A woman experiencing heavy periods may experience any of the signs and symptoms - periods lasting more than a week, passing blood clots as big as or larger than a quarter, frequent need to change menstrual pads or tampons, needing to change menstrual pads and tampons at night, or wearing multiple menstrual pads to control bleeding.
According to Pinar H. Kodaman, MD, an OB-GYN at Yale Medicine and associate professor of Clinical Obstetrics, Gynaecology and Reproductive Sciences at the Yale School of Medicine, "An occasional period that is heavier than normal is not generally concerning. However, if periods are consistently heavy … you should see an OB-GYN."
Heavy periods may be caused due to 6 potential causes. Read below to learn about the causes and their remedies.
1. Copper Intrauterine Device (IUD)
Kodaman says that copper IUDs "can make periods heavier and crampier by causing inflammation and changing the blood flow to the uterus, especially during the first few months after insertion."
Out of hormonal IUDs, copper IUDs and contraceptive implants, a 2014 study revealed that 70% of women who experienced heavier bleeding within the first three months after insertion were users of copper IUDs.
After a six-month check-in, 25% of the women reported lighter bleeding experience.
Anne L. Banfield, MD, FACOG, director of Women's Health Services at the Davis Medical Center and vice chair of the West Virginia section at the American College of Obstetricians and Gynecologists, says that heavy bleeding caused by copper IUDs can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, a prescription drug called desmopressin, or tranexamic acid, which improves blood clotting.
2. Bleeding Disorders
Heavy periods may be caused when blood fails to clot properly leading to bleeding disorders such as von Willebrand Disease or haemophilia. As per a 2001 report, bleeding disorder is present in an estimated one in 10 people experiencing heavy periods. Bleeding disorders are typically diagnosed in a person during adolescence after experiencing periods for the first time.
Bleeding symptoms also include symptoms such as frequent nosebleeds, frequent bruising, and blood in stool or urine.
The exact cure for bleeding disorders have not been found yet but a person can control heavy bleeding by taking hormonal birth control, iron supplements or desmopressin which brings back red blood cells to normal levels or increases the number of clotting factors in a person's blood.
3. Non-Cancerous Fibroids or Polyps
Heavy periods may also be caused when the ability of the uterus to stop and prevent bleeding is impaired by benign growths. There are two types of growths:
- Fibroids, about 20% to 70% of women are affected by this type of growth in the uterus.
- Polyps, which grow in the lining of the uterus, affect about 7.8% to 34.9% of women.
These types of growth in the uterus may cause pain or bleeding during sex and bleeding between monthly periods.
Heavy bleeding due to such growths in the uterus may be controlled by hormonal blood controls. In order to shrink or remove the growths to control heavy bleeding, surgical treatments such as ultrasound surgery, myomectomy or hysterectomy may be necessary.
Medicines like aspirin which thins out the blood or anticoagulants such as warfarin and heparin could be one of the causes of heavy periods. It has been revealed that the menstrual flow of 70% of women has been affected by taking anticoagulants.
The reason for such an occurrence is the thinning of blood by such medications which slow down the blood-clotting process of the body and also prevent the formation of the blood cells.
Hormonal IUD, taking tranexamic acid during the flow or using blood control may help to control heavy bleeding due to anticoagulants.
It is important to note that heavy bleeding involving medications should be discussed with the doctor concerned who can determine the best option for the person and her medical conditions. As per Banfield, estrogen-containing medications should be avoided by patients who need blood thinners such as aspirin.
5. Hormonal Imbalance
Banfield says, "Conditions causing irregular ovulation, such as puberty, perimenopause, polycystic ovary syndrome (PCOS), and hypothyroidism, maybe hormonal reasons for heavy periods."
Other symptoms involving hormonal imbalance are:
- Weight changes
- Irregular bowel movements
- Low libido
These symptoms are, however, non-specific and may indicate other conditions.
Treating the underlying issue of hormonal imbalance can help in treating heavy periods. This includes taking a synthetic thyroid hormone medication for hypothyroidism or oral medications for PCOS, such as birth control pills or progestin therapy.
According to Kodaman, "Hormonal contraceptives, such as the birth control pill, are frequently used to control heavy periods and for cycle regulation once the underlying cause of the heavy bleeding is identified and addressed."
The tissue lining of the uterus of a person with Adenomyosis tends to grow into the uterine muscle wall. The person may experience abnormal uterine bleeding caused by the swelling of the uterus due to the tissue. About 20% to 65% of menstruating people have been affected by it and have experienced pelvic pain and painful sex.
Adenomyosis can be cured by undergoing hysterectomy, which involves removal of the uterus. The person may also manage the condition by taking pain medication and hormonal birth control.
However, after menopause, its symptoms, including heavy bleeding, gets resolved.
When To See A Doctor
A person experiencing the following signs and symptoms may consider seeing an OB-GYN:
- Blood clots the size of a quarter
- Filling tampons so quickly that you must use multiple ones within several hours
- Having your period for more than a week
The person is advised to see a professional as these could be a sign of serious underlying conditions such as fibroids, polyps, or adenomyosis. The other causes could be copper IUD or certain medications.
According to Kodaman, gynecologic exams, cervical cultures, and routine pap smears may be needed to rule out other possible causes of abnormal bleeding. This includes changes in the uterine lining, structural problems of the uterus, or cervical abnormalities.
Banfield says, "Anyone who perceives their period as heavy or problematic should discuss this with their doctor. It is always important if heavy bleeding occurs that pregnancy is eliminated as a cause for the bleeding episode."