Why Are My Periods So Heavy?

Your period is approaching and you know you have to stock up on tampons, pads, or both, in anticipation of heavy and, perhaps prolonged, bleeding. It may be of some comfort to know that you’re in good company — one in five women who have periods report heavy bleeding, or menorrhagia as it’s medically known.

Aside from being fairly common, the team of board-certified OB/GYNs at Bay Area Physicians for Women’s Health also wants you to know that you aren’t without solutions when it comes to abnormal bleeding like this.

Let’s take a look at what we consider to be heavy bleeding, some potential causes, and how we can treat the issue.

Defining heavy bleeding

There are certain attributes that we look for when we diagnose menorrhagia, such as:

• Soaking through tampons or pads every couple hours
• Soaking through tampons or pads at night
• Having to use both tampons and pads for double protection
• Periods that last for more than seven consecutive days
• Passing quarter-sized (or larger) blood clots 
• Passing so much blood that you become anemic

Even though these are good rules of thumb, defining heavy bleeding can also be personal to you. For example, perhaps you’ve had normal to light periods for years and, all of a sudden, there’s a change, including a lot more blood or longer than usual periods. This change may not fit the definition of menorrhagia, but the difference is noteworthy and one we should investigate.

Common causes of heavy bleeding

Now let’s get into why millions of women have their lives upended each month thanks to heavy bleeding, including some of these more common causes:

• Endometriosis, which affects about 11% of women in their reproductive years
• Uterine fibroids
• Adenomyosis
• Polycystic ovary syndrome
• Sexually transmitted infections and pelvic inflammatory disease
• Obesity, which can lead to hormone imbalances
• Use of an intrauterine device

There are also one-off issues that can lead to heavy bleeding, such as a miscarriage or ectopic pregnancy, but we’re focusing on chronic heavy bleeding here.

We also want to point out that heavy bleeding can develop before menopause, during the perimenopausal stage.

Lightening your periods

As you can see by the wide range of causes of heavy bleeding, our first order of business is to figure out what’s behind your abnormal menstrual periods.

In many cases, such as with endometriosis and fibroids, we can try hormonal controls that regulate your reproductive hormones and lighten your periods. We can also try different medications, such as gonadotropin-releasing hormone agonists and antagonists that also regulate your hormones to promote lighter, more regular, periods.

If medications don’t do the trick and the heavy bleeding is really negatively impacting your life, we can perform an endometrial ablation to remove the lining of your uterus, which is highly effective in putting an end to heavy bleeding. This treatment, however, also means that you can't get pregnant afterward.

Before we get too far ahead of ourselves in discussing treatment options for heavy bleeding, we want to stop here because the more important step is to figure out what’s driving the issue.

To get to the bottom of your heavy bleeding, please contact our office in Mobile, Alabama, to schedule an appointment with one of our women’s health experts.