What Are Period Cramps
Period cramps, sometimes called dysmenorrhea, are the pain associated with menstruation. Mild pain is a normal part of the menstruation process.
About every month, the ovaries release an egg into the uterus. The endometrial lining thickens as it prepares the body for pregnancy. When the egg isnt fertilized, the uterus sheds its lining and starts the process over again.
To shed the lining and move the blood out of the body, the uterus must contract. This contraction causes pain which many female bodies experience as cramping. Some women have period cramps but no blood, which can be a sign of different health conditions.
Treatment Of Heavy Menstrual Bleeding
At Childrens Hospital of Philadelphia, adolescent medicine specialists are able to manage the majority of cases of heavy menstrual bleeding. However, if necessary, a coordinated approach may be used with specialists from gynecology, hematology, radiology and endocrinology and others to accurately diagnose and treat patients with heavy menstrual bleeding.
Treatment for heavy menstrual bleeding will be recommended by your adolescent’s physician based on:
- Your adolescent’s age, overall health and medical history
- Cause and severity of the condition
- Your adolescent’s tolerance for specific medications, procedures or therapies
- Your adolescents future childbearing plans
- Effects of the condition on your adolescents lifestyle
- Your adolescent’s opinion or preference
What Are Heavy Periods
The amount of blood lost during a period varies a lot between women. This makes it difficult to give a general description of heavy periods. The amount of blood lost can also vary at different times in your life, including if you have had surgery or take medication. However, most women have a good idea of how much bleeding is normal for them during their period and can tell when this changes.
| A good indication that your periods are heavy is if you: |
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Heavy periods can lead to low iron levels and anaemia. These can cause you to feel tired more easily, feel weak or dizzy, be short of breath or have chest pains.
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Youre Actually Pregnant And Have Placenta Previa
This type of heavy vaginal bleeding is actually unrelated to a period, though you might think it is one if you don’t yet know you’re pregnant. Placenta previa is a condition that happens during pregnancy where the placenta covers the cervix, explains Dr. Horton.
Patients will usually have heavy vaginal bleeding throughout their pregnancy and will need to deliver their baby by C-section. Take a pregnancy test and see your doctor to figure out the best treatment method.
Causes Of Abnormal Uterine Bleeding
While in many cases it is not possible to determine the exact cause, there are a number of reasons a woman may experience abnormal uterine bleeding. Some of the known causes of abnormal uterine bleeding include:
- spontaneous miscarriage in pregnancy
- ectopic pregnancy lodgement of the fertilised egg in the slender fallopian tube instead of the uterine lining
- hormonal disorders conditions such as hypothyroidism , polycystic ovarian syndrome and hyperprolactinemia can disrupt the menstrual cycle
- ovulatory dysfunction this is when the ovary does not release an egg each month. Most commonly, this occurs at either end of a woman’s reproductive years, either during puberty or at menopause
- endometriosis the cells lining the uterus can travel to, attach and grow elsewhere in the body, most commonly within the peritoneal cavity
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Cervical Or Uterine Cancer
Gynecological cancers, including cervical and uterine cancer, are forms of cancer affecting female reproductive organs.
Anyone with female reproductive organs is at risk for gynecological cancer, and risk increases with age.
The HPV vaccine is recommended to help protect against cervical, vaginal, and vulvar cancers.
Abnormal bleeding, including heavy bleeding and irregular discharge, is a common symptom of cervical, ovarian, uterine, and vaginal cancer.
Pelvic pain or pressure is another symptom of uterine cancer.
Treatments for gynecological cancers include surgery, chemotherapy, and radiation.
Symptoms of gynecological cancers vary both by location of cancer and the person experiencing it. Heavy bleeding can be a symptom of many disorders, so this symptom alone doesnt indicate cancer.
Is Heavy Menstrual Bleeding Serious
Heavy menstrual bleeding can be serious if you lose so much blood that you show signs of anemia. Anemia is a condition arising from having too little iron in your body. Anemia can be life-threatening without treatment.
Also, some of the conditions that can cause heavy period bleeding, like cancer, require early medical intervention. Speak with your healthcare provider to discuss any risks related to your period bleeding.
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How Is Menorrhagia Treated
Your healthcare provider will consider your age and overall health and your personal preferences when finding the best treatment for you.
Treatment for hormone problems may include:
- Prostaglandin inhibitors. These are nonsteroidal anti-inflammatory medicines , including aspirin or ibuprofen. They help reduce cramping and the amount you bleed.
- Birth control pills. These stop ovulation and result in lighter periods.
- Progesterone. This is a type of hormone treatment.
Treatment for problems with the uterine lining may include:
- Ablation. Healthcare providers use this procedure to destroy the lining of the uterus .
- Resection. In this procedure, the lining of the uterus is removed.
- Hysterectomy. This is the surgical removal of the whole uterus.
- Iron supplements. If you have anemia as a result of the heavy loss of blood, you may need iron supplements.
A Period Thats Heavy On The First Day
Many women experience heavier bleeding on the first day of a period and lighter bleeding on the last days. A heavy flow that might get in the way of your normal activities is unusual.
Birth control changes
If you recently stopped using hormonal birth control, your periods may be very heavy in the first days as your cycle adjusts to the hormone changes.
Medication changes
Like birth control, medications you take may interfere with your cycle and lead to heavy bleeding on the first day of your period.
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Cervical Or Endometrial Cancer
Cervical cancer, which can be caused by human papillomavirus , can invade other parts of the body. Treatment for cervical cancer includes surgery, chemotherapy, and/or radiation therapy.
Endometrial cancer occurs when abnormal cells in the endometrium grow into the uterus and/or other organs. While the cause of endometrial cancer is unknown, the most common age for diagnosis is the mid 60’s.
Treatment for endometrial cancer is usually a hysterectomy, possibly followed by chemotherapy and/or radiation treatments.
Early diagnosis is key to the effective treatment of cancer. In addition to regular Pap screening for cervical cancer, the American Cancer Society recommends that women at high risk of endometrial cancer have an annual endometrial biopsy.
Possible Complications Of Menstrual Cramps
Menstrual cramps wont cause any other medical complications if you go to see a doctor on time in order to prevent further conditions to occur. It mainly affects your daily activities. Furthermore, if endometriosis is not discovered in time, it may cause fertility problems. The pelvic inflammatory disease can increase the risk of a fertilized egg implanting outside of the uterus,
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How Is Heavy Menstrual Bleeding Diagnosed
Your healthcare provider will ask a series of questions about your medical history and menstrual cycle to diagnose heavy menstrual bleeding.
Your provider may ask about:
- Your age when you got your first period.
- The number of days your period lasts.
- The number of days your period is heavy.
- Family members with a history of heavy menstrual bleeding.
- Your pregnancy history and current birth control methods.
- Current medications you’re taking, including over-the-counter ones.
Come prepared to talk about your quality of life, too. Your provider needs to know if you’ve been doubling up on menstrual products, avoiding activities or placing restrictions on your life in any way because of heavy periods.
How Do You Know If You Have Heavy Menstrual Bleeding
Heavy menstrual bleeding interferes with your quality of life. Many people with heavy periods assume that periods are supposed to be inconvenient and uncomfortable. They may have watched people in their families live with heavy periods without seeking care and followed their example. But periods should never cause you to restrict activities or accept inconvenience.
During your period, you should be able to:
- Wear a standard pad or tampon every three to four hours without changing it.
- Wear a single menstrual product without having to double-up at any point.
- Leave your home without having to pack extra bags of pads or clothing changes.
- Live your life as usual, without missing work, avoiding going out in public, or skipping activities you enjoy.
If your periods are disrupting your life, it’s time to see your provider.
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Is It Normal To Have Cramps Before Your Period
Pregnancy cramps are very mild and due to implantation. You can quickly confirm pregnancy by its early symptoms. Very common pregnancy symptoms are fatigue, body weakness, feeling like vomiting and light bleeding before your period. Bonus Tip: You may be pregnant without knowing.
Having increased emotions before period is a sign your period is coming soon. Mood changes that occur after ovulation is a sign your period will start soon. If you are persistently having mood changes throughout your menstrual cycle, then it may be due to other causes. You should inform your doctor.
Possible Consequences Of Heavy Menstrual Bleeding
Whenever you have a period, you lose blood. For those with normal bleeding, anda diet containing normal amounts of iron, blood loss and iron intake should bein balance. However, for those with heavy menstrual bleeding, and especiallywhen the diet is deficient in iron, blood loss can exceed iron intake and mayresult in an iron deficiency and possible low red blood count, or anemia. Iron deficiency, with or without anemia, can cause fatigue and interfere with the ability to concentrate, exercise, and, enjoy life in general.
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Your Body’s Gearing Up For Menopause
Oh yes, simply getting older can mess with your period. Menopause, which technically means you’ve gone 12 or more months without a period, hits women around age 50. However, your body starts the natural decline in hormones that leads up to menopause as early as 35, says Christiane Northrup, MD, author of Womens Bodies, Womens Wisdom.
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When this happens, you may notice your periods getting longer or shorter, your cycle becoming more random, and other slight changes in your menstruation.
If you’ve ruled out everything else, and you’re in your mid- to late-30s, your prolonged periods might simply be due to the natural process of aging. There is, however, such a thing as early menopause, which can affect women even in their twenties. So talk to your doctor if this runs in your family or if you’re showing other signs of menopause, like a low sex drive or insomnia.
Is It Normal To Have Longer And Heavier Periods During Perimenopause
Excessive bleeding and long periods are fairly common during perimenopause. Many women experience an increased flow and extended perimenopause periods before entering menopause.
In fact, one in four women say that their periods are heavy enough to interfere with day-to-day activities, such as going to work or attending social events. According to University of Michigan researchers, 91 percent of women aged 4252 surveyed reported heavy menstruation for 10 or more days during their transition to menopause. This phenomenon occurred one to three times within a three-year period.
There are various other health factors which come into play, including body mass index , use of hormones, and the presence of uterine fibroids.
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Are There Any Complications From Having A Long Menstrual Period
Often, the biggest problem from having a long menstrual period is the way it impacts your quality of life. If this is the case, dont be shy about exploring ways to change your cycle with your doctor.
Its okay to treat something simply because its a bother. Women dont have to live that way, Thielen says
And since blood is rich in iron, women who bleed a lot are at risk of anemia, she says. Talk to your doctor about whether you might need iron supplementation, and what schedule you should take it on. A study by Indian researchers published in December 2019 in the Annals of Hematology found that women taking 120 mg of iron every other day reached the same blood levels after six weeks as women taking 60 mg daily, with the alternate-day dosing causing less nausea.
What Underlying Conditions May Cause Prolonged Menstrual Bleeding
A visit with your gynecologist or other healthcare professional is the first step in determining the cause of your prolonged menstrual bleeding. Your doctor will make a diagnosis after performing a series of tests.
Depending on your age and other symptoms, your doctor may test your blood for pregnancy, hormone levels, and thyroid function. Other diagnostic tests may include Pap smears, endometrial biopsies, ultrasounds, laparoscopic surgery, or other procedures.
A wide range of medical conditions can be the cause of abnormal menstrual bleeding. These include:
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You’re On Hormonal Birth Control
Anything that manipulates your hormones has the potential to make your periods longer, says Dr. Toth. This includes all types of hormonal birth control like the pill, patches, rings, shots, and implants. The good news is that there are lots of options with varying levels and types of hormones, so if your body doesn’t respond well to one type or dosage, there’s a good chance you can find a different one that will work.
The length of your period is just one factor your doctor will use to help you determine which type of birth control works best for you.
What Tests Will Be Done To Diagnose Heavy Menstrual Bleeding
Your provider will do a physical exam and a pelvic exam. Many non-invasive procedures are available that can help your provider diagnose what’s causing your bleeding, such as:
- A sonohysterogram to check for problems in the lining of your uterus. A sonohysterogram allows your provider to see the inside of your uterus while it’s filled with saline. It offers higher accuracy and sensitivity when detecting abnormalities in your uterine cavity than an ultrasound without saline.
- A hysteroscopy to check for polyps, fibroids or other irregular tissue in your uterus. Hysteroscopy allows your provider to inspect your vagina, cervix and uterus. Your provider can remove growths that may be causing your bleeding, like fibroids or polyps, during a hysteroscopy.
You may have other tests, depending on your age and how severe your symptoms are. Other tests may include:
- A blood test to check for signs of anemia, clotting issues, or thyroid disease.
- A Pap smear to study cells from your cervix for changes that may indicate cancer.
- An endometrial biopsy to check uterine tissue for cancer cells or other irregularities.
- Transvaginal ultrasound to check the appearance of the organs and tissues in your pelvis.
- Magnetic resonance imaging to check for abnormal structures inside your uterus when an ultrasound doesn’t provide enough information.
- A cervical culture to test for infection, as indicated by your medical history and the results of your physical exam.
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Youre Experiencing An Ectopic Pregnancy
An unusually heavy period can be a sign of an ectopic pregnancy , says Dr. Horton. Taking a pregnancy test can help you figure out if that’s what’s going on.
If you have a positive pregnancy test and have pain and vaginal bleeding, you should be evaluated, she says. Your doctor will get blood work and a pelvic ultrasound to see where the pregnancy is located and, if it is ectopic, treat it with medicine or surgery. Unfortunately, it’s not safe for a mother to carry an ectopic pregnancy.
My Period Lasting Longer Than Usual Is It Normal
If your period usually lasts for four days and increased to 6 days, then its not prolonged. Also, some women may experience prolonged bleeding once in a while and normalize the next periods.
If your period is persistently long and lasting more than seven days then it abnormal.
Causes of period lasting longer than usual include
Longer than normal period? What to do
If your period lasts longer than normal, then you should monitor it.
Is your bleeding heavy with blood clots? Is it the first time you notice it? Has it been persistent? Do you experience excessive menstruation?
If this is the first time, then you should monitor your next period. If its persistent, then you should let your doctor know.
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Vaginal Infections In Women
If you have infection down there at your vagina, then it may cause blood clots in period.
What are vaginal infection symptoms?
Abnormal discharge like greenish yellowish discharge, yellowish smelly discharge or thick white discharge with odor are symptoms of vaginal infections. Others are vaginal itching, vulva sore, fever, abdominal pain and body weakness.
You should inform your doctor if you have these symptom. Vaginal discharge samples are collected and tested for the cause. Treatment with antibiotics will follow after testing your blood and vaginal discharge with good success rate.