Causes Of Heavy Menstrual Bleeding
There are a variety of conditions that can cause HMB. The most common conditionsinclude:
Polyps, or growths in the uterine lining, usually cause spotting or bleedingbetween periods and sometimes HMB.
Adenomyosis, the abnormal growth of uterine lining into themuscular wall of uterus, but can sometimes cause heavy and/or painful periods.
Uterine fibroids, benign growths on the uterus, alsoknown as *leiomyomas*, can sometimes cause HMB. If they grow in the uterinelining they will most likely cause HMB.
Cancers and precancers are very uncommon, but important, causes of abnormalbleeding, particularly for individuals under the age of 40. While they can causeHMB, cancers and precancers more likely cause irregular bleeding or bleedingbetween periods.
Coagulopathy, an inherited disorder preventing the blood from clottingnormally, will cause HMB usually from menarche .
Ovulatory disorder, the absence or irregularity of ovulation, is ahormonal problem that may cause irregular bleeding that may or may not includeHMB as a symptom.
Endometrial disorder, an abnormality in the lining of the uterus, preventsthe tissues from stopping the bleeding normally.
Most medications and birth control pills donât cause HMB, but there are twoexceptions: Copper-containing intrauterine devices may increase the amountof blood lost during menstruation and anticoagulants ,which prevent blood clots, usually cause HMB.
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.
How Are Heavy Periods Treated
The choice of treatment will depend on the cause of your bleeding. If a reason for the heavy bleeding is found, such as a fibroid, this will be treated.
However, sometimes no cause for heavy periods can be found. In these cases, heavy periods can be treated by medicines or by surgery, with the aim of decreasing the amount of bleeding. Some treatments may stop your periods completely and others may affect your fertility.Considerations for treatment include your age, general health, whether you require contraception or want to have children. Some treatments are ongoing and others are done one time.
Discuss all your options with your doctor to decide which is best for you.
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Why Is My Period So Heavy
Heavy periods have a wide range of causes, most commonly, theyre due to hormone imbalances, particularly high estrogen levels or not ovulating, but they can be due to a variety of underlying causes from PCOS to an uncommon but not completely rare genetic bleeding disorder that can cause heavy periods .
You can read about the causes below and see if you can identify whether any of these sound similar to what youre experiencing in addition to your heavy flow. The underlying cause will help you to find the best strategy for reducing your heavy flow once and for all. Depending on the cause, self-care strategies may be all you need or you may need to pay a visit to your favorite medical provider to help you sort out a diagnosis and the next best steps.
Lets start with the most common causes of heavy periods and then Ill walk you through what you can do both natural options and some conventional medical ones, too. Then you can decide whats best for you!
High Estrogen Levels
Estrogen is a marvelous hormone. At the right levels it plays a central role in our reproductive, brain, bone, and heart health. During the first half of each menstrual cycle, called the proliferative phase, your uterine lining naturally builds up under the influence of estrogen. This lining is then shed with each menstrual cycle, leading to our menstrual flow. Heavy periods can be a sign that this layer has been building up too thickly as a result of estrogen levels that might be too high.
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
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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.
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.
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How Do You Know If Your Bleeding Is Too Heavy
It is very difficult to determine whether your bleeding is too heavy. The best guide is to decide whether your period is having an impact on your quality of life if it is causing you to be housebound, interrupting your daily activities, or causing you stress and anxiety. The following signs might indicate you are experiencing heavy bleeding:
- bleeding or ‘flooding’ not contained within a pad/tampon
- changing a pad/tampon every hour or less
- changing a pad overnight
- clots greater than a 50-cent piece in size
- bleeding for more than seven to eight days.
Can My Doctor Help
If home and herbal remedies dont seem t be helping it may be time to visit your doctor. If heavy periods are having a negative impact on your life there may be some treatment options available:
- Contraceptive pill Your doctor may put you on the contraceptive pill which contains artificial versions of the female sex hormones oestrogen and progesterone, although carefully consider any side effects the pill may bring
- Other contraceptives Other methods of contraception can also help balance your hormones. Progesterone-dominant methods such as the coil or implant may help to lessen your periods or even stop them altogether
- Endometrial ablation An ablation is a surgical procedure which involves removing the lining of your womb. This is often used in older women who suffer from heavy periods although it can only be carried out in women who dont want any more children
- Other medications Pain killers, anti-inflammatory or antispasmodic medication may also be available from your doctor.
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When To See Your Doctor
If bleeding is so heavy that you must replace a pad or tampon every hour, talk with your doctor.
Likewise, if your period prevents you from doing normal activities because of pain, cramping, and heavy bleeding, its time to see your doctor.
During a visit, your doctor may:
- conduct a physical exam
- request your health history
- request that your symptoms be recorded
They may also order a biopsy or imaging tests to look more closely at your uterus.
Its difficult to know if your period is considered normal or heavy without your doctors help. Theyll be your guide in the process of figuring out if an underlying issue is the reason for your heavy periods.
Typical treatments for heavy periods focus on regulating blood flow. Some treatments can also eliminate symptoms such as pain and cramping.
If an underlying condition is causing your heavy bleeding, treating it may eliminate your unusually heavy periods.
Typical treatments for heavy periods include:
Can Herbal Remedies Help
Herbal remedies may also be useful in treating heavy periods:
- Agnus castus Agnus castus is fantastic for women who suffer from PMS and are oestrogen dominant. An imbalance in oestrogen can give rise to symptoms such as anger and irritability, mood swings, sore breasts and heavy, painful periods. Agnus castus gently increases the amount of progesterone your body makes which creates a better balance between progesterone and oestrogen.
- Kelp Kelp is a food source of many vitamins and minerals including iodine, iron, magnesium, calcium and B vitamins. It is especially rich in iodine which gently supports your thyroid .
Please note if you are taking hormonal contraceptives such as the pill, hormone-balancing herbal remedies may not be suitable for you.
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You Just Switched Up Your Birth Control
If youve just switched to the mini-pills or are coming off oral contraceptives entirely, chances are you will notice a heavier flow. The patch is also associated with lighter periods, so discontinuing use of it may cause your flow to get heavier.
In general, when discontinuing hormonal contraception, your period habits will likely revert to what they were prior to initiating.
When it comes to IUDs, while the hormonal varieties such as Mirena tm, Kyleena tm and Liletta tm are associated with lighter periods, the non-hormonal copper IUD Paraguard tm, may actually cause heavier bleeding in many women.
How Is Heavy Menstrual Bleeding Treated
Treatment depends on what’s causing your bleeding, how severe your bleeding is, your health, age and medical history. Also, treatment depends on your response to certain medicines and your preferences. For instance, you may not want to have a period at all, or you may want to reduce your bleeding. In addition, your plans to get pregnant will affect your treatment options.
Talk with your provider about your health concerns and your goals for treatment.
Medications used to treat heavy menstrual bleeding
- Iron supplements improve your iron stores.
- Nonsteroidal Anti-inflammatory Drugs like Ibuprofen® or Aspirin® can ease your cramps and reduce your bleeding.
- Birth control may help make your periods more regular and lighten your blood flow.
- Hormone therapy can help balance the amount of estrogen and progesterone in your body so that your menstrual flow isn’t as heavy. HT is often recommended for heavy menstrual bleeding associated with perimenopause but comes with risks that you should discuss with your provider.
- Gonadotropin-releasing hormone agonists can temporarily stop or reduce bleeding by preventing ovulation.
- Gonadotropin-releasing hormone antagonists can manage heavy period bleeding related to fibroids.
- Desmopressin nasal spray can stop bleeding associated with von Willebrand disease by helping your blood clot.
- Antifibrinolytic medicines, like tranexamic acid, prevent clots from breaking down and causing excessive bleeding.
Procedures used to treat heavy period bleeding
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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.
What Causes Heavy Periods And Abnormal Bleeding
In girls, pregnancy and dysfunctional uterine bleeding are likely to cause abnormal bleeding.
In perimenopausal women, consider endometrial carcinoma. General bleeding problems such as von Willebrand’s disease may be the cause as well.
It is an abnormal thing if you have to use 2 or more pads within two 2 hours.
Heavy bleeding can also be related to the following issues:
Dysfunctional uterine bleeding . This is a heavy and/or irregular bleeding in the absence of recognizable pelvic pathology. It is associated with anovulatory menstrual cycles. Anovulation is a medical term for the situation when the ovaries do not release an oocyte during a menstrual cycle. Therefore, ovulation does not take place.
Complications in pregnancy. Heavy periods can be due to a miscarriage and it can also be as a result of an abnormal location of the placenta .
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