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.
How To Manage Period Clots
Most menstruators experience occasional period clots, but for some, clotting is an every-day-of-your-period annoyance accompanied by things like uncomfortable pad or period underwear wetness, messy period product removal, and unexpected tampon slippage .
If youre just a naturally clotty person , there are a few tips and tricks to control the situation.
First, if tampons are causing you trouble, try switching to a period product that collects rather than absorbs your menstrual flow. Menstrual discs and cups are a great option, not only because they keep blood and clots neatly contained within a body-safe receptacle , but they also allow you to monitor just how much blood and clots youre shedding on a given day.
Flex Disc and Flex Cup can both be worn for up to 12 hours at a time. On ultra heavy days, you may need to dump your cup or change your disc twice in a day, but youll be less prone to leaks and avoid the annoying wet-and-stickiness that comes with wearing pads or period underwear. Cups and discs offer three to four times the capacity of traditional period products. Oh, and they wont shoot out of your vagina unexpectedly like a slippery tampon!
Heavy periods with lots of clotting can be frustrating to deal with, but as long as youve ruled out any underlying conditions, managing the flow is usually just a matter of choosing the right period products.
What Do You Do If You Bleed Alot On Your Period
Were often able to manage heavy periods with treatments ranging from diet changes to prescription medication.
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What Should I Do
If you experience a heavy flow then there are some simple steps you can take to ease the effects of symptoms you might experience while on your period.
Increase your iron intake from foods
When you lose a large amount of blood, your iron levels can drop, making you feel fatigued and sluggish. Some examples of high iron foods are: red meat, liver, egg yolks, deep green vegetables and dried fruits like raisins and prunes. These types of foods can help increase your iron intake!
Increase salty fluids and drink more liquids
If blood volume is low in your body you may feel dizzy or light headed. To help get rid of that feeling, drink more liquids and increase the salty fluids you drink such as tomato or other vegetable juices or salty broths.
Take an ibuprofen
Ibuprofen can help decrease your period flow by 25-30% and will also help you alleviate some of the pain of period cramps. You can take an ibuprofen every 4-6 hours during your period.
Speak to your doctor
If you are experiencing a heavy period and its interfering with your regular schedule, it might be worth making an appointment with your doctor or gynecologist. Your doctor can run any relevant tests and rule out any serious conditions. Theyll also be able to help you find different options that work best for you to help manage your period!
How Can I Tell How Much Blood I Am Losing
Measuring the amount of blood lost via menstruation is not that easy, since it is hard to tell how much blood has been absorbed by a pad or tampon. Different products have different absorbencies, and each woman has a different perspective on when a tampon or pad needs to be changed. Using a menstrual cup is one way of getting an accurate measurement of blood loss. Alternatively, you can use this Pictorial Blood Assessment Chart which helps identify whether your blood loss is excessive.
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Is Losing Too Much Blood During Your Period Life
You might be asking, when should you go to the hospital for heavy menstrual bleeding? Blood loss from heavy periods can lead to a more severe, urgent medical condition. Heavy blood loss can decrease the amount of circulating blood in the body and the usual amount of oxygen the body needs. So, can losing too much blood during your period be life-threatening? The answer is, if youre experiencing any of the following while you have heavy vaginal bleeding, you should seek immediate medical attention:
- Shortness of breath
Pink To Light Pink Or White
Low Estrogen Levels / Low Flow
Youll most likely see pink to light pink blood at the beginning or end of your cycle, and this just means a low flow of fresh menstrual blood. If its the only blood you see over multiple periods, its a possible sign that your estrogen levels are low. Another symptom of low estrogen levels is vaginal dryness. If you notice both, we recommend you see your doctor.
Outside of your regular period cycle, pink spotting can be from mid-cycle bleeding, this is quite common and normal for some people.
If you get pink vaginal discharge when youre not on your period or outside of whats typical of your body, it could be a sign of cervical cancer and you should get it checked out by your healthcare provider.
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Symptoms Of Abnormal Uterine Bleeding
- bleeding for more than eight days
- heavy blood loss during the menstrual period for example, soaking through one or more sanitary pads or tampons every hour for several hours in a row
- needing to change your pad or tampon during the night
- have to change or restrict your daily activities due to your heavy bleeding
- bleeding or spotting between periods
- cramping and pain in the lower abdomen
- any vaginal bleeding after menopause.
If you think you may be experiencing heavy menstrual bleeding, you may find it useful to keep a pictorial blood loss assessment chart this can help you give your doctor an idea of how heavy your period is.
Symptoms Of Significant Heavy Bleeding
The official definition of menorrhagia is based on the amount of bleeding and how long it lasts.
During an average period, 2 to 3 tablespoons of blood is lost over 4 or 5 days. Its considered heavy bleeding if you lose more than this amount of blood during your period and/or if you bleed for at least 7 days.
If you have any of the following signs or symptoms, its worth talking with a doctor:
- You pass clots the size of a quarter or larger.
- You get up during the night to change your pad or tampon.
- During the day, you have to change your pad or tampon at least every hour for several hours in a row.
- You use a reusable menstrual cup and bleed 5 milliliters or more an hour for several hours in a row.
- You bleed so much that having your period keeps you stuck at home.
- You have significant abdominal pain and cramping that interferes with your regular routine.
- You dont meet those above criteria, but the bleeding is affecting your well-being.
There are several possible causes of heavy menstrual bleeding. Your doctor will ask more about your symptoms and medical history. Bloodwork or medical imaging may be done to further investigate.
Here are some reasons why your bleeding may be so heavy.
Heavy menstrual bleeding can have major effects on your health and well-being. Its important to pay attention to your body and seek help if you need it.
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When Is It Time To Schedule A Visit With Your Practitioner
Youre the person who knows your body best, so consider going to a doctor if you detect any changes in your usual menstrual cycle. If you believe you are suffering from menorrhagia or hypomenorrhea, your doctor will be the best person to diagnose and treat the underlying cause.
Depending on your symptoms, your doctor will perform a physical examination. They can also order imaging tests or blood tests to determine what is causing your abnormal menstrual bleeding. Once you have a diagnosis, they will also be able to prescribe treatment and other lifestyle changes to help you get better.
Many causes of abnormal menstrual bleeding are treated through the use of hormonal contraceptives. If youre suffering from anemia, your doctor could also prescribe supplements and dietary changes. A doctor or nutritionist will be able to advise you on what to eat after blood loss. These dietary changes could include eating more protein, citrus fruits, and leafy greens to improve your hemoglobin levels.
There are many things that can cause abnormal menstrual bleeding. Whether your period is too light, too heavy, short, long, or irregular, it can cause distress and other physical symptoms.
The easiest way to start dealing with any menstrual issues is by tracking your cycle. That way, youll have plenty of information for your doctor, and youll learn more about the way your body works.
How Do You Measure Menstrual Blood/ Fluid Loss
We can roughly calculate blood loss by simply halving the total fluid loss So this really depends on the collection method you prefer to use.
Menstrual cups now provide the easiest and most accurate way to measure fluid levels, since many of them come with a handy scale on the inside . Others may just list their total capacity size, which still enables users to estimate how much fluid has been collected over the course of a period. Simply look at how much fluid is in the cup when changing it and note it on your phone, or on paper. Do this throughout the whole period, since diagnostic cut off points are based on total blood loss per period.
Disposable items, such as pads and tampons all have to meet the same absorbency standards . This means that it is possible to roughly estimate fluid loss by counting how many tampons or pads you bleed through during your period.
The chart below shows the exact standard ranges , which are actually based on weight, rather than fluid level- but this is still a good way to roughly calculate fluid loss. For example, each regular soaked tampon or pad ~ 7ml, each super ~ 10ml, each super plus ~ 13ml, and each ultra ~ 16ml.
|Ranges of absorbency in grams||Corresponding term|
|15 to 18||Ultra|
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Can I Figure Out How Much Im Bleeding
The easiest way, knowing that one soaked, normal-sized sanitary product holds about a teaspoon of blood loss. Keeping the Menstrual Cycle Diary or Daily Perimenopause Diary is a convenient way to assess the amount and timing of flow using either a count of soaked regular sized sanitary products or a measuring menstrual cup. . To accurately record the number of soaked sanitary products each day you need to recall the number you changed that were half full and multiply that to give the number of fully soaked ones. A maxi or super tampon or pad holds about two teaspoons or 10ml of bloodtherefore record each larger soaked sanitary product as a 2. In addition, record your best judgment about the amount of flow where a 1 is spotting, 2 means normal flow, 3 is slightly heavy and 4 is very heavy with flooding and/or clots. If the number of soaked sanitary products totals 16 or more or if you are recording 4s you have very heavy flow. To measure your flow using a menstrual cup with measurements, just add up the approximate amounts from each time you emptied it and record on the “# of pads/tampons” line.
A Bonus Note For Clinicians/ Menstrual Health And Rights Enthusiasts
A few years ago, it was decided to just trust that people who sought help from their doctor for very heavy periods, really did have them . This is actually a very nice intention a decision to believe in female patients rather than dismiss them as prone to exaggeration . Unfortunately, menstruation education is typically of poor quality and so people who menstruate often do not have an informed idea if their flow is average, heavy- or even heavy enough to be Heavy Menstrual Bleeding .
It has been argued that it is better to treat all of those who think they have this condition, rather than measuring fluid/ blood loss or otherwise making a diagnostic distinction . However, I am concerned that by doing this we are actually reinforcing a sexist myth that positions all menstruating people as debilitated , as well as normalising the exceptionally severe experiences of those few who really do lose over 80 ml of blood per period .
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Getting Moody Before And During A Period Isnt Just Life Angst
Its more likely to be PMS or premenstrual syndrome, also known as PMT . As well as sore breasts, aches, pains and bloating, women can get mood swings in the run up to a period. Thats because of fluctuations in the amount of estrogen your body is producing. Result: an emotional rollercoaster ride for a few days or even weeks.
A minority of women suffer from such extremes of emotion that medical help is needed. This is more than just PMS, this is premenstrual dysphoric disorder or PMDD, and it can result in panic attacks, depression, extreme rage and even suicidal thoughts. Its essential to get help if this sounds like you, as PMDD cant be handled on your own.
Thankfully, for most women, while PMS is annoying and upsetting, its not a problem on the level of PMDD. Dealing with PMS means finding ways to manage your emotions and taking maximum care of yourself. To help balance out the emotional highs and lows of PMS, try aerobic exercise like running, dancing or spinning ideally combined with yoga, which helps keep you calm and evens you out. Getting plenty of sleep and eating a balanced, healthy diet can also help. You may feel like treating yourself and thats fine as long as its not chocolate or junk food. Stick to a bit of pampering, or better still, a massage.