Why Is My Period So Heavy?

Getting your period is a fact of life for most women, but heavy periods can be a huge hassle. A heavy period is referred to as a menorrhagia and this is when you lose an excessive quantity of blood in consecutive periods. Some women will only experience the heavy periods while others have additional symptoms, such as severe menstrual pain. Menorrhagia doesn't always indicate a serious issue, but it can still affect you socially, emotionally and physically. If you are still concerned, then talk to your doctor about bleeding between cycles or heavy menstruation.

Why Is My Period So Heavy?

1. Hormonal Imbalance

The most common reason for heavy periods is a hormonal imbalance, particularly during menopause or adolescence. Hormone levels constantly fluctuate during adolescence right when you get your first periods and again for a few years before menopause. These fluctuations can lead to excessive bleeding that can frequently be treated with hormonal treatments such as birth control.

2. Uterine Fibroid Tumors

In most cases, a uterine fibroid tumor will be non-cancerous and they are common in women during their 30s and 40s. Experts know they are dependent on estrogen but aren't sure about their cause. There are various surgical and non-surgical treatments available. In many cases with non-severe symptoms, your doctor may suggest simply waiting and seeing what happens. Uterine fibroid tumors will usually shrink and disappear during menopause without any treatment.

3. Cervical Polyps

If you wonder “why is my period so heavy”, the answer may be cervical polyps. These small, fragile growths start in the end cervical canal or the mucosal surface of your cervix. They are frequently due to infection and linked to abnormal responses to increased levels of estrogen or blood vessel congestion in the area. Most women with cervical polyps have had children and are over 20. You can remove the growth as an outpatient treatment followed by antibiotics.

4. Endometrial Polyps

These are usually non-cancerous growths and they are found in the uterine lining. They are also linked with excessive estrogen levels after hormone treatment and sometimes with ovarian tumors. Treatments for this cause of menorrhagia include D&C and a hysterectomy.

5. Pelvic Inflammatory Disease

Pelvic inflammatory disease or PID is an infection that can affect the cervix, uterus, and/or fallopian tubes. It is typically transmitted sexually but may occur after abortion, childbirth, or a gynecological procedure. It is treated with antibiotics.

6. Cervical Cancer

Cervical cancer can sometimes be the answer to “why is my period so heavy”. This type of cancer occurs if cells within the cervix are abnormal, multiply too much, and then damage healthy areas of your body. HPV (human papillomavirus) causes more than 90 percent of cervical cancers. Treatment may involve radiation, chemotherapy, and surgery.

7. Endometrial Cancer

Endometrial cancer is when abnormal cells within the endometrium (uterine lining) or uterus multiple excessively and then cause damage to your uterus or other organs. Most women with this cancer are over 50 and frequently undergo hormone replacement therapy or have endometrial hyperplasia. Treatment typically begins with a hysterectomy and then radiation and/or chemotherapy.

8. IUDs

You may notice heavy bleeding during your period if you use an IUD (intrauterine device) for contraception. If this happens to you while using an IUD, you will need to consult your doctor. They will likely recommend removing the device and switching to another birth control method.

9. Bleeding Disorders

Some women suffer from bleeding disorders that make it hard for the bleeding to stop. Among them, VWD (von Willebrand Disease) is the most common among women. Treatment can require releasing stored clotting factors within your blood or replacing it via a prescription nasal spray or IV treatment.

When Should I Be Concerned?

Before answering “why is my period so heavy”, consider that heavy bleeding is typically classified as more than 80 milliliters of blood each cycle. You can't necessarily measure this easily, so you can pay attention to how frequently you change your tampon or sanitary pad. Changing every few hours may indicate a heavy flow. You can also judge a heavy flow based on the number of blood clots. There may be an underlying issue if you have clots larger than an inch of diameter or a large number of clots.

Signs to Watch for

You should also pay attention to the following signs that may confirm you have a heavy period:

  • Your flow soaks through at least one tampon or pad each hour for several consecutive hours.
  • You have to use multiple pads to control the flow.
  • You must change tampons or pads in the middle of the night.
  • Your menstrual periods last over 7 days.
  • Blood clots in your flow are the same size as a quarter or bigger.
  • Your flow is heavy enough to prevent you from participating in normal activities.
  • You lack energy, are tired, or have shortness of breath.
  • There is constant lower stomach pain during your periods.

How to Treat Heavy Periods

1. Medications

There are multiple medications that your doctor may suggest if you have menorrhagia, or heavy periods. Ibuprofen, naproxen, and other nonsteroidal anti-inflammatory drugs can help with pain and reduce blood loss. Hormone therapies can stabilize your uterine lining, correct hormonal imbalances, or regulate your cycle. Your doctor may also suggest a hormone secreting IUD or tranexamic acid (Lysteda), which is a non-hormonal medication promoting blood clotting.

2. Surgeries

In some cases, your doctor may suggest a surgical procedure to treat your heavy period. There are several possible recommendations:

  • Dilation and curettage, known as D&C which involves dilating your cervix and then scraping your uterine lining.
  • A hysteroscopy involves inserting a long and thin scope into the uterus via your vagina and cervix. The procedure lets your doctor see then remove any uterine masses in your uterine lining that may cause bleeding. It can also be used to evaluate your uterine lining.
  • Endometrial ablation or resection involves destroying or removing the lining of your uterus. It isn't possible to have a baby after this procedure.
  • A hysterectomy involves surgically removing your cervix and uterus. It also makes it impossible to have a child. 

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