What is Considered Heavy Periods?


What is Considered Heavy Periods?

Heavy periods, also known as menorrhagia, is known as prolonged heavy bleeding during the menstrual cycle. A menstrual cycle is considered a heavy period if the blood loss is more than 70 ml or the period lasts for seven days or more.

You may observe it as more blood loss than normal, requiring more frequent changes of pads or tampons, experiencing blood clots, or episodes of flooding or leakage.

Who Does Heavy Periods Affect?

Heavy periods mostly affect women aged 30 – 50 years old. Almost one in five women suffers from heavy bleeding for most of her life until she reaches menopause.

How Does Heavy Periods Occur?

There are a number of methods in which heavy periods occur, and each method has a different mechanism for the heavy bleeding. For example, in cases of hormonal imbalance, the endometrial lining of the uterus grows thicker and in excess, resulting in heavy periods when it sheds. Fibroids and polyps also cause heavy periods as they are excess growths in the endometrial layer of the uterus.

Causes Of Heavy Periods?

Heavy periods can be caused by:

  1. Hormonal imbalance, especially higher estrogen levels

  2. Polycystic ovary syndrome (PCOS)

  3. Polyps or Fibroids in the uterus

  4. Certain medications including oral contraceptives (estrogen based)

  5. Pelvic inflammatory disease (PID)

  6. Use of Contraceptive pills or intrauterine device (IUD)

  7. Pathology of the uterus, cervix or vagina such as cancer or pre-cancer

  8. Infection of the vagina or uterus

  9. Problems with blood clotting

  10. Trauma to the vagina

Symptoms of Heavy Periods

It is possible for women to have a heavy period occasionally, before returning to their normal cycle. However, when the following signs are occurring more frequently, they act as an indication that a woman is having heavy periods. The signs include:

  1. Increased blood loss – This is one of the biggest indicators for heavy periods. If the blood loss is more than 3 -5 tablespoons (60 – 80 ml of blood) per period cycle, the periods are identified as heavy. An easier way to determine increased blood loss is that you have to change your tampon or sanitary pad every hour for a number of consecutive hours.

  2. Duration of bleeding – Normal menstrual bleeding last 4 – 5 days on average. If you are experiencing 7 or more days of bleeding, it is a sign of heavy periods.

  3. Night time bleeding requiring having to change a pad or tampon during the night.

  4. The appearance of small dark red blood clots in the menstrual blood.

  5. Heavy flow is known as flooding which cannot be contained by a tampon or a pad.

  6. Period cramps of severe intensity, also known as dysmenorrhea.

  7. Anemia due to heavy blood loss.

  8. Feeling tired, unproductive or low on energy all the time due to the resulting anemia secondary to the heavy periods.

Stages Of Heavy Periods

The appearance of heavy periods and the collection of signs vary from woman to woman.

How are Heavy Periods Diagnosed?

To diagnose heavy periods, your doctor may consider any of the following investigations:

  • Take your complete medical and gynecological history and perform a complete physical examination, including a pelvic examination.

  • Perform a Cervical Screening Test “CST” or Pap Smear Test to rule out cervical pathology.

  • Order some lab tests including blood tests and hormonal assays to ascertain the degree of bleeding in causing anaemia or iron deficiency, or test for hormone levels.

  • Perform a pelvic ultrasound to image pathologies in the uterine cavity or cervical canal.

  • An endometrial biopsy to rule out or confirm specific causes.

  • A hysteroscopy and sono-hysterography.

How are Heavy Periods Treated?

Treatment of heavy periods depends on the cause but can include steps that would reduce bleeding and period pain.

Your doctor will suggest a specific treatment based on your overall health, age, the cause of heavy periods, your plans for having children in the future and your personal preference.

Some therapeutic options include hormonal or non-hormonal medications:

  • Oral tablets NSAIDs such as Ibuprofen

  • Oral contraceptive pills

  • Progestins and injections

  • Intravaginal rings or hormonal IUDs

  • Endometrial ablation, which works by using a laser or radiation to remove the endometrial lining of the uterus, to reduce or stop menstrual bleeding during periods

  • Myomectomy – surgical removal of fibroids

  • Resection of endometrial tissue lining the uterus, which results in lower bleeding

If a uterine structural pathology is found, such as polyp or fibroid, usually surgical treatment is all that is required, these can include:

  • Hysteroscopy which is a surgical procedure involves a thin long camera is inserted through the cervix into the uterine cavity to visualise any pathology,

  • Curettage is a biopsy (curettage) can be done at the same time to be sent for histopathology to look for pathology at the cellular level, to rule out cancer or pre-cancer.

  • Hysterectomy to remove the uterus and cervix as a permanent solution

If anemia has been also been diagnosed as a result of the heavy periods, your doctor will also prescribe iron supplementation.

What If Heavy Periods Is Untreated

If heavy periods are left untreated, they can result in anemia and cause excruciating period cramps in each menstrual cycle. If the heavy bleeding is being caused by cancer and it goes untreated, it can result in loss of life as well. Therefore, it is important to consult your doctor at the earliest.

Your Next Step

If you have any symptoms of relating to your vaginal bleeding your condition may require further investigation.

We would advise that you see your general practitioner and possibly obtain a referral to see Dr Alexander.

Dr Alexander can offer specialised help, advice on a possible diagnosis, further investigations and suitable treatment. Contact his rooms at www.my-obgyn.com.au