Heavy periods may result from a hormonal imbalance, IUD use or as a side effect of medication. In other cases, heavy menstrual bleeding could indicate a serious medical concern.
Heavy periods, medically known as menorrhagia, mean having to change your pad or tampon every one hour for at least two successive hours. You may also experience pain that makes it difficult for you to carry your routine activities.
Your periods are may be heavy due to the following reasons:
- Hormonal problems. Having a normal menstrual cycle requires the balancing of two hormones, estrogen and progesterone, which is what causes you to shed the lining of your uterus (endometrium) in your menses. When this balance is disturbed, there may be heavy shedding and bleeding. The common causes of hormone problems are polycystic ovary syndrome (PCOS), thyroid problems and obesity.
- Growths in the uterus. Polyps are small, benign (noncancerous) growths on the lining of the uterus. Fibroids are small-to-large benign tumors that grow within the uterus. Both of these can result in heavy or prolonged periods.
- Nonhormonal IUDs. Intrauterine devices or IUDs are devices that women use for birth control. They can be either hormonal or nonhormonal, with the latter potentially causing heavy periods as a side effect.
- Complications of pregnancy. Rarely, the embryo attaches itself to places outside of the uterus. This condition is called an ectopic pregnancy, where the baby cannot grow normally. This results in heavier bleeding during periods. Miscarriage can also cause heavy periods.
- Cancer of the reproductive system. Cancer of the uterus, cervix or ovaries is another reason why some women may get heavy periods. However, this reason is rare as compared to other causes.
- Bleeding disorders. Similar to cancer, this is also a rare cause of heavy periods. Bleeding disorders that are passed down in your family across generations may make you bleed heavier than usual during injuries as well as periods.
- Certain medications. Blood thinners, such as warfarin or anti-inflammatory drugs, may cause excessive bleeding during periods.
- Other medical conditions. Existing kidney disease or liver disease may also be the cause of heavy periods.
What tests help doctors know the cause of your heavy periods?
After reviewing your medical history and asking about your menstrual cycles, your doctor may recommend one or more of the following tests or procedures:
- Blood tests. These tests will look at the hemoglobin and iron levels (for iron-deficiency anemia) and thyroid hormone levels.
- Ultrasound. This is an imaging test that uses sound waves to produce images of your reproductive system.
- Pap test. This is a small procedure in which your doctor takes a small sample of your cervix and sends them to the laboratory for analysis.
- Endometrial biopsy. This involves taking a sample of tissue from the inside of the uterus and sending them to the laboratory to check for cancer.
- Hysteroscopy. This procedure involves using a thin, long flexible tube fitted with a lighted camera to look inside the uterus.
How do doctors treat heavy periods?
Doctors will ask about certain factors before they decide the right treatment for you, such as:
- If you suffer from any other medical conditions
- How is your overall health?
- What is the condition causing your heavy periods?
- How severe is your condition?
- Whether you want to have a child and if yes, how soon?
- What is your personal preference?
Based on these factors, your doctor may recommend medications or surgery as treatment.
Medications
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen or naproxen, can help reduce your excess bleeding during periods and alleviate pain.
- Tranexamic acid. This is a common drug that is prescribed to temporarily control heavy periods.
- Oral contraceptives. Oral contraceptives also help regulate the menstrual cycles and thus help alleviate menstrual blood loss.
- Oral progesterone. The hormone progesterone is effective at correcting hormone imbalance, which helps alleviate heavy periods.
- Hormonal IUD. Hormonal intrauterine devices (IUDs), such as Liletta and Mirena, release a type of progestin called levonorgestrel, which helps control menorrhagia.
Surgery
Myomectomy. This procedure removes fibroids.
Uterine artery embolization. This involves cutting the blood supply of the fibroid by blocking the arteries that supply the blood. This surgery helps shrink the fibroid and helps bring heavy periods under control.
Focused ultrasound surgery. This involves using ultrasound waves to destroy the fibroids.
Dilatation and curettage (D & C). This surgery involves removing the lining of the uterus.
Endometrial ablation and resection. These procedures permanently remove or destroy the lining of the uterus. This may cause your periods to become lighter or stop permanently.
Hysterectomy. This is a major surgery that involves the removal of the uterus with or without the ovaries. You may stop getting your periods and would never be able to get pregnant.