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.
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
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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Signs And Symptoms Of Heavy Periods
Unsure if you have heavy periods?
Diagnosing heavy periods isnt always easy and women can often have the odd heavy period and then back to normal again. Below we outline some signs to look out for. If these are occurring more often than not, then it might suggest that your periods are heavy.
In addition to these indicators, women typically experience a whole host of other symptoms which appear to be associated with the heavy periods. Often hormones are the root cause of many of these issues. You are also at risk of becoming anaemic if you suffer from very heavy periods which can cause problems in itself.
If you find you suffer a number of symptoms around the time of your period and these impact on your day to day life, then it is possible you also have pre-menstrual syndrome . Click the link to visit our PMS Health Hub and learn more about the symptoms of PMS.
Signs And Symptoms Of Heavy Periods:
Diagnosing heavy periods isnt always easy and women can often have the odd heavy one and then return to normal again.
Here are a few signals and signs that indicate you are facing a heavy period.
If these are occurring more often than not, then it might suggest that your periods are heavy.
Let us dive deeper into it to understand these symptoms
How much blood you lose
The amount of blood loss per period is the obvious indicator of how heavy your period is. Periods are considered heavy if you lose more than 60 80ml per period . However, unless you have a tablespoon handy this might be hard to measure. Generally, if you are having to change your pad or tampon every hour for several consecutive hours then this is classed as a heavy period.
Flooding is a heavy surge of blood loss that often results in you soaking through your period product and onto your clothes or bedding. This shouldnt happen for an extended period of time or you can become anaemic very quickly. Frequent flooding suggests you have heavy periods.
Note make sure you are choosing the right period products for you. If the shape or size is wrong, you could leak as a consequence and confuse this for flooding.
Changing your period product during the night
Generally having to get up during the night to change your period products can suggest you have a heavy flow.
Try avoiding intense exercise, hot baths, and the sauna in order not to increase the flow during sleep.
Length of your period
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How To Treat The Problem
The NHS recommends you see your doctor if your periods have suddenly got heavier and youre concerned about it. Also, they state that if you are experiencing other symptoms such as severe cramp and bleeding between periods then a doctor will be able to see if there is an underlying cause for this.
Some common treatments for heavy periods include contraceptives though I wont go into the details much more than this as what you are prescribed will depend on whats going on with your body!
Once youve got the green light from your doctor, a herbal remedy such as Agnus castus may be used to address heavy periods.
This symptom is often associated with too much oestrogen or too little progesterone but the remedy helps to balance these things out. Please note however, that Agnus castus cannot be used alongside hormonal contraceptives.
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Youre Experiencing Early Signs Of Menopause
When a patient mentions a diminishing return on her tampon investment, the first thing Dr. Choi looks at is age. Menopause might be around the corner, but not always. Sometimes with aging the cycles change, she says, noting that its not necessarily a sign of infertility. Someone who needed to use a super pad in their 20s and early 30s may find they need less protection in their later 30s.
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Causes Of Abnormal Uterine Bleeding
While in many cases it is not possible to determine the exact cause, there are a number of reasons a woman may experience abnormal uterine bleeding. Some of the known causes of abnormal uterine bleeding include:
- spontaneous miscarriage in pregnancy
- ectopic pregnancy lodgement of the fertilised egg in the slender fallopian tube instead of the uterine lining
- hormonal disorders conditions such as hypothyroidism , polycystic ovarian syndrome and hyperprolactinemia can disrupt the menstrual cycle
- ovulatory dysfunction this is when the ovary does not release an egg each month. Most commonly, this occurs at either end of a woman’s reproductive years, either during puberty or at menopause
- endometriosis the cells lining the uterus can travel to, attach and grow elsewhere in the body, most commonly within the peritoneal cavity
When Should You Be Concerned About Heavy Periods
Lets be frankheavy periods ruin the quality of your life.
Its more than an inconvenience. Its a monthly reminder that makes it difficult to complete day-to-day activities. In fact, its one of the most common conditions we treat.
But when should you be concerned?
What is considered a heavy period?
How much blood is too much?
You should be on the watch for the following symptoms:
- Becoming pale, dizzy or weak. If this happens, you should contact us immediately. This may be a sign of anemia.
- Passing blood clots that are bigger than a quarter.
- Having to change pads or tampons during the night.
- Bleeding through your clothes on a regular basis.
- Being unable to participate in daily activities such as work, school or sports.
Nationwide, more than 10 million women have menorrhagiathe medical term for heavy bleeding during your cycle.
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How To Get Rid Of Heavy Period Surgically
Surgery can be an option if medically treatment of heavy flow fails. If you already completed childbirth, then surgery option totally solves your bleeding problems.
This process uses an electrical diathermy loop to destroy the endometrium preventing it from regenerating.
Removal of the fibroid mass
What Counts As A Heavy Period
Before I start to explain the reasons why periods can suddenly get heavier, I thought it would be useful to examine what defines a period as heavy in the first place.
Firing through the box of tampons or pads
The first thing to consider is the amount of sanitary products you have to use during the course of your period. If you have to change your sanitary pad or tampon every hour or two then this can definitely not be considered normal. Also, if you find yourself having to use more than one of these products at the same time in order to protect yourself from leakages then again, this can be deemed a heavy period.
Lots of leakages
If leakages, known as flooding, are a common occurrence for you then this may also indicate that your period is heavy and can be associated with clots. However, do bear in mind that the strength of your chosen sanitary product may just be inadequate for your flow.
A long period
Another thing to consider here is the length of your period. It is normal for periods to last anywhere between three and seven days but if yours lasts beyond this its an indicator that things are a little heavier than they should be.
Large blood clots
Most women pass blood clots during the course of their periods so the key here is the size. If yours are regularly bigger than a 10 pence piece then it suggests your period is overly heavy.
Signs of anaemia
Lots of blood
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How Is Heavy Bleeding Treated
Your doctor might prescribe the following treatments to reduce bleeding and pain:
- Anti-inflammatory drugs can reduce inflammation, pain and blood loss.
- Tranexamic acid can reduce blood loss by about 50%. It is non-hormonal and is taken only on the heavy days of the period.
- Insertion of a Mirena® intrauterine device releases a progestin hormone that thins the endometrium and can reduce bleeding by up to 95% after 12 months.
- The oral contraceptive pill can reduce bloodflow by up to 50%.
- Progestins can reduce blood loss by about 30%
What Causes Variations In Menstrual Bleeding
There are certain factors that can influence menstrual bleeding, including:
Birth control. Most oral contraceptive pills tend to normalize your menstrual flow. However, certain birth control methods, such as a copper IUD, can result in abnormal bleeding .
Exercise. With increased exercise, hormone levels tend to shift. As testosterone rises with more physical activity, some women can see a decrease in their menstrual flow. In cases of extreme training, some women will stop getting menstrual periods altogether. This is known as amenorrhea.
Age. As age increases, menstrual flow tends to change as well. As menopause approaches, periods tend to gradually slow, and become more infrequent, although there may be fluctuations. Some women will have heavy menstrual bleeding as they approach menopause.
Diseases. Certain medical conditions can impact your menstrual flow as well. For example, a condition known as polycystic ovarian syndrome can cause decreased menstruation.
Hormonal fluctuations. Changes in your levels of various hormonesâsuch as estrogen, progesterone, LH, FSH, testosterone, cortisol or thyroid hormoneâcan affect your menstrual cycle. The Everlywell at-home Womenâs Health Test gives you a comprehensive look at 10 key hormones so you can check in on your personal hormone balance from the comfort of your own home. If you do have a hormone imbalance, you can speak with your healthcare provider about relevant medical treatment that may help with hormone health.
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Is My Heavy Bleeding Just A Normal Part Of Menopause
The most common cause of heavy periods during menopause is hormonal imbalance. During the beginning of a normal menstrual cycle, a hormone called follicle stimulating hormone rises which stimulates follicles to mature in the ovaries. Many follicles are stimulated during a cycle and these follicles produce oestrogen which is required to thicken the lining of the womb . Only one follicle will be mature enough to be ovulated.
As there is a decline in the number of follicles at perimenopause, the body tries to recruit as many as possible at the beginning of the cycle. It does this by increasing FSH levels. This part of the cycle can take longer than usual as it becomes harder to recruit eggs. There is an increase in oestrogen from the many follicles stimulated. These higher levels of oestrogen act on the endometrium during the long stimulation period, making it thicker and resulting in heavy periods.2
Ovulation is required for a period to occur. The progesterone produced by the ovulated egg, and its subsequent withdrawal, is what causes a period. During the perimenopause, anovulation becomes more frequent. Thus there is still oestrogen production by the follicles causing the endometrium to thicken, but no progesterone. The endometrium only continues to thicken. Eventually the lining outgrows its blood supply and breaks down, resulting in shedding which is seen as irregular and/or prolonged and/or heavy bleeding.
Preparing For Your Appointment
Chronically heavy periods are not normal. Dont let them hamper your lifestyle. We want to help you and ensure that you have the healthiest life possible.
Not sure where to begin? Dont worry. Well ask you some brief questions to get an overall picture of your gynecological health history.
These questions might include:
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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.
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.
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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
What Tests Might Be Needed For Heavy Periods
Your doctor might do or advise one or more of the following tests:
- An examination to see whether the bleeding is coming from your cervix, not your uterus. This is done in a similar way as a cervical smear or HPV screening test.
- Blood tests to look for anaemia, iron levels, thyroid disease or a bleeding disorder.
- An ultrasound of your uterus and ovaries to detect abnormalities in your uterus, such as polyps or fibroids.
- A cervical smear in which a sample of cells is collected from your cervix and then looked at to see if you have an infection, inflammation or changes in the cells that might be or cause cancer.
- A sample of the lining of the uterus to see whether there are any precancerous or cancerous changes.
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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:
- a feeling of fullness in the abdomen
- frequent urination
Treatment options typically include medications, such as birth control, or surgery to remove the fibroids.