Heavy Menstrual Bleeding: Solutions for an Often-Silent Problem

Heavy menstrual bleeding, or menorrhagia, disrupts the lives of many women, who often cope in silence for years before asking a provider about their bleeding. Also called abnormal uterine bleeding, heavy bleeding is behind 20% to 30% of all outpatient gynecological visits in the U.S and accounts for nearly a third of all hysterectomies. Heavy periods can make it difficult to go to school or work. It’s hard to focus or be productive if you’re constantly worried about bleeding through your clothing or your heavy bleeding also comes with severe pain.

The good news? Relief is possible.

“There are several effective treatments for managing heavy periods,” says Maggie Bisceglia, CRNP, a board-certified nurse practitioner who sees patients in the Beaufort and Okatie Beaufort Memorial Obstetrics & Gynecology Specialists practice locations. “You don’t need to endure discomfort in silence.”

How Much Bleeding is Too Much?

Heavy menstrual bleeding is generally defined as losing more than 80 milliliters of blood during a menstrual cycle or bleeding for more than seven days. It also means needing to use one or more standard-sized pads or tampons every one to two hours and passing blood clots that are larger than a quarter during your period.

While heavy menstrual bleeding can be frustrating, it can also cause long-term health issues. Excessive blood loss can cause anemia, a condition in which your blood cannot get enough oxygen to your body. Many women develop anemia because they have low levels of iron, a nutrient that helps produce red blood cells that carry oxygen. Anemia can cause symptoms including dizziness, weakness or fatigue during your period or right after. Over time, anemia can weaken your immune system, cause heart and lung problems, and increase your risk of birth complications if you get pregnant.

Read More: Heavy Periods: Causes and Treatment

Bleeding Disorders and Other Causes

Dealing with heavy menstrual bleeding is a significant challenge for numerous women and can interfere with their quality of life. This condition not only impacts daily activities but can also indicate the presence of underlying health issues. Some of the potential causes include:

• Bleeding disorders, which are typically inherited
• Certain medications, like blood thinners and some hormonal therapies
• Excess weight, which can make your periods heavier or less regular
• Hormonal imbalances, fluctuations in hormones due to polycystic ovary syndrome (PCOS), endometriosis and thyroid disease
• Copper intrauterine devices (IUDs), which can contribute to heavy menstrual bleeding, especially in the first few months of use
• Ovulation problems, which can cause the uterine lining to build up excessively, causing heavy, unpredictable bleeding
• Uterine abnormalities, such as fibroids and polyps

Read More: Get Help for Uterine Fibroids

Managing Heavy Menstrual Bleeding at Home

Understanding and tackling heavy menstrual bleeding doesn’t just end with a doctor’s visit. Managing symptoms at home can significantly improve your quality of life during your period. Start with these tips:

• Head to the pharmacy. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can lessen the impact of cramps and reduce bleeding.
• Maintain a balanced diet. Include iron-rich foods, such as lean meat, poultry and seafood, to reduce the risk of anemia caused by heavy bleeding.
• Track your cycle. Keeping a detailed diary of when your periods start and end, how many times you have to change pads or tampons, and other symptoms you experience can help identify patterns to discuss with your provider.

When to Seek Care for Heavy Menstrual Bleeding

“It’s always a good idea to talk to your women’s health provider if you’re experiencing heavy menstrual bleeding,” says Bisceglia.

During your visit, your provider will complete an initial assessment. They may perform a pelvic exam to look for any visible reasons for heavy bleeding and order tests to assess blood loss, check for anemia and other blood disorders, or evaluate hormone levels. Your provider may also order an ultrasound, an imaging test that uses sound waves to help identify abnormalities such as fibroids or cysts, or an endometrial biopsy to examine your uterus for abnormalities.

Based on the results of the exam and tests, your provider can create a treatment plan. Options may include:

• Antifibrinolytic agents, medications that control bleeding, such as tranexamic acid and aminocaproic acid
• Endometrial ablation, a procedure in which the lining of the uterus (endometrium) is destroyed, providing long-term relief from heavy bleeding
• Hormone treatments, including conjugated estrogen injections and desmopressin
• Hormone-based IUDs, which, research suggests, can reduce menstrual bleeding over time

In advanced cases, your primary care provider may refer you to a specialist for further evaluation.

Read More: For Women, Health Care Is Self Care

Your Body, Your Strength

Heavy menstrual bleeding, while common, should not dampen your spirit. By being proactive about your health and consulting a provider when needed, as well as keeping regular yearly appointments, you can find effective ways to manage heavy bleeding and improve your quality of life.

Request an appointment with a women's health provider at Beaufort Memorial.