Understanding Heavy Bleeding and Ways to Deal

How heavy your period is can vary throughout your life and from month to month, but if it’s usually heavy, you might have menorrhagia, or excessive bleeding. It affects around 53 in a thousand women and is defined by bleeding more than two ounces per cycle. You don’t need to get out a measuring cup to check, though – if you’re bleeding that much, you can usually tell.

What are the signs that you’re bleeding excessively?

• Having to change your pad or tampon once an hour, every hour, during the day, otherwise you’ll bleed through your clothes.
• Needing to wear two pads or a tampon and a pad at the same time to feel secure.
• Needing to change your pad or tampon in the middle of the night.
• Passing blood clots around the size of a quarter.
• Periods that last longer than seven days.
• You might also have cramps so severethey stop you from completing daily tasks and the blood loss can lead to iron-deficiency anemia, which will leave you breathless and exhausted.

What causes excessive bleeding?

Often it can signal an underlying health condition. Some of the most likely suspects are:

• Polycystic ovary syndrome (PCOS) – when follicles inside an ovary swell into tiny cysts, they can cause heavy and irregular periods.
• Pelvic Inflammatory Disease – an inflammation in the uterus, ovaries or fallopian tubes caused by bacteria or a sexually-transmitted disease, it often makes periods heavier and more painful.
• Fibroids – non-cancerous growths in the uterus that can make periods heavier, more painful, and longer-lasting.
• Polyps – similar growths to fibroids but usually found in the uterus lining, they are occasionally (but not usually) cancerous.
• Endometriosis – when the uterus lining grows outside the womb it often causes painful periods and sometimes results in blockages that can lead to excess bleeding.
• Hypothyroidism – longer, heavier periods with painful cramps can be a sign that your thyroid is underactive.
• Blood clotting disorders – some genetic disorders, like Von Willebrand disease, can also cause heavy periods. (Chances are, you already know if you have this.)
• Cancer – cancer of the uterus, cervix, or ovaries can present as a heavy period, but this less likely than the causes above.

Occasionally, the reason will be unclear.

Can it ever be related to medication?

Sometimes. If you’ve had an IUD fitted, you should expect heavier periods for the first few months and anticoagulant medication such as Warfarin, which is prescribed to prevent blood clots, will also make you bleed more.

How is excessive bleeding diagnosed?

A doctor will take a medical history and then probably run some blood tests and carry out a pelvic exam. If there’s no obvious cause after that, they might also take a biopsy of your uterus lining, do an ultrasound scan, or examine your uterus using a tiny telescope called a hysteroscope.

How is it treated?

That will depend on the cause, how badly it affects you, and whether or not you might want children in future.

Some possible options include:

1. Birth control pills or an IUD to rebalance your hormones (provided that’s not the cause of your excessive bleeding, in which case changing your preferred contraception should help).
2. Medication to make your period lighter, such as tranexamic acid or anti-inflammatory painkillers like Advil or Aleve (if you want to take them for that reason, consult a doctor first).
3. Surgery. Your doctor might recommend D&C (dilation and curettage) which removes the top layer of your uterus, a myomectomy to remove fibroids, endometrial ablation, where a laser is used to destroy uterine tissue, which often leads to lighter periods – but can only be done if you don’t plan to have children, or the last resort, a hysterectomy (uterus removal).

If menorrhagiahas made you anemic or your iron stores are low, you might also need an iron supplement.

What should I do if I think I have excessive bleeding?

Keep track of the problem. Take note of how often you need to change your sanitary protection, how often you leak, how long your period lasts, and any other symptoms like exhaustion and pain. If you fit the symptoms above, or if you suddenly start bleeding a lot more than usual, see your doctor ASAP. And try not to worry: Excessive bleeding may be a real pain and a complete mess, but there is hope for lighter days ahead.