How do I know if I have a Heavy Period?
There are many variants of the volume of menstrual blood within the “normal limits”. Generally, a woman loses an average of 50mL of blood during her period every month (around 5 tablespoons). Bleeding can last up to 8 days, but typically 5 days in most women. For women who have always had heavy and prolonged periods, their bodies might be more tolerant of heavier blood loss than someone who tends to bleed less. Therefore, if you believe that your periods are unusually heavy or prolonged (or both), and it is affecting your physical/emotional/social quality of life, speak to a Gynaecologist who will explain the many treatment options for you.
What are the causes of Heavy Periods?
Several conditions may cause Heavy Periods. This includes:
- Abnormalities of the womb, e.g. polyp, adenomyosis, fibroids, hyperplasia, malignancy (rarely)
- Hormonal conditions, e.g. PCOS, prolactin abnormalities, peri-menopause, thyroid conditions
- Bleeding disorders, e.g. Haemophilia, Von Willebrand disease, clotting problems
- Others, e.g. kidney/liver diseases, medication-related (e.g. the Pill)
Is there anything I can do to manage a heavy period?
Treatments are dependent on the following:
- Underlying cause
- Need for birth control
- Future plans for child-bearing
- Other concurrent medical conditions
Medical treatments generally utilise hormones to manipulate the body into ‘stabilising’ or ‘thinning out’ the endometrial lining. This can be achieved through various routes, including oral, implants, injections, intrauterine devices. The hormone-secreting intra-uterine device is the most effective and practical method to control heavy bleeding. This can either be inserted in your Doctor’s office, or at the time of hysteroscopy (see below). Other non-hormonal medical treatments include tranexamic acid, which enhances the blood to clot more effectively, thus minimising blood loss through the uterus.
At times, surgical treatments might be indicated as first-line therapy or when medical treatments have not worked. The most simple and straightforward procedure is called a hysteroscopy, which is essentially a day procedure to insert a small camera through the cervix to assess the uterus lining. This procedure allows removal of polyps and correction of any uterine abnormalities, including removing fibroids or insertion of an intrauterine device at the time of surgery. Another hysteroscopic procedure that is quite effective is endometrial ablation, which uses heat to destroy the uterus lining. This option is only suitable if you don’t plan to fall pregnant in the future. Other options include a laparoscopy to remove fibroids in positions that are not amenable to hysteroscopic resection. The definitive treatment, however, remains a hysterectomy, which can be performed through a key-hole approach.
When should I seek a doctor review of a heavy period?
As mentioned above, there is a broad spectrum of ‘normal periods’ amongst women. However, generally, you should consider specialist review if you:
- experience sudden,
- unexplained change to your periods,
- experience bleeding between your periods or after intercourse,
- feel that your heavy period is adversely impacting your daily living or mental health, or
- develop any symptoms that you are concerned about.
This information is designed to support, not replace, the relationship that exists between a person and their existing health care professional/s. Please discuss any health concerns with your doctor or specialist.
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