smooth muscle of the uterus. They can vary greatly in size and number. Although the exact cause is unknown, uterine fibroids are hormone-dependent. They have significantly higher concentrations of estrogen and progesterone receptors and are hypersensitive to estrogen stimulation compared to normal uterine tissue.
Endometriosis - Endometriosis is a condition where the tissue that normally lines the inside of the uterus grows in areas outside of the uterus. This uterine tissue can be found on the ovaries, fallopian tubes, intestines, rectum, bladder, cervix, and other abdominopelvic areas. Endometriosis can cause heavy, painful periods.
PCOS - Polycystic ovarian syndrome is a metabolic disease that can impact ovulation and the menstrual cycle. PCOS can prevent you from ovulating. Without ovulation, minimal progesterone is made, leaving estrogen unopposed. Excess estrogen causes the lining of the uterus to grow thicker and thicker. By the time your period rolls around, you have more lining to shed, which makes periods heavier.
Hypothyroidism - Hypothyroidism is a condition in which your thyroid gland stops producing enough thyroid hormones. Hypothyroidism can affect your periods by setting off a cascade of hormonal changes that impact ovulation and cyclical health. There is a strong association between menorrhagia and hypothyroidism, even if ovulation still occurs.
Perimenopause - Perimenopause refers to the years before menopause when hormones begin to shift. Estrogen dominance is common in perimenopause because estrogen levels rise and fall unevenly, which is referred to as a hormone surge. This can result in menstrual cycle changes including lengthening or shortening, and cessation of ovulation. Due to estrogen dominance and anovulation, periods tend to become heavier around this time.
Stress - Stress causes the body to produce more cortisol. Producing high amounts of cortisol in response to stress can deplete progesterone levels. Progesterone helps keep estrogen in check. So with lower progesterone, estrogen levels increase. Higher estrogen levels mean heavier periods due to a thicker uterine lining.
Medication or birth control changes - Heavy periods can be a side effect of certain medications like blood thinners. Changes to your birth control can affect the flow of your period, especially if you switch to a copper IUD. Talk to your doctor if you notice changes to your period after starting a medication or birth control.
How are heavy periods diagnosed?
Diagnosing the cause of heavy periods, or menorrhagia, involves a comprehensive approach that includes a thorough medical history, physical examination, and sometimes additional diagnostic tests. The goal is to identify the underlying factors contributing to the heavy menstrual bleeding. Here are several things your doctor may suggest to determine the cause of heavy bleeding:
Pelvic examination to assess the reproductive organs, including the uterus, ovaries, and cervix. This can help identify any abnormalities, such as fibroids, polyps, or signs of infection.
PAP smear to look for signs of infection, inflammation, cancer, or other unusual changes.
Blood tests to check for iron deficiency anemia, thyroid disease, or clotting issues.
Endometrial biopsy to check for cancer.
Transvaginal ultrasound to screen for uterine fibroids, endometriosis, PCOS, as well as blood flow issues.
Sonohysterogram to better visualize the uterine lining.
Hysteroscopy to check for uterine fibroids, polyps, and other possible causes of heavy bleeding.
It's important to note that the diagnostic process may vary based on individual circumstances and the healthcare provider's clinical judgment. Once a diagnosis is established, appropriate treatment options can be discussed to address the underlying causes of heavy menstrual bleeding and improve overall menstrual health.
Natural ways to manage heavy periods
Managing heavy periods naturally involves adopting lifestyle changes, incorporating specific dietary elements, and exploring alternative therapies. While these approaches may not replace medical intervention, they can complement traditional treatments and contribute to overall well-being.
Eat foods rich in iron and vitamin C: Consuming foods high in iron, such as leafy green vegetables, lean meats, and legumes, can help prevent or address anemia resulting from heavy menstrual bleeding. Foods rich in vitamin C, like citrus fruits and berries, can enhance iron absorption, supporting the body in maintaining healthy iron levels.
Engage in regular exercise: Engaging in regular physical activity can help regulate hormonal balance and improve overall health. Exercise may also alleviate menstrual cramps and reduce stress, which can contribute to heavy periods. Weight loss attributed to regular exercise may help reduce uterine fibroids due to its estrogen-lowering effects.
Stress management: Chronic stress can impact hormonal balance and exacerbate menstrual issues. Practices such as yoga, meditation, deep breathing exercises, and mindfulness can help manage stress levels.
Limit caffeine use: Caffeine is known to have vasoconstrictive properties, meaning it can narrow blood vessels. This vasoconstriction could affect blood flow to the uterus, potentially influencing menstrual bleeding. There is also some evidence to suggest that caffeine intake may be associated with an increased risk of uterine fibroids.
Reduce alcohol intake: There are several ways in which alcohol can contribute to heavy periods. Alcohol can interfere with hormonal regulation, including disrupting the balance between estrogen and progesterone. Chronic alcohol use can result in nutrient deficiencies, including those related to vitamins and minerals essential for hormone metabolism. Additionally, alcohol use can contribute to inflammation throughout the body. Chronic inflammation may affect the reproductive organs and potentially influence menstrual health.
Consider supplementing with omega-3 fatty acids: Found in fish oil, flaxseed, and walnuts, omega-3 fatty acids have anti-inflammatory properties that may help alleviate heavy menstrual bleeding.
Add ginger to your diet: Known for its anti-inflammatory properties, ginger may help alleviate heavy bleeding. Ginger can be consumed as a tea or added to meals.
Heavy periods can be a challenging and often isolating experience for many women. However, by gaining a deeper understanding of the causes, symptoms, and available treatments, individuals can navigate these challenges more effectively. Seeking medical advice, maintaining a healthy lifestyle, and exploring appropriate treatment options are essential steps in managing heavy periods and improving overall well-being.
Disclaimer: Not medical advice. For educational purposes only. Please consult with your doctor before making any changes.