Heavy menstrual bleeding, or menorrhagia, occurs when your periods are extremely heavy or last longer than seven days. Bleeding may be so heavy you have to change your tampon or pad every hour for several hours, and you may pass blood clots larger than a quarter.
While heavy periods are common, affecting up to half of menstruating women, those that interfere with your daily life are never normal, and you need to seek medical attention.
Board-certified OB/GYN Dr. Hany H Ahmed in Houston, Texas, advises his patients never to ignore heavy or irregular menstrual bleeding.
When you come into the office, he performs a comprehensive examination to determine the underlying cause of the problem. Then he draws up a treatment plan tailored to your individual needs. Here’s why you shouldn’t ignore heavy periods.
What causes heavy periods?
Heavy periods may be caused by a number of problems, some serious and some not. These include:
Your body produces the hormones estrogen and progesterone to help regulate your menstrual cycles. That includes how heavy your periods are. When hormone levels become unbalanced, it can lead to heavy menstrual bleeding. Causes of imbalance include:
- Anovulation (ovaries fail to release egg)
- Thyroid disease
- Polycystic ovary syndrome (PCOS)
- Being overweight or obese
Noncancerous uterine growths
Benign uterine growths and conditions that lead to uterine cells growing improperly can cause heavy menstrual bleeding. These conditions include polyps, fibroids, and adenomyosis, when the tissue lining the uterus grows into the uterine wall.
Cancerous uterine growths
Cancers that affect your reproductive system, including uterine and cervical cancers, can cause heavy menstrual bleeding.
Infections such as chronic endometritis can also cause heavy bleeding. So can sexually transmitted diseases, including trichomoniasis, gonorrhea, and chlamydia.
Heavy bleeding can be a warning sign of pregnancy complications, such as an ectopic pregnancy (implantation outside the uterus), miscarriage, or a C-section niche.
Having several C-sections can lead to a scar that forms a pocket in the uterus. This pocket collects blood that can accompany your menstrual flow out of the body.
Underlying medical conditions
Heavy menstrual bleeding can be caused by a number of medical conditions, some bleeding disorders and some nonbleeding disorders:
- Liver disease
- Kidney disease
- Pelvic inflammatory disease (PID)
- Leukemia or platelet disorders
Rounding out the list of heavy bleeding causes are certain medications, especially:
- Blood thinners
- Hormone replacement therapy (HRT)
- Tamoxifen (breast cancer drug)
- Intrauterine devices (IUDs)
- Birth control pills and injectables
Failure to remove contraceptive devices when appropriate can also cause abnormal uterine bleeding.
While some of these causes are relatively innocuous, others clearly aren’t. If you’re experiencing heavy periods, see Dr. Ahmed for a full evaluation.
Diagnosing and treating heavy periods
Dr. Ahmed takes a medical history, including information about your symptoms and their duration, and performs a physical and pelvic exam. He may also order diagnostic tests to confirm or rule out a potential cause.
Treatment depends on the underlying reason for your problem. Medication possibilities include:
- Iron supplements (if you’ve become anemic from blood loss)
- Birth control to help make your periods more regular and lighten blood flow
- Hormone therapy (HT) to balance the levels of estrogen and progesterone in your body
He might also recommend gonadotropin-releasing hormone (GnRH) agonists that temporarily stop or reduce bleeding by preventing ovulation.
- Hysteroscopy to inspect the uterine cavity and remove any growths
- Myomectomy to remove fibroids from your uterus
- Uterine artery embolization (UAE) to restrict blood flow from fibroids and tumors
- Endometrial ablation to destroy all or part of the lining of your uterus
If you’ve had an ablation procedure, Dr. Ahmed generally recommends sterilization afterward because losing the uterine lining puts a fetus at risk of serious complications.
If you’re experiencing long or heavy periods, don’t ignore them. Schedule a consultation with Dr. Ahmed to determine the underlying cause and get appropriate treatment. Call the office at 713-489-3348, or schedule your consultation online.