What Is A Chemical Pregnancy
While as many as one in five known pregnancies will result in a miscarriage, research suggests that the rate may be as high as 50% when including women who are unaware of their pregnancy.
Very early miscarriage occurs when a pregnancy is lost shortly after implantation. This typically results in heavy bleeding which usually doesn’t last any longer than your usual period. As such, it is possible that a late and/or especially heavy period could have, in fact, been a chemical pregnancy.
Whether or not this is important is debatable. In the end, unless there was a pregnancy test, there is really no way to know for sure if youve had a chemical pregnancy, and there could be any number of reasons for a heavy and/or late period.
How Is Heavy Bleeding Diagnosed
After a thorough history and clinical examination including a cervical screening test and swabs your doctor might order blood tests and/or a pelvic ultrasound to eliminate some of the possible causes listed previously. The gold standard is to perform a hysteroscopy and curette in all women over 35 years of age to rule out endometrial hyperplasia or cancer. This is where the lining of the womb is viewed with a telescope the hysteroscope and is then lightly scraped away and a biopsy taken for examination.
What Is Considered Heavy Menstrual Bleeding
HMB, which used to be called menorrhagia, is prolonged or excessive heavy bleeding during periods that can be so bad it can interfere with your daily life. It can be nerve-wracking when youre just not sure why your periods are so heavy, and HMB can make you dread getting your period each month.
If you have HMB, your menstrual flow can be heavy enough to require changing your pad or tampon every hour for several hours in a row. You might also have cramps so severe it makes it difficult to do your usual daily activities. It can be hard to go to work, play sports, or even socialize because youre in pain or worrying about leaking.
Its important to remember that HMB can affect anyone, and nothing you have done is causing this heavy bleeding. Though the causes cant always be determined, its important to be aware of the condition because it could be happening as a result of an underlying issue. For example, HMB has been linked to iron-deficiency anemia, which can make you feel exhausted and short of breath, so figuring out if you have it can help you manage how youre feeling.
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Heavy Menstrual Bleeding: Why Is My Period So Heavy
As if mood swings, cramps, backache, and headaches werent enough to make your period your least favorite time of the month, theres also the blood loss.
Because we are all so different, our periods are too. Some of us have a heavy start to our period which then tails off, while others have heavy or light bleeding throughout. Period length also varies from person to person. And 25% of women and people who menstruate have blood loss so severe that its categorized as heavy menstrual bleeding .
Here, well explain what HMB actually is and discuss the signs, symptoms, and causes. If youre suffering from HMB, take comfort in the fact that there are plenty of treatment options available that can hopefully provide you with some relief.
What Causes Heavy Menstrual Bleeding
Heavy menstrual bleeding can have many causes, ranging from hormone-related issues to various medical conditions and even stress.
The hormones that your body produces, like estrogen and progesterone, help regulate your menstrual cycle, including how heavy your periods are. Having a condition that causes your hormones to become imbalanced can lead to heavy period bleeding. Causes include:
- Birth control pills and injectables .
Failing to remove contraceptive devices when needed can also cause abnormal uterine bleeding.
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What Is Menorrhagia And How Much Bleeding Is Too Much
A period usually lasts about 3-5 days and, on average, produces a total of 30-40 mL of menstrual blood. The medical definition of menorrhagia is passing more than 80mL of menstrual fluid over the course of a period. This is more than double the typical amount.
These numbers are probably meaningless to youunless you use a menstrual cup, in which you can see the actual volume of the blood youre shedding. Even then, were guessing youre probably not sitting on the toilet measuring out your blood like a goth scientist. So, if youre not sure whether your periods are technically heavy or not, look out for these other signs:
- Large blood clots
- Bleeding through tampons in less than an hour
- Needing to double up on pads and tampons to prevent leaks
- Bleeding for longer than a week
- Bleeding so much that you feel like you cant manage it
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Sooooo Why Do Some People Have Nightmare Periods From Hell When There Are Other People Out There Getting By With Lite Tampons And Panty Liners
Honestly, sometimes the cause of a heavy period isn’t known some people just bleed more than others, says Minkin. At the same time, here are some things known to be associated with heavy menstrual bleeding :
Structural abnormalities such as fibroids and polyps, which are growths in the uterus. Find out more about the difference between them here.
Irregular ovulation caused by puberty and perimenopause, or medical conditions such as polycystic ovary syndrome and hypothyroidism. This is because when you don’t ovulate regularly, the lining of the uterus can become super thick. So when your period does finally come? “It’s a festival of blood,” says Minkin.
Endometriosis. AKA, a condition where the tissue that normally lines the inside of the uterus actually grows outside of the uterus .
Pelvic inflammatory disease. AKA, an infection of the female reproductive organs that is often a complication of some STIs, but not always.
Bleeding disorders that cause blood not to clot properly.
Certain medications like blood thinners and aspirin.
Endometrial cancer. But this is rare and usually diagnosed in women who are past menopause meaning that heavy menstrual bleeding is definitely a sign that something isn’t right.
It sounds like a lot thanks, body but don’t fall down a WebMD rabbit hole. Your doctor will help you figure out what’s actually going on.
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My Period Just Started What Should I Do
If youve started your period and dont have something to use for the blood, try not to worry. You can fashion a temporary pad out of toilet paper to hold things over until youre able to get a proper pad or tampon.
If youre at school, you may consider asking your teacher or nurse for a pad or tampon. Theyve been asked before trust us.
Your first period may only last a couple of days. Your first period . .
It may take a couple of months for your period to settle into a regular schedule and consistency.
Once it does, your period may last anywhere from two to seven days each month.
Although a persons first few periods are often light bringing a few spots of red-brown blood throughout the week you may have a heavier flow.
Your monthly period will follow a more consistent pattern once your hormones stabilize.
Heavier bleeding isnt necessarily cause for concern. But if you feel like youre losing too much blood, tell your guardian or talk to the school nurse.
You should also tell a trusted adult if you:
Signs To Watch For With Heavy Periods
Here are some signs that menstrual bleeding may be too heavy, and that you should call the doctor:
- The girl is looking pale and feels dizzy and/or weak. If this is happening, you should call your doctor immediately.
- She needs to change her pad or tampon during the night.
- She is bleeding through her clothes.
- She is passing clots that are bigger than an inch wide.
- Her periods are interfering with her ability to go to school, play sports, or otherwise engage in regular activities.
There are many reasons why girls may have heavy periods. The most common reason is simply that the body is just getting started and getting regulated. If that is the case, it usually gets better with time. However, there are other causes as well, which is why its important to see the doctor.
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Do I Need Any Tests If I Have Heavy Periods
See your doctor if your periods change and become heavier than previously. For most women, the cause is unclear and there is no abnormality of the womb or hormones. However, it is very important to get it checked out properly.
A doctor may want to do an internal examination to examine your neck of the womb and also to assess the size and shape of your womb. However, an examination is not always necessary, especially in younger women who do not have any symptoms to suggest anything other than dysfunctional uterine bleeding.A blood test to check for anaemia may be performed. If you bleed heavily each month then you may not take in enough iron in your diet, needed to replace the blood that you lose. This can lead to anaemia which can cause tiredness and other symptoms. Up to 2 in 3 women with recurring heavy periods develop anaemia.If the vaginal examination is normal and there are no other associated symptoms, no further tests may be needed. The diagnosis is usually dysfunctional uterine bleeding and treatment may be started if required. Further tests may be advised for some women, especially if there is concern that there may be a cause for the heavy periods other than dysfunctional uterine bleeding. For example, if you:
If tests are advised then they may include one or more of the following:
Causes Of Heavy Menstrual Bleeding
There are a variety of conditions that can cause HMB. The most common conditionsinclude:
Polyps, or growths in the uterine lining, usually cause spotting or bleedingbetween periods and sometimes HMB.
Adenomyosis, the abnormal growth of uterine lining into themuscular wall of uterus, but can sometimes cause heavy and/or painful periods.
Uterine fibroids, benign growths on the uterus, alsoknown as *leiomyomas*, can sometimes cause HMB. If they grow in the uterinelining they will most likely cause HMB.
Cancers and precancers are very uncommon, but important, causes of abnormalbleeding, particularly for individuals under the age of 40. While they can causeHMB, cancers and precancers more likely cause irregular bleeding or bleedingbetween periods.
Coagulopathy, an inherited disorder preventing the blood from clottingnormally, will cause HMB usually from menarche .
Ovulatory disorder, the absence or irregularity of ovulation, is ahormonal problem that may cause irregular bleeding that may or may not includeHMB as a symptom.
Endometrial disorder, an abnormality in the lining of the uterus, preventsthe tissues from stopping the bleeding normally.
Most medications and birth control pills donât cause HMB, but there are twoexceptions: Copper-containing intrauterine devices may increase the amountof blood lost during menstruation and anticoagulants ,which prevent blood clots, usually cause HMB.
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What Causes Heavy Periods
For many people with heavy periods, no cause is ever found. This is known as dysfunctional uterine bleeding . DUB can occur at any age and is more common in your late thirties.
Heavy periods may be caused by:
- a problem with the lining of your uterus . This lining is called the endometrium. It can sometimes become too thick or even become cancerous
- lumps in the muscle of the uterus, called fibroids
- a medicine that you take, such as a blood thinner
- a medical condition
How Can You Tell If You Have Heavy Menstrual Bleeding
There are some common symptoms and signs that may indicate your flow is heavy, so if youre experiencing one or more of the below, its possible you might have HMB:
- You soak through one or more tampons or pads an hour for several hours in a row.
- You have to use two kinds of period products, like a tampon and a pad at the same time.
- You have to get up at night to change your period products.
- You pass blood clots that are 1 inch or larger during your periods.
- Your periods soak through your bedding or clothes.
- You have to restrict your everyday activities because of heavy menstrual bleeding.
- You experience symptoms and signs of iron-deficiency anemia, including shortness of breath, fatigue, or tiredness.
The average person loses between 30 and 40 milliliters, or two to three tablespoons, of blood during menstruation. However, people suffering from HMB can lose up to 80 milliliters each month.
To give you an idea of how much 80 milliliters is, a menstrual cup can hold up to around 30 milliliters of menstrual blood a regular-absorbency tampon absorbs up to five milliliters and a standard pad absorbs about 15 milliliters.
Measuring blood loss can be tricky because your menstrual fluid also contains a mix of mucus and uterine tissues, which can add to the volume of your overall fluid loss. One way to work out if you have HMB is to measure your flow. Speak to your health care professional about the best way to do this.
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Signs And Symptoms Of Heavy Menstrual Bleeding
Symptoms of heavy menstrual bleeding may include:
- Soaking through one or more sanitary pads or tampons every hour for several consecutive hours
- Needing to wake up to change sanitary protection during the night
- Needing to use double sanitary protection to control the menstrual flow
- Menstrual bleeding that lasts longer than a week
- Symptoms of anemia, like fatigue, light-headedness and shortness of breath
- Passing blood clots larger than a quarter
- Restricting activities because of heavy menstrual flow
For Chronic Abnormal Uterine Bleeding
- If the woman is not wanting to become pregnant in the near future and there is no distortion of the endometrium on ultrasound then Mirena is the recommended first line treatment.
- If Mirena is not suitable due to contraindication or patient preference:
- first choice is continuing on the oral contraceptive pill as this is protective against endometrial carcinoma
- second choice: progestogens . Starting doses: medroxyprogesterone acetate 10 mg od or norethisterone 5 mg bd. Note this does NOT provide contraception.
Trial for at least 3 full months and preferably 46 months.
- Antifibrinolytics: Tranexamic acid 1 g tds for 35 days, and/or
- NSAIDs: Ibuprofen 400mg tds for 34 days.
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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.
Is There Anything I Can Do About Heavy Bleeding Or Do I Just Kind Of Live Like This
There’s plenty you can do! Heavy bleeding that disrupts your life is something you should get treatment for, no matter how much you’ve been taught that shitty periods are things you just have to deal with. Obviously your doctor will be the one to talk to you about the best treatment for you, but just as an FYI, here are some of the options that might come up:
Hormonal treatment just as birth control pills, hormonal IUDs, and hormonal injections. “These treatments work well for young women because they are reversible most often and allow them to maintain their fertility if they’re interested in having children,” says Basinski.
Other drugs that control blood flow. Things like ibuprofen have been show to moderately decrease blood flow, according to Basinski. Then there are drugs such as tranexamic acid that you take during your period that can help you clot better.
Surgery to get rid of fibroids and polyps if you have them.
Uterine artery embolization, which is used to treat fibroids by blocking blood vessels to the uterus so fibroids are unable to grow. Because a doctor uses a catheter to inject embolic agents into the uterine arteries to cut off blood supply, it is an alternative for those who don’t want surgery to treat fibroids, according to Minkin.
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What Are The Causes Of Heavy Periods
Heavy flow is most common in the teens and in perimenopauseboth are times of the lifecycle when oestrogen levels tend to be higher and progesterone levels to be lower.
Note: There are also various other ways that your menstrual cycle can affect your physical performance daily.
Understanding the possible cause behind your heavy periods can help you figure out the best way to approach it.
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.
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