Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team
Most people with a uterus have experienced a heavy period at some point. But how do they know if their period is too heavy? Thankfully, there are several ways to tell the difference between a normal period and a more serious medical condition.
While it is always best to seek advice from a medical professional, know that if you are suffering discomfort or pain to the point in which your life is negatively impacted, you should seek help.
So, without further ado, here are some details to keep in mind when deciding if your period symptoms point to menorrhagia, a.k.a. abnormally heavy periods.
What is Menorrhagia?
Menorrhagia is the medical term for abnormally heavy periods. These periods are so intense that they disrupt daily activities due to large amounts of blood loss and cramping. Sounds pretty rough and that’s because it is!
What are the Signs?
“Heavy periods” can be interpreted differently depending on the individual. Here are some signs to look out for to help decide whether or not you have menorrhagia:
- Soaking through a pad or tampon every hour for a few hours in a row
- Needing to use double protection to control your flow
- Having to change your menstrual hygiene product during the night
- Experiencing symptoms of anemia (e.g. feeling cold, tired, or short of breath)
- Bleeding for longer than a week
- Passing blood clots larger than the size of a quarter
- Skipping daily activities due to pain from heavy flow
Experiencing these symptoms does not guarantee that you have menorrhagia, but it may mean you have a more serious condition than the average period. If you have one or more of the above, talk to a doctor.
What are the Causes?
While the cause of menorrhagia may be unknown in some cases, there are some health conditions that make an individual more susceptible to heavy periods.
Hormone imbalance – Estrogen and progesterone, the hormones that regulate buildup of the uterine lining, may be imbalanced. This could lead to excessive growth of the lining of your uterus, which eventually sheds, leading to heavy menstrual bleeding.
Uterine fibroids or polyps – These are two types of non-cancerous growths in the uterus, which typically appear during child-bearing years and may lead to prolonged and/or heavy bleeding.
Intrauterine device (IUD) – When an IUD is first introduced to the body, abnormal bleeding may occur as a side-effect. If you have prolonged or excessive bleeding, contact a doctor.
Bleeding disorders – Disorders such as Willebrand’s disease, which impact blood-clotting, cause menorrhagia.
Medications – Taking certain medications such as anti-inflammatories (NSAIDs, ibuprofen), estrogen and progestins, or anticoagulants (blood thinners) may cause more bleeding than usual.
Other medical conditions – Other health conditions including, but not limited to obesity, diabetes, PCOS, and kidney disease are risk factors for menorrhagia.
In addition to the above, causes of menorrhagia differ by age. For instance, adolescent women who experience anovulation, or the skipping of a period during some months, may notice a heavier flow when they finally do get a period. This is especially common during the first two years after menarche, or the onset of a period. On the other hand, older women are more likely to have fibroids, polyps, bleeding disorders, and/or kidney disease.
What are the Long-Term Impacts?
When left untreated, menorrhagia may lead to long-term negative health effects:
Anemia – This occurs when the number of red blood cells in an individual’s circulatory system is reduced. The body uses iron stores to make more hemoglobin, a protein that carries oxygen to red blood cells. As a result, iron deficiency becomes likely and further leads to pale skin, weakness, cold fingers and toes, and feeling tired.
Severe pain – The heavy bleeding caused by menorrhagia may result in intense period cramps, or dysmenorrhea. This pain may be severe enough to require medical intervention.
How can I find out if I have menorrhagia?
If you have the symptoms above, the next step in learning whether or not you have menorrhagia is seeing a doctor. After an initial evaluation in which a doctor asks about your medical history and menstrual cycles, there are multiple procedures that can be completed.
Blood test – A sample of blood can be tested for anemia, thyroid disorders, and blood-clotting abnormalities.
Other tests to check reasons for heavy bleeding:
Pap test/smear – This test entails a swabbing of cells of the cervix to test for infection, inflammation, or changes that may lead to cancer.
Endometrial biopsy – A doctor may take a sample of tissue from the lining of the uterus (a.k.a the endometrium) for examination by a pathologist to look for cancer.
Ultrasound – While this is often thought to be used only during pregnancy, this imaging system is a useful tool in discovering abnormalities in the uterus, ovaries, and pelvis.
Once the doctor rules out other menstrual disorders or medical conditions as possible causes of the heavy bleeding, they can be certain of the menorrhagia diagnosis.
What are the Different Types of Treatment?
Although a diagnosis may seem daunting, it can actually be a good thing. When a doctor knows which condition is at hand, it is easier to create a treatment plan. Different types of treatment may be implemented based on factors such as medical history, severity of symptoms, and childbearing plans.
The most common treatment is medical therapy. While over-the-counter painkillers (i.e. Advil and Motrin) are a good first step in relieving pain associated with heavy periods, additional medications may be prescribed in order to decrease blood loss.
One prescription option is tranexamic acid (Lysteda), which can be taken at the time of the bleeding to prevent excessive blood loss. Birth control (i.e. the pill or IUD with hormone) can also be used to regulate the menstrual cycle or even stop it altogether.
In more extreme cases when medical therapy is unsuccessful, additional procedures may be necessary. These range from quick surgeries to clean out the uterus to full removal of the uterus (hysterectomy).
What To Do Next?
Menorrhagia is no joke and should be taken seriously. No one should have to suffer such pain to the point where their life is disrupted. Thankfully, receiving the diagnosis does not mean that heavy periods are in the cards for good. Working with a doctor to determine the best plan of care based on individual needs can bring some peace of mind and eventual recovery.
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Disclaimer: This article was written for informational purposes only and should not be a substitute for professional medical advice, diagnosis, or treatment.