CSP Team Note: We recently interviewed Dr. Portia Cohens, an OB/GYN with Atrium Health’s, Greater Carolinas Women’s Center, about heavy periods (menorrhagia): what they are, how we get them, and what can be done. We thank her for her time and knowledge!
What is a “heavy period?”
Each woman is different and therefore each menstrual cycle is different, but overall, a heavy period is defined as heavy bleeding that interferes with a woman’s physical, social and emotional quality of life.
The duration of an average menstrual flow lasts about five to eight days and the average menstrual cycle typically lasts about 21 to 35 days. If you have bleeding between periods or any irregular vaginal bleeding, then you may be experiencing abnormal uterine bleeding and should speak to your OB/GYN about your symptoms.
These are a few signs of irregular vaginal bleeding:
– Passing large blood clots
– Bleeding for longer than a week
– Soaking at least one pad or tampon an hour for more than two hours
What causes it?
There are many different causes of heavy periods:
– Structural abnormalities, such as growths within the uterus (like uterine fibroids and endometrial polyps), as well as adenomyosis (a condition where the endometrium, or lining of the uterus, grows into the wall of the uterus)
– Ovulatory dysfunction, meaning cycles where no eggs are released, or eggs are irregularly released
– Bleeding or clotting disorders
– Medications, such as birth control pills, IUD and anti-clotting medications
– Cancer
– Infection
– Miscarriage or ectopic pregnancy
Are heavy periods more common in certain age groups of women?
Abnormal and/or heavy bleeding can occur at any age.
What are some treatment options for women with heavy periods?
Treatment will depend on the cause of the heavy period, risks and benefits, cost, and the patient’s own desire. Many can be treated with medication, including:
– Nonsteroidal anti-inflammatory drugs, like ibuprofen and naproxen sodium
– Progestins
– Birth control pills
– A levonorgestrel intrauterine device (IUD)
– Tranexamic acid, a medication used to help with clotting
Medications will typically be tried first; if these fail, then there are procedures or surgical options available.
Are there any procedures that can be done to help?
Surgery may be needed or recommended for certain structural abnormalities. This includes hysterectomy (removal of the uterus), myomectomy (removal of fibroids), and minimally invasive surgical options (i.e. endometrial ablation, hysteroscopy with resection, uterine artery embolization).
What are some questions a woman with a heavy period should ask her doctor?
Patients shouldn’t be afraid to communicate symptoms of heavy periods to their OB/GYN. This will help your doctor recommend the best treatment for you and your lifestyle. Patients should ask about any alternative treatment options available to them before making a decision.
