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
What Is Considered Heavy Menstrual Bleeding
HMB, which used to be called menorrhagia, is prolonged or excessive heavy bleeding during periods that can be so bad it can interfere with your daily life. It can be nerve-wracking when youre just not sure why your periods are so heavy, and HMB can make you dread getting your period each month.
If you have HMB, your menstrual flow can be heavy enough to require changing your pad or tampon every hour for several hours in a row. You might also have cramps so severe it makes it difficult to do your usual daily activities. It can be hard to go to work, play sports, or even socialize because youre in pain or worrying about leaking.
Its important to remember that HMB can affect anyone, and nothing you have done is causing this heavy bleeding. Though the causes cant always be determined, its important to be aware of the condition because it could be happening as a result of an underlying issue. For example, HMB has been linked to iron-deficiency anemia, which can make you feel exhausted and short of breath, so figuring out if you have it can help you manage how youre feeling.
Signs You’re Losing Too Much Blood During Period
A typical period lasts four or five days. During that time, an individual sheds 2 to 3 tablespoons of blood. Those with menorrhagia can lose twice as much blood each month.
The following indicate menorrhagia. These are signs that you’re losing too much blood during your period and should see a healthcare provider:
- Bleeding for seven or more days
- Needing to change a pad or tampon every hour for several hours
- Wearing more than one pad at a time in order to control the bleeding
- Having to change your tampon or pad in the middle of the night
- Passing menstrual blood that contains clots that are the size of a quarter or bigger
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Cancer Of The Endometrium
Cancer that affects the endometrium of the uterus can cause bleeding in women especially after 40 years. However, younger women may have prolonged heavy period, abdominal pain and vaginal pain during intercourse.
If your doctor suspects cancer as the cause of your long heavy periods, removal of the uterus or hysterectomy will be performed. Removal of the uterus with radio or chemotherapy can achieve cure if done early.
Possible Consequences Of Heavy Menstrual Bleeding
Whenever you have a period, you lose blood. For those with normal bleeding, anda diet containing normal amounts of iron, blood loss and iron intake should bein balance. However, for those with heavy menstrual bleeding, and especiallywhen the diet is deficient in iron, blood loss can exceed iron intake and mayresult in an iron deficiency and possible low red blood count, or anemia. Iron deficiency, with or without anemia, can cause fatigue and interfere with the ability to concentrate, exercise, and, enjoy life in general.
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What Is The Normal Menstrual Flow
In a randomly selected group of premenopausal women, the most common amount of menstrual flow was about two tablespoons in a whole period . However the amount of flow was highly variableit ranged from a spot to over two cups in one period! Women who are taller, have had children and are in . That means it is normal to soak one to seven normal-sized pads or tampons in a whole period.
Abnormally Short Or Long Periods
Normal periods can last anywhere from two to seven days. Short periods may be nothing to worry about, especially if theyre typical for you. Using hormonal birth control can also shorten your cycle. Going into menopause can disrupt your normal cycles as well. But if your periods suddenly get much shorter, check in with your doctor.
Some of the same factors that cause heavy bleeding can make your periods longer than usual. These include a hormone imbalance, fibroids, or polyps.
Cramps are a normal part of periods. Theyre caused by uterine contractions that push out your uterine lining. Cramps typically start a day or two before your flow begins, and last for two to four days.
For some women, cramps are mild and not bothersome. Others have more severe cramps, called dysmenorrhea.
Other possible causes of painful cramps include:
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Female Bleeding: When Should You See A Doctor
Thankfully, most of the time your period will come and go without causing much fuss. But what about those times when your cycle gets thrown out of whack and you have abnormal bleeding? Should you be concerned?
Every woman is different when it comes to her cycle. However, when period changes happen such as a heavier or lighter flow than usual or timing abnormalities it can be hard to decide if you need to call your doctor or if what youre experiencing is in the range of normal.
Its a good idea to always track your menstrual cycles, including how heavy your flows are, how long they last and how many tampons or pads you use during a single cycle. This information can be useful for your doctor.
We spoke to INTEGRIS Health OB-GYN Dr. Elise Schrop to get her insights on a scary topic. What causes abnormal bleeding, just what is abnormal anyway, and when should you consult your doctor?
Abnormal bleeding is a very common problem for women, Dr. Schrop says. In fact, about a third of office visits to the gynecologist are for abnormal bleeding. It can happen to women of all ages but most commonly occurs in the first several years after a young woman starts having a period and as women start to make the transition to menopause.
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How Are Heavy Periods Treated
There are several options available to treat heavy periods. Your doctor will recommend options that are right for you based on your age, your medical history and whether you would like to be pregnant in the future.
Some medicines may lighten blood loss. These include anti-inflammatory medicines, tranexamic acid and the oral contraceptive pill . A hormonal intrauterine device placed in the uterus may also lighten bleeding.
Sometimes heavy periods are treated with surgery, for example to remove a fibroid or to reduce the lining of the uterus. The uterus can be removed in an operation known as a hysterectomy.
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What Should You Know About Bleeding After Period
- Spotting lightly after your period does not always mean you are pregnant. Most women thought its implantation spotting but its not. In fact, implantation spotting does not occur after your period, it happens a week before your menstruation.
- Women can positively conceive a baby only after ovulation and successful fertilization. The process occurs ten days after their menstrual cycle. Thus, the possibility of getting pregnant right after you have your monthly period is too low.
- Spotting a week after your period cannot be linked to early miscarriage. Unlike spotting, miscarriage is always accompanied with excessive bleeding and cramps.
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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When Its Time To See A Doctor
You know your body best, so if you feel like youre bleeding too much, you probably are. If youre concerned that your period is too heavy or if its interfering with your daily life, it may be time to see your doctor.
Your doctor will ask you about your menstrual cycle, heavy bleeding and other symptoms you are experiencing. They will ask about your family medical history, and they may run bloodwork and check iron levels, a sign of anemia and blood loss.
For the first few years of your period, there may be months where you dont ovulate, called anovulatory cycles. This is normal but can cause some inconsistencies with your uterine lining and may lead to heavy or irregular bleeding.
Sometimes, a heavy period can be an indicator of a more serious problem. Common conditions that can cause heavy menstrual bleeding include:
· Hormonal disorders. Hypothyroidism and other hormonal disorders can cause heavy bleeding both during your period and bleeding before or after your period, called breakthrough bleeding.
· Fibroids. Noncancerous growths that develop along the lining of the uterus and can cause heavy, painful periods.
· Von Willebrand disease. A hereditary blood disorder caused by either not having enough Von Willebrand factor a protein that helps form blood clots to stop bleeding or having VWF that does not work as it should. As many as 20 percent of adolescents with heavy periods may have this disorder.
Uterine Polyps Or Fibroids
SAGE Open Medicine , uterine polyps often have no symptoms. However, they can cause health issues, such as heavy bleeding and infertility.
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
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Bleeding In Between Periods
Your period should have some regularity to it. The average menstrual cycle is 25 to 35 days. On a side note, if you have periods that are much further apart than every month, there may be a hormonal cause such as Polycystic Ovarian Syndrome that is causing infrequent periods. If you start to experience your monthly period showing up much more often than once a month, check in with your doctor. While heavier bleeding during perimenopause can be normal, so too can periods that come more often. But it is always better to ask your doc.
Is It Normal For Period Blood To Come Out In Clumps
During my period most of my blood comes out in quarter-sized clumps. My periods are normally heavy, but do these clumps mean that something is wrong?Jessica*
Its perfectly normal to notice some clumps from time to time during your period. These are blood clots that may contain tissue. As the uterus sheds its lining, this tissue leaves the body as a natural part of the menstrual cycle. So clots of tissue are usually nothing to be concerned about. But if you notice large or frequent clots, talk to your health care provider to make sure your period is normal.
You also mention that your periods are heavy. If your period soaks through more than one pad or tampon every 12 hours, talk to your doctor or nurse practitioner. Its also a good idea for a girl to get checked out if her periods last for longer than a week or if she is having a lot of pain with her periods.
*Names have been changed to protect user privacy.
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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 Does Dark Red Period Blood Mean
You may see dark red blood upon waking during your period or after youve been lying down for a while. The deep color may simply mean that the blood has been sitting in the uterus for a while but hasnt oxidized to the point of turning brown.
Dark red blood is associated with:
The end of your period
You may also see this color blood toward the end of your normal menstrual period as your flow slows.
Lochia
The bleeding after delivering a baby starts out heavy and may contain clots. It may appear dark red in color for the first three days before changing to different shades and textures. Women who had cesarean sections may only experience this heavy bleeding for the first 24 hours.
Your period may start with bright red bleeding. This means that the blood is fresh and is flowing quickly. Your blood may stay this way your whole period or may darken as your flow slows.
Red blood is associated with:
Infection
Some infections, like chlamydia and gonorrhea, may cause bleeding between periods. If youre seeing blood before youre due to start your period, consider contacting your doctor.
Pregnancy
Bleeding during pregnancy of any color may or may not be reason for alarm. Sometimes, however, its a sign of miscarriage. Sometimes women have bleeding and go on to deliver healthy babies. Each case is unique. Its best to check in with your doctor whenever you see blood during pregnancy.
Polyps or fibroids
Pink blood is associated with:
Lochia
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Should I Be Concerned About Heavy Bleeding During My Period
Heavy menstrual periods can be distressing. Women who experience heavy menses often report an interruption in their daily activities. Heavy periods can cause you to cancel plans, miss out on things you enjoy, and get in the way of productivity.
Womens health professionals are your best resources when you have questions or concerns about your period. Board-certified gynecologist Lillian Schapiro, MD, and womens health nurse practitioners Kathyrn Garren, WHNP, and Kimberly Barbee, FNP, can answer your questions and address your concerns surrounding heavy menstrual bleeding.
What Could Cause 2 Periods In One Month
The average menstrual cycle is 28 days long. But that doesnt mean that everybodys cycle runs like clockwork. Some of us have shorter or longer cycles. And some women have very irregular periods.
Also, its worth noting that even if your cycle is around the average 28 days, most months are slightly longer. This means your period wont begin on the same date every month and, over time, will shift to an entirely different time of month.
The combination of:
- A slightly shorter menstrual cycle, plus
- A period that falls at the start of one month could result in two periods occurring within the same calendar month.
A shorter or irregular menstrual cycle may be caused by:
- Anovulation: The lack of ovulation in a menstrual cycle.
- Hyperthyroidism:An overactive thyroid may cause an irregular cycle.
- Hypothyroidism:An underactive thyroid may also cause irregular bleeding.
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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