What Causes Heavy Bleeding During Periods

Do I Need Any Tests If I Have Heavy Periods

Heavy bleeding during pregnancy- Dr. Shalini Varma

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:

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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How Do I Know If My Periods Are Abnormal

Periods are considered abnormal if they last more than seven days, have less than 24 days or more than 35 days between starting dates, or are very irregular or very heavy. Bleeding is considered very heavy if you have to change tampons or pads more than every one to two hours, or if you often pass clots larger than 1 inch. Vaginal bleeding in children or in women after menopause is always abnormal.

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What Is Very Heavy Period Flow Or Menses

Normal blood loss during period in women is usually less than 80mls. If your period is more than 80mls then it is heavy. However, it may be difficult to calculate how much of blood youve lost during menstruation.

One easy way to know is the frequency at which you change you pads. If you change pads too frequently than usual it could mean heavy or increased menstrual flow.

What Is Normal Period Length And Menstrual Flow

Light Bleeding After Plan B

In women, period occurs due to regular cyclic shredding of the endometrium covering the uterus. This is due to hormonal changes that occur during the menstrual cycle.

What is menstrual cycle? Menstrual cycle is the time difference between 2 of your periods. It varies from women to women but usually last 21 to 35 days.

How long do your period last? Normal girls period last for 2 to 7 days. Period flow may be heavy during the first days of menstruation. However as your period progresses, it becomes lighter with less pain during period

How does period occur? During your cycle, estrogen and progesterone play a crucial role to ensure the thickening and maturation of the endometrium. After ovulation occurs and if the egg released is fertilized by the sperm, it is implanted into the endometrium.

Before ovulation, estrogen is the dominant type of hormone produced by the growing follicles. However, after ovulation, the ruptured follicle forms the corpus luteum which increases production of progesterone.

If your egg released is not fertilized and implanted into the uterus, it causes the corpus luteum to breakdown. This will result to decreased hormones and shredding of your endometrium as period.

When is period said to be prolonged?

Long or prolonged periods is when your menstruation last more than the usual 7 days.

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Causes Of Heavy Menstrual Bleeding

How do you know when your period is normal and when its not? Menstrual bleeding is different for every woman and can change as you age. There might be days when you have a heavy flow and cramps, which is completely normal. But if you have heavy bleeding that interferes with daily activities, you could have a condition called menorrhagia, or heavy menstrual bleeding.

Heavy menstrual bleeding can be caused by subtle health problems that can go unnoticed. In some cases, a larger health issue is the problem. For instance, endometriosis can cause painful and heavy periods. March is Endometriosis Awareness Month, so now is a good time to get familiar with its symptoms.

If you experience heavy menstrual bleeding, it might be time to talk to your doctor. Your doctor will ask you about your health history, perform a physical exam and may order tests like an ultrasound, Pap test or blood tests. After your doctor rules out other potential health problems, they may be able to diagnose you with menorrhagia.

Signs and symptoms of menorrhagia may include:

  • Soaking through one or more sanitary pads or tampons every hour for several hours
  • Waking up in the middle of the night to change their sanitary pads
  • Using two sanitary pads to manage heavy menstrual bleeding
  • Bleeding longer than a week
  • Passing blood clots larger than a quarter
  • Restricting daily activities due to heavy menstrual bleeding
  • Symptoms of anemia, tiredness, fatigue, and shortness of breath

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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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.

What Causes Heavy Bleeding

Treating Fibroids with Heat

About 50% of women with heavy menstrual bleeding have no abnormalities in their uterus. It might be related to hormonal or chemical levels in the endometrium or conditions not yet identified in the endometrium.

In the other 50% of cases, the cause might be related to:

  • Pregnancy or complications of pregnancy please contact your doctor if you have bleeding during pregnancy.
  • Polycystic ovary syndrome some women can have heavy menstrual bleeding if the lining of the uterus is thickened this can lead to pre-cancerous or cancerous changes.
  • Endometriosis occurs when tissue similar to that found in the lining of the uterus grows outside of it.
  • Endometrial polyps usually non-cancerous growths in the endometrium that look like a large ‘teardrop’ of tissue.
  • Endometrial hyperplasia an overgrowth of the endometrium, which can progress to cancer.
  • Endometrial cancer cancer of the uterus.
  • Adenomyosis endometrium growing in small pockets inside the muscle layer of the uterus.
  • Fibroids non-cancerous growths or lumps within the uterus wall.
  • Intrauterine device a contraceptive device.

There is a range of other possible causes that are not as common, such as:

  • hormonal disorders, such as an underactive thyroid gland
  • bleeding disorders in which excessive bleeding can occur, such as Von Willebrand disease
  • chronic kidney or liver disease.

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How Are Bleeding Disorders Diagnosed

To diagnose a bleeding disorder, your doctor will:

  • Talk to you about your symptoms and any history of bleeding disorders in your family
  • Do a physical exam
  • Do blood tests. Your doctor may do tests on your blood to check for anemia caused by blood loss. Your doctor may also check the amount of platelets and white blood cells that you have and how well your liver and kidney are working. Other blood tests for blood clotting problems will tell your doctor whether you have a bleeding disorder and what type you have.

You may need to see a hematologist for special blood tests to detect a bleeding disorder. A hematologist is a doctor who specializes in problems with the blood.

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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Do You Have Heavy Menstrual Bleeding

Understanding whether or not you suffer from HMB requires the accurate recordingof your menstrual history. The intensity of bleeding varies from person toperson, so determining what is clinically heavy is tricky. Furthermore, while asingle period can be heavy, a real problem isnât likely to exist unless the HMBis present at least most of the time.

The medical definition of this is when HMB is present for the majority of periods within the previous six months. Entering your bleeding intensity diligently and correctly in your Clue app will make it easier to assess if bleeding qualifies as heavy.

Your healthcare provider may ask you how many pads/tampons youhave been using in one day. Also, blood clots are very important to note â theirsize, number and color. They contain blood, and it is important to measure andcount them to get an approximation of how much blood has been lost.

  • Distinguish between regular and maxi tampons or pads, as maxi can usually absorbtwice more than regular .

  • Check how soaked your tampon or pad is. Is it fully soaked with blood, or justhalf?

  • Count blood clots they contain blood too.

  • For a menstrual cup, check the volume capacity and measure how full the cup is.

  • If the number of soaked tampons or pads is **sixteen or more** for the entireduration of your period , thenyour flow is heavy.

  • If you note 80mL or more blood with your menstrual cup for one entire cycle,your flow is heavy.

  • Diagnosis And Treatment For Abnormal Bleeding

    Menstrual Periods

    Treatment of menorrhagia is possible once your doctor is aware of the condition.

    Your doctor will most definitely ask of your medical history if you are an adult. This is most likely because if it were an adolescent, his or her first guess would be anovulation due to her age.

    He or she may recommend you for some test procedures after he or she must have told you to keep tabs on your menstrual cycle. These tabs or notes will now help the doctor during diagnosis.

    Some test which might help to diagnose menorrhagia include:

    • Ultrasound or laparoscopy. These tests due to its imaging abilities help to show the image of your uterus, pelvis and ovaries using sound waves/ direct visualization and so can help detect abnormalities if spotted.
    • Pap smear/test. This test works with the collection of cells from your cervix. These cells are tested to look out for inflammation or an infection around the cervix which may be cancerous and so lead to heavy bleeding when you menstruate or irregularly.
    • Blood tests. Your doctor takes your blood sample and checks if there is a case of iron deficiency in your blood due to Anemia and some other problems like blood-clotting anomalies and thyroid disorder .
    • Endometrial biopsy. A tissue sample of your uterine wall might be taken to a pathologist by your doctor in order to know why it keeps shedding blood.
    • Further tests such as hysteroscopy, sonohysterography, etc. depending on what the previous set of tests would show.

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    When Should I See A Doctor For Heavy Periods

    Heavy periods arent something that you have to put up with. If your period affects your daily life by causing you to miss work or school, cancel social activities or plan your day around bathroom breaks, its time to seek treatment.

    We recommend making an appointment with one of our womens health experts if you experience any of the symptoms of menorrhagia described above. An expert will be able to diagnose whats causing your heavy periods and recommend effective treatments. If youre not sure whether your period is normal, just ask.

    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

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    How Are Abnormal Periods Treated

    It depends on the cause. Your doctor may recommend weight loss or anti-inflammatory medicines, such as ibuprofen . He or she may prescribe hormonal medicines, such as birth control pills, or an intrauterine device to help decrease the bleeding. If these dont help, you may need to see a gynecologist. Surgery may be needed to stop the bleeding.

    Treatment Of Heavy Menstrual Bleeding

    Approach to bleeding disorders – causes, pathophysiology and investigations

    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

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    Treatment: How To Stop Heavy Menstrual Bleeding

    If you think you might have HMB, make an appointment to see your health care professional for a checkup. Often, theyll ask you questions about your periods and general health. They might also perform a physical examination.

    After this, theyll be able to suggest a variety of treatments to help, which can include:

    Very Heavy Menstrual Flow

    When periods are very heavy or you are experiencing flooding or passing big clots you have what doctors call menorrhagia. The purpose of this article is to define normal and very heavy menstrual bleeding, to explain what causes heavy flow, and to show what you yourself can do in dealing with heavy flow.

    This, and the article called Managing MenorrhagiaEffective Medical Treatments for your doctor or health care provider, are to help you avoid surgeries for heavy flow (

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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.

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