Heavy Period Bleeding

While many women experience heavy period bleeding their entire lives and are completely healthy, it is often the sign of a more serious condition.

What constitutes abnormally heavy period bleeding?

Excessive bleeding, or menorrhagia, is usually defined as the loss of blood in a quantity two or more times what the average woman loses during a period. Most often, menorrhagia occurs in women who are ovulating normally and who have regular menstrual cycles.

What causes menorrhagia?

The causes are varied. For some women, there is no cause; heavy periods are simply normal for them. Sometimes, however, heavy period bleeding is caused by a condition which should be promptly addressed.

• Endometriosis. This is a thickening of the uterine lining that usually results in tissue that is shed and then reattached in areas it does not belong. In addition to heavy bleeding, it can cause lighter bleeding between periods. Often, the patient has severe cramps or pelvic pain.
• Cancers and tumors. Cancerous conditions in the cervix, uterus, or fallopian tubes can cause heavy period bleeding.
• Other conditions. Especially in women over 40, endometrial hyperplasia may be heralded by severe bleeding.

Other, less serious causes include:

• IUD’s – In general, IUD’s can cause abnormal bleeding. This is normally spotting between periods. However, an IUD can cause heavy bleeding, particularly if it has become dislodged or if the tissue around it has become infected.
• Infections – Some bacterial infections trigger abnormal period bleeding. Pelvic inflammatory disease, thrush, and Chlamydia can all cause heavy bleeding.
• Medications – Certain prescription medications can cause irregular periods. Blood thinners and oral contraceptives, as well as hormone replacement drugs, can all impact the menstrual flow.
• Benign tumors or polyps – Growths in the lining of the uterus or cervix can cause heavy period bleeding.

What symptoms should be a cause for alarm?

• Severe pain or cramping in the pelvic or abdominal region.
• Heavy bleeding that does not slow down or stop as the period progresses.
• Fever.
• If you are pregnant or think you might be pregnant.
• If you have recently given birth, had a miscarriage or abortion, or a procedure called a D & C, or dilation and curettage.
• If you are younger than 12 or experiencing one of your first periods.
• If you are post-menopausal.
• If you have other medical conditions such as diabetes or anemia.

What are the treatment options for heavy period bleeding?

While the exact cause may never be determined for most patients, there are several ways the condition can be treated.

• Oral contraceptives or hormone replacements can often control or lessen the severity of the period.
• Bed rest may be prescribed.
• A D & C (dilation and curettage) may be ordered to not only control the bleeding but to look for the conditions that may be causing it.
• If all else fails, a hysterectomy may be necessary. This option is normally reserved for the most severe cases that have not responded to other treatments.
• If polyps or benign tumors are the cause, they can be surgically removed.
• Antibiotics will be prescribed for infections.

An IUD may have to be removed. Sometimes, a new one can be reinserted immediately, but it is often necessary to wait until the infection or other problem is resolved.

If bleeding is extremely heavy, immediate medical attention should be sought. Thoroughly saturating a sanitary pad in fifteen minutes or less is considered a danger sign if this continues for more than an hour or so. This can signal an internal hemorrhage for which professional intervention may be required. And if there are additional symptoms involved, such as fever or severe pain, it is even more critical to seek medical care. Age also is a factor; if the patient is a pre-teen or post-menopausal and experiencing the flow described, care should be immediate. A hospital emergency room should be utilized if the patient’s physician is unavailable.