It May Be Due To Polycystic Ovary Syndrome
PCOS is a condition where the ovaries produce an abnormally large amount of androgens, which are male sex hormones. Some women with PCOS will have small fluid-filled sacs, or cysts, form in the ovaries. These hormonal changes can prevent a woman from ovulating normally, which can lead to a host of unpleasant symptoms, including acne or oily skin, weight gain, and excess body hair. Other symptom of PCOS are irregular and missed periods. When women do get their period, it may be heavier or lighter than average. Talk with your doctor if youre experiencing these symptoms.
When Is A Heavy Period Too Heavy
- By Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing
Its common for girls and their parents to wonder if the bleeding with their periods is too often or too much. Especially in the first few years of having a period, any bleeding can feel like too much. Usually, its not but sometimes it is, and its important for parents to know what to watch for, and when to call the doctor.
In the first couple of years after periods begin, its really normal for periods to be irregular and for some of them to be heavy. At the beginning, periods arent associated with ovulation, and the hormones and hormonal patterns that help regulate periods havent fallen into place yet. If its just the occasional period that is heavy, thats usually nothing to worry about.
Its not always easy to know what counts as a heavy period. As I said, for some girls anything is too much. And while we doctors often ask how often the girl changes her pad or tampon, thats very subjective and dependent on personal preference. Some girls change as soon as there is any blood present or every time they use the bathroom. Others wait until they are completely soaked.
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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Uterine Polyps Or Fibroids
In some cases, uterine polyps become cancerous, so it is important to see a doctor. Treatment for uterine polyps may involve:
- watchful waiting to assess whether they pose a risk of becoming malignant
- hormone therapy
- surgical options, such as a hysteroscopic polypectomy
Fibroids are noncancerous growths in or around the uterine lining. According to the , people may not always experience symptoms. In those who do, the symptoms can be hard to live with and may include:
- heavy bleeding
- a feeling of fullness in the abdomen
- frequent urination
Treatment options typically include medications, such as birth control, or surgery to remove the fibroids.
My Period Is 4 Days Early What To Expect
If your period is four days early, then its likely due to implantation. Implantation can cause you to have spotting or slight vaginal bleeding that last for hours or days. You should wait for some days then take a pregnancy test. Other causes like stress, eating disorders, emergency contraception can affect your period too.
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What Are The Signs And Symptoms Of Heavy Menstrual Bleeding
Signs of heavy menstrual bleeding include:
- Abdominal pain.
- Periods lasting longer than seven days.
- Passing blood clots that are the size of a quarter or bigger. The blood may appear red, pink, brown, or even rust-like.
- Bleeding through 1 or more tampons or pads each hour for more than two consecutive hours.
- Losing more than 80 milliliters of blood during your period instead of what is typical, 35-40 milliliters.
- Anemia symptoms, like feeling exhausted, tired or short of breath.
With anemia, you may also notice signs of a condition called pica. Pica symptoms include hair loss, pale skin, and the urge to eat non-food items . See your provider if have these symptoms.
Could It Be Hypothyroidism
Menstrual abnormalities, particularly menorrhagia, can be one of the first noticeable symptoms of thyroid abnormalities, particularly hypothyroidism.10 The incidence increases with age and thyroid dysfunction can be masked by menopausal symptoms.
The physiology behind menorrhagia in hypothyroidism is anovulation due to thyroid hormone deficiency. Correct levels of thyroid hormone levels are required to produce luteinising hormone which is needed to trigger ovulation. If the balance is disturbed, there can be a delay in LH production. Hypothyroidism can also alter coagulation factors which are required for blood to clot effectively, and therefore this can result in excessive bleeding.11
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Uterine Polyps Or Cervical Polyps
Uterine polyps can be the cause of your prolonged menstrual flow. These are masses attached to the wall of the uterus and can sometimes extend down into the cervix. They cause irregular spotting between periods and can be visualized with a hysteroscope or ultrasound.
Uterine polyps are a common cause of bleeding after menopause. If you are below 4o years, then you may have pain and prolonged periods.
If your doctor finds uterine polyps as the cause of your prolonged periods, a D& C will be advised.
A Hysterectomy Isnt Your Only Option
Dr. Bradley says some women avoid getting help with heavy periods because theyre worried a hysterectomy is their only option. And the statistics may make that concern seem very real. One in three women has had a hysterectomy, but only 10% are due to cancer, she says.
Not every woman who has a heavyperiod has an underlying problem. But even if there are medical issues, Dr.Bradley says doctors can treat many of them with minor surgery or medications.
If fibroids are located in theuterine cavity , we can easily treat them with a briefoutpatient procedure called operative hysteroscopy, she says.
For healthy women who dont want to reschedule their lives for one week out of every month, birth control pills can help lighten or even stop the flow altogether. Lysteda, a non-hormonal, FDA-approved medication, also is useful in treating heavy periods, she says.
Previously, endometrial ablation was a common option to help treat abnormal bleeding, but its not typically done very often anymore. The procedure involves destroying the lining of the uterus to reduce menstrual flow. Its not recommended for women who may want to have children in the future and there is the potential for complications later down the road.
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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.
Could It Be A Coagulation Problem
Although most people with a coagulation problem are likely to have had menorrhagia at a young age and therefore be diagnosed, it is possible for clotting problems to occur later in life. Bleeding disorders can occur during perimenopause and those that do have sudden heavy bleeding should be investigated.12 Medication such as warfarin, heparin, or steroids can also effect your clotting, as can disorders of the liver, thyroid, bone marrow.
Besides the causes stated above, there are many other causes of heavy periods that occur at a younger age that still apply to those going through menopause, such as pregnancy and infection. If you are having periods, it is possible to become pregnant no matter your age.
Heavy periods are becoming more common due to the rise in body mass index of the general population. Adipose tissue produces oestrogen which has the same effect on your endometrium as the oestrogen from follicles. If heavy bleeding is new to you, you should see your doctor. Endometrium exposed to prolonged periods of oestrogen can result in a condition called endometrial hyperplasia which can be a precursor to cancer. However, the risk of developing endometrial cancer with simple hyperplasia is low less than 5% over 20 years.13
Your heavy periods may be nothing or it could be an indicator that something else may be going on inside your body. We as doctors would be very happy to see you as we want to be able to rule out anything serious.
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Scar Tissue In Your Uterus Is Causing Issues
Most women who have gone through routine dilation and curettage procedures heal with zero complications, but sometimes severe scarring causes the walls of the uterus to stick to each other, causing whats known as Ashermans syndrome. If your period seems to have lightened up a lot after youve had a D& C, this might be your problem. You may need surgery to remove the scar tissue.
Miscarriage Or Abnormal Pregnancy
In the first trimester, signs of a miscarriage can mimic a menstrual period, because there will be bleeding and clotting, says Dr. Ross. For some women, they may not have even known they were pregnant. According to Penn States Milton S. Hershey Medical Center, as many as 30% of women will experience this at least once, and causes can include chromosomal abnormalities, autoimmune disease, infections, and structural issues with the uterus, among other factors.
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What Are The Symptoms Of A Heavy Period
Heavy periods fall on a spectrum. For some women, it can simply be defined as having a heavier flow than usual, causing you to soak through pads or tampons at a more rapid pace. Menorrhagia, on the other hand, is a serious diagnosis and can result in significant blood loss. Per the Mayo Clinic, some signs to watch out for include:
- Soaking through one or more sanitary pads or tampons every hour for several consecutive hours
- Needing to use double sanitary protection to control your menstrual flow
- Needing to wake up to change sanitary protection during the night
- Bleeding for longer than a week
- Passing blood clots larger than a quarter
- Restricting daily activities due to heavy menstrual flow
- Symptoms of anemia, such as tiredness, fatigue or shortness of breath
You Have An Overactive Thyroid
An overactive thyroidalso known as hyperthyroidismbegins producing too many thyroid hormones, which can cause serious issues for your heart, blood pressure, muscles, and more. Abnormally light periods and missing periods are also a symptom of hyperthyroidism. If youre experiencing some of the other symptoms of an overactive thyroid, make an appointment to see your doctor.
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Treating Heavy Periods In Blood Disorders
Treatment for blood disorders varies depending on the type and severity of the disorder. In some cases, women take iron supplementation to replenish the iron in their body lost from excessive bleeding in others, women may receive intravenous iron or a blood transfusion in which they receive blood from a donor to replace lost blood.
If we find that a hormonal imbalance is causing a patients heavy periods, hormones often are effective. The most common types include:
- Birth control pills
- Intrauterine device , a small, T-shaped plastic device inserted into the uterus
- Birth control ring , a tiny, flexible ring thats inserted into the cervix
When we diagnose a young woman with a blood disorder, we have other tricks up our sleeves to control her periods better, such as allowing her to have a period only four times a year using hormones to prevent anemia or using non-hormonal options for additional protection. We also work with dentists and surgeons to make plans for dental procedures and surgeries so patients do not experience unnecessary bleeding.
Additionally, some women with heavy periods receive psychiatric care because mental health problems such as anxiety and depression can arise while experiencing symptoms. In this case, a hematologist, Ob/Gyn, or adolescent doctor will refer patients to a psychologist or psychiatrist.
To find out whether you or a loved one might benefit from the Young Womens Blood Disorders Program, call or request an appointment online.
What Do Blood Clots During A Period Mean
Its common to pass blood clots during your period, although not everyone does. You may pass blood clots up to the size of a quarter, or you may not pass any at all. Menstrual blood clots are a mixture of blood cells, tissue from the uterus lining and proteins regulating blood flow.Blot clots arent often anything to worry about, but if you see something that worries you, dont be afraid to reach out to a medical professional for reassurance.
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When To See A Doctor
If your period lasts longer than a week, consider calling a doctor for advice. Depending on your symptoms, they may suggest setting up an in-person appointment for a physical exam.
On the other hand, if you think youre showing symptoms of a rare cause or if youre pregnant, see a doctor immediately.
If you experience severe heavy bleeding and youre soaking through four or more pads and tampons in a 2-hour period, go to an emergency room right away.