Do you experience heavy menstrual periods? Here is what you need to know.
Do you dread your period every month? Are you having to get up during the night to change your sanitary pads?
And do you find yourself restricting your daily activities because of your heavy menstrual periods?
Heavy menstrual bleeding (previously called menorrhagia), affects about 1 in 5 women.
It’s really important to understand that, just because it’s common, does not mean this is necessarily normal, or something you have to put up with.
What is a heavy period? How do I know if my period is heavy?
Heavy menstrual bleeding is defined as blood loss greater than 80ml, over all the days of your period.
How much is 80ml I hear you ask?
One ‘regular’ pad or tampon holds up to 5ml blood whereas a ‘maxi’ or ‘super’ pad or tampon generally holds up to 10ml blood.
This is equal to 16 fully soaked regular tampons, or 8 fully soaked super tampons.
A menstrual cup can hold anywhere between 20-60ml depending on the brand.
Other symptoms of heavy menstrual bleeding include:
• Soaking through one or more tampons or sanitary pads every hour for several hours
• Needing to change your sanitary pad in the night
• Passing blood clots larger than 50 cents
• Menstrual bleeding for more than 7 days
• Limiting your daily activities due to heavy menstrual flow
Common causes of heavy periods
Okay, so now that we’ve established what heavy periods are, what’s actually causing your period to be so heavy?
The common causes of heavy menstrual bleeding are:
1. Hormonal imbalances: Fluctuations in oestrogen and progesterone levels can cause irregular menstrual cycles and heavy bleeding. Commonly, a combination of low progesterone and excess oestrogen leads to heavy periods. To read about common symptoms of excess oestrogen, head over to my post here.
Hormonal imbalances are a common cause of heavy bleeding in adolescents and in perimenopause, but also when first stopping hormonal contraception, such as the Oral Contraceptive Pill or IUD.
2. Not ovulating regularly (anovulatory cycles): This causes your menstrual period to be irregular or absent, and once the period returns it causes heavy bleeding. One common cause of anovulatory cycles is with PCOS (polycystic ovary syndrome), but it can also occur in perimenopause, or with other conditions.
3. Uterine fibroids: These are noncancerous growths that develop in the uterus and can cause heavy or prolonged bleeding. Other common symptoms of fibroids include
Menstrual periods lasting more than a week, pelvic pressure or pain, frequent urination, difficulty emptying the bladder, constipation, backache or leg pains.
4. Endometrial hyperplasia or Endometriosis: Endometrial hyperplasia is a condition in which the lining of the uterus becomes too thick, leading to heavy or prolonged bleeding. Endometriosis – where endometrial-like tissue grows outside of the uterus, and thickens and bleeds just as normal endometrial tissue does a menstrual cycle – can also cause heavy bleeding, but also other symptoms like pain, changes to bowel movements, bloating and sometimes fertility issues.
5. Polyps: These are growths connected to the inner wall of the uterus. They can lead to irregular and heavy bleeding, as well as bleeding between periods.
6. Adenomyosis: This is a condition in which the endometrial tissue in the lining of the uterus grows into the muscle wall. This leads to an enlarged uterus, causing heavy or prolonged bleeding as well as clotting.
7. Pelvic inflammatory disease: This is an infection of the reproductive organs that can cause heavy bleeding, as well as other symptoms like heavy discharge and lower abdominal pain.
8. Thyroid disorders: An underactive thyroid (for example, due to subclinical hypothyroidism or Hashimoto’s) may lead to insufficient coagulation factors, causing heavy bleeding.
9. Blood clotting disorders: Disorders that affect blood clotting (for example, Von Willebrand disease) can cause you to bleed easily and thus lead to heavy or prolonged bleeding during menstruation.
10. Certain medications: Some medications, such as anticoagulants or hormonal contraceptives, can cause heavy bleeding as a side effect.
What can I do about my heavy periods?
Every woman experiences periods differently. Though some women will have a heavier menstrual bleed than others, an excessively heavy period is not normal, and this could be due to hormonal imbalance or another underlying issue.
If you are experiencing heavy or prolonged periods, it is important to consult with your healthcare provider first.
Determining the underlying cause of your heavy periods is essential.
In addition, seeing a Clinical Nutritionist can be helpful to improve your symptoms naturally.
Working with a Nutritionist can help you by
• Identify any nutrient deficiencies or hormonal imbalance via testing
• Regulate oestrogen levels in the body and reduce heavy bleeding
• Reduce menstrual cramps
• Reduce inflammation associated with heavy periods
• Manage iron deficiency (common as a result of heavy periods)
• Work together with your medical team
Specific treatment is tailored to the needs of each individual woman.
If you would like to find out more about how we could work together to support your health, I offer a complementary, obligation free 15 minute chat which you can book here.