When Is Menstrual Bleeding An Emergency
It can take a serious toll on your body when a significant amount of blood is lost every month. Dont hesitate to seek emergency care if you experience new or severe symptoms related to heavy menstrual bleeding.
Uterine lining is rich in iron, so you lose iron every time you have your period. Heavy periods can be linked to anemia. Anemia occurs when your body doesnt have enough of certain blood cells or when blood cells arent functioning properly.
Anemia can make you feel:
What Is Considered A Heavy Period
We dont lose as much blood as many of us may think. The average blood loss during a menstrual cycle is 30-80 ml, which is about 2-6 tablespoons.
If your bleeding is more than 80 ml per menstrual period, or the bleeding is heavy enough to interrupt your normal activities, you may be suffering from whats known as menorrhagia .
When Do You Call Your Healthcare Provider If You Suspect Heavy Period Bleeding
You should call your provider if you’re experiencing the symptoms of heavy menstrual bleeding or anemia, or if your period bleeding has become abnormal. Tracking your periods using a calendar or app can help you identify if your periods are heavier and longer-lasting than usual. Share these notes with your provider.
You should also schedule an appointment if you notice that you’re having to double-up on menstrual products or if you’re skipping activities you enjoy because of heavy bleeding.
Can heavy menstrual bleeding be life-threatening?
Heavy periods arent usually life-threatening, but they can be if you lose too much blood. Bleeding through two or more tampons or pads each hour for two hours in a row is a sign that you should see your provider or seek emergency care immediately.
A note from Cleveland Clinic
Just because heavy periods are common doesn’t mean that you have to learn to live with the discomfort they cause. If managing your blood flow is getting in the way of your emotional and physical well-being, speak with your provider. They can provide a care path that will provide relief.
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Is Heavy Bleeding After 50 Normal
Heavy bleeding is common among women transitioning into menopause, the point when your bodys reproductive system stops releasing eggs. One study found that among women ages 42 to 52, more than 90% experienced periods that lasted 10 days or more with 78% reporting their blood flow as heavy.
This is because when women approach menopause, there are fewer eggs to mature in the ovaries. The body releases higher levels of follicle-stimulating hormone in an attempt to maintain normal ovulation, which produces more estrogen.
These greater levels of estrogen thicken the lining of the uterus, often resulting in heavier, longer periods. The time it takes for a womans body to complete this cycle can extend as well, leading to longer gaps between periods and more blood flow.
This change in reproductive hormone levels called perimenopause generally begins about four years before a woman has her last period. But the transition can start as early as 10 years before menopause.
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.
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Estrogen Dominance And Progesterone Deficiency
During each menstrual cycle, estrogen is produced to develop a mature egg and thicken the endometrial lining in preparation for ovulation.
Upon ovulation, progesterone is released to help with the implantation of a fertilized egg and the thinning and shedding of the endometrial lining, if an implantation does not take place.
This is the normal ovulatory cycle.
If theres a disruption along the way and ovulation does not occur due to various reasons, the ovaries will not release progesterone.
Without the counterbalancing effect of progesterone, the endometrial lining can grow excessively due to elevated estrogen levels.
A thicker than normal endometrial lining means theres more to shed .
For this reason, heavy menstrual flow is most common in the teens and in perimenopause both are times of the life cycle when ovulation is irregular and consequently estrogen levels tend to be higher and progesterone level to be lower.
However, heavy bleeding caused by this type of hormonal imbalance can also occur during other times of a womans life cycle due to other factors at play.
Key Points About Heavy Period Bleeding
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What Are The Symptoms Of Menorrhagia
If you have to change your pad or tampon every 1 to 2 hours because it is soaked, or bleed longer than 7 days, see your doctor. Spotting or bleeding between periods is also a sign of a problem.
The symptoms of menorrhagia may look like other conditions or medical problems. Always consult your healthcare provider for a diagnosis.
The Combined Oral Contraceptive Pill
This reduces bleeding by at least a third in most women. It often helps with period pain too. It is a popular treatment with women who also want contraception but who do not want to use the LNG-IUS. If required, you can take this in addition to anti-inflammatory painkillers , particularly if period pain is a problem. See the separate leaflet called The Combined Oral Contraceptive Pill for more details. Other options which work in a similar way are combined hormonal contraceptive rings or patches.
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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.
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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Symptoms Of Painful Periods And Heavy Bleeding
Signs and symptoms of heavy menstrual bleeding include:
- Bleeding for more than seven days
- Bleeding that soaks through one or more tampons or pads every hour for several hours in a row
- Need to use multiple pads to control menstrual flow
- Need to change pads or tampons during the night
- Menstrual flow with blood clots larger than a quarter
- Flooding of clothing and bedsheets with menstrual bleeding
- Symptoms of anemia, such as fatigue and shortness of breath
Symptoms of menstrual pain include:
- Lower back pain
- Pain that starts a few days before the period, worsens during the period, and lasts two to three days after the period ends
- Throbbing or cramping pain in the lower abdomen that can be intense
- Lower back pain during menses
Patients should see their doctors if:
- Their periods stop for more than 60 days
- Their periods become erratic
- They have any vaginal bleeding after menopause
- They suddenly get a fever and feel sick after using tampons
When Is A Heavy Period Too Heavy
It is difficult to measure blood loss accurately. Some medical definitions of blood loss during a period are:
- A normal period is a blood loss between 30 and 40 ml per month. Bleeding can last up to eight days but bleeding for five days is average.
- A heavy period is a blood loss of 80 ml or more. This is about half a teacupful or more. However, it is difficult to measure the amount of blood that you lose during a period.
- For practical purposes, a period is probably heavy if it causes one or more of the following:
- Flooding through to clothes or bedding.
- You need frequent changes of sanitary towels or tampons.
- You need double sanitary protection .
- Soaking of bedclothes.
- You pass large blood clots.
- Restriction to your normal lifestyle because of heavy bleeding.
- Menorrhagia means heavy periods that recur each month. Also, that the blood loss interferes with your quality of life. For example, if it stops you doing normal activities such as going out, working or shopping. Menorrhagia can occur alone or in combination with other symptoms.
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What Is Heavy Menstrual Bleeding
Heavy menstrual bleeding is when your periods are extremely heavy or prolonged. “Heavy” means that your period lasts longer than seven days or that you lose more blood than is typical during menstruation. You may bleed so much that you have to change your tampon or pad every hour for several hours back-to-back. You may pass blood clots the size of a quarter or even larger.
Menstrual bleeding that’s so heavy that it interferes with your daily life is never normal. Your provider can recommend treatments to manage heavy blood 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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Cancer Malignancy And Hyperplasia
Some women may develop an abnormally thick lining of the inside surface of their uterus. This condition is called endometrial hyperplasia and it may cause heavy menstrual bleeding, irregular bleeding or a bloodstained vaginal discharge. In some cases, endometrial hyperplasia may progress to endometrial cancer, a condition that is more common after menopause but can occur in younger women.
- are over the age of 45 years
- are over 90 kg in weight
- have never had children
- have a family history of endometrial, ovarian or bowel cancer
- have polycystic ovarian syndrome
- carry a gene that increases their cancer risk .
Common Causes Of Heavy Menstruation
Heavy menstrual bleeding is frustrating and disruptive, but not uncommon. Typically, your period lasts about 5-7 days, but if you have heavy bleeding, it may last longer.
Heavy menstrual bleeding also means you may need to change your hygiene product often every hour or two. You may pass clots of blood the size of a quarter, or larger.
At Capital Womens Care, we dont want you to suffer heavy menstrual bleeding if you dont have to. Heavy bleeding is not just inconvenient, it can lead to anemia and be accompanied by abdominal pain and emotional distress.
Our OB/GYN team does its best to identify why you have heavy menstrual bleeding and offer the best treatment possible.
Learn more about three of the most common causes we look for.
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Possible Consequences Of Menorrhagia
Menorrhagia is a condition so extreme that you shouldnt take it for granted. Heres what your doctor might tell you about the consequences of playing ignorant.
- Anemia. It is an obvious consequence. Losing more blood than you replace every month will cause you to turn pale to the whims of anemia before long. This happens in two forms. Blood loss leads to reduction in the number of red blood cells being circulated. This turns you pale and also reduces hemoglobin which helps in oxygen transportation to tissues.
Now when it comes to iron deficiency anemia, you find out that this occurs in the bid for your body to replace the red blood cells it lost by using up your bodys stored up iron to produce hemoglobin that will help transport oxygen to your body tissues. This causes iron depletion.
- Severe dysmenorrhea. Menstrual cramps come naturally with your periods and therefore causing you to witness painful menstruation. But menorrhagia makes dysmenorrhea look like an amateur when it comes to causing painful cramps because then it becomes so severe due to heavy menstrual bleeding with clots larger than a quarter that you might need to be evaluated medically.
Nobody wants to live through this much pain, you definitely dont want either. So make sure youve got timely medical help.