Heavy Periods (Menorrhagia): Here is what you need to know

Periods can be as varied as the weather.

For some women, it may come and go with little concern as if nothing happened but for other women, their period can sometimes make it tricky and difficult to leave the house without worrying.

Heavy periods and achy cramps are some common experiences women face during some point of their period journey.

The scientific name given to heavy menstrual bleeding is menorrhagia.

Heavy periods are not normal. In fact, any period that prevents you from doing your daily activities isn’t considered normal.

In this article, we are going to discuss heavy periods, their causes, complications and their treatment.

I am sure at the end of this article you are going to find a solution to your problem.

WHAT ARE NORMAL PERIODS?

So how do you know that your periods are normal or not?

A period which 

• Comes every 22 to 35 days
• Lasts for 2 to 8 days
• Is not very painful
• Has unclotted blood
• Blood loss is somewhere about 35 ml to 50 ml
• No intermenstrual bleeding
• No post-coital bleeding
• No postmenopausal bleeding

is considered normal.

If your periods fulfil all the points of the checklist, you can say that your periods are normal.

WHAT ARE HEAVY PERIODS (MENORRHAGIA)?

By definition, a blood loss of more than 80 ml per cycle is considered a heavy period.

However, there is no particular quantitative test to actually find out how much a  woman is losing. So it is quite subjective.

So how exactly can we say that the period is heavy or not? Here is the checklist 

1. If your periods last longer than eight days.
2. You need to change your pads or any other period products every hour or less.
3. You change pads in the middle of the night.
4. If you are passing blood clots larger than a 50 paisa coin.
5. If you are having period pain that won’t go away even after taking pain killers.
6. You are wearing two sanitary pads simultaneously to manage your menstrual flow.
7. You feel excessively tired or dizzy.
8. You are having symptoms of anaemia.
9. You are bleeding even after menopause.
10. You are restricting your daily activities due to heavy flow.

If you are experiencing these symptoms, you could be having heavy periods.

It is particularly common in teenagers and women over 30 years of age.

CAUSE OF HEAVY PERIODS

Structural causes such as fibroid or polyps 

In this condition, there is growth in the uterus. The growth can be from the muscle of the uterus which is called the fibroids or it can be small growth in the lining of the uterus which is called a polyp.

Both these conditions can cause heavy periods. ^[1]

Endometriosis

One out of every ten women suffers from endometriosis. ^[2]

In this condition, the lining of the uterus implants itself outside the uterus but even though it is outside the uterus, it still builds up every month and bleeds every month.

These women can also have heavy menstrual bleeding but more commonly they have painful periods. ^[3]

Adenomyosis

There is another condition related to endometriosis called adenomyosis. 

It is not as common as endometriosis but again that lining of the uterus has implanted itself somewhere where it shouldn’t be and in adenomyosis, it’s implanted itself in the actual muscle wall of the uterus. 

This can also cause heavy menstrual flow along with painful periods. ^[4]

Problem with your thyroid gland

If your thyroid gland is under-functioning and not producing enough hormones you can have heavy periods.

PCOS

Polycystic ovarian syndrome (PCOS) or polycystic ovarian disease (PCOD) is a condition that affects the normal working of ovaries. 

Due to hormonal imbalances, this condition may cause ^[5]

• Delayed periods
• Missed periods
• Irregular periods
• Painful periods
• Heavy periods

Certain medication

If you are on a blood thinner medication, you are likely to have heavy periods. ^[6]

Changes in birth control medication can also result in heavy flow.

Hormonal changes

The menstrual cycle is mainly governed by two hormones, estrogen and progesterone.

If the body is producing too much estrogen, this can lead to the thickening of the uterine lining therefore heavy flow.

Perimenopause

Perimenopause is a time period before menopause actually happens. During this transition period, the hormones are very fluctuating. 

Due to some drastic changes in hormones, a woman can encounter heavy bleeding during her periods. ^[7]

After childbirth

After you have given birth to a baby, expect heavy periods for few months. Your periods may take several months to come back on track as they were before you were pregnant. ^{[8] [9]}

Intrauterine device (IUD)

One of the main side effects of an IUD is heavy bleeding. So it is quite common to experience heavy periods after an IUD insertion. ^[10]

Ovaries dysfunction

Sometimes the ovaries don’t release an egg that means ovulation doesn’t happen in a menstrual cycle (anovulation). As a result, the body doesn’t produce the hormone progesterone as it would do during a normal menstrual cycle.

This creates an imbalance of the hormones and heavy periods may occur as a result. ^[11]

Pregnancy complications

Sometimes heavy periods can be caused due to some pregnancy complications ^[12] which includes

• Miscarriage
• Ectopic pregnancy
• The unusual location of the placenta

Cancer

Cervical cancer, which has become a widespread issue nowadays and uterine cancer can cause abnormally heavy bleeding in women.^[13] If heavy bleeding starts after menopause, it could be a sign of cancer. 

HEALTH RISKS OF HEAVY PERIODS

Prolonged and heavy periods may lead to several other health issues.

They include problems like

• Anaemia
• Iron deficiency
• Severe pain
• Pale skin
• Fatigue
• Weakness in the body

TREATMENT OF HEAVY PERIODS?

Treatment of heavy periods depends upon the cause. It can be medical or surgical.

Here are few options that your doctor may suggest to you for heavy periods.

MEDICAL OPTIONS

Intrauterine system or mirena

Studies say that this is the best treatment for heavy periods. ^{[14] [15]}

For 3 out of 4 women, Mirena was found effective. ^[16]

This is a T-shaped device that is inserted into the uterus and releases a hormone over time. This causes your periods to become less frequent or lighter.

It lasts up to 5 years.

Medications

Your doctor may prescribe you several medicines that can help.

There are medicines that don’t contain hormones such as mefenamic acids and tranexamic acids that are sometimes used or there are medicines that do contains hormones that are sometimes quite helpful. ^{[17] [18]}

And these are the medicines that can contain a combination of estrogen and progesterone.

SURGICAL OPTIONS

Endometrial ablation

In this process, the lining of the uterus is thinned and it can be done in a variety of ways.

This cause menstrual flow to reduce. In some women, the flow may stop completely. ^[19]

Myomectomy

In case a woman has fibroids that are causing abnormal heavy flow, she has to undergo a myomectomy. ^[20]

It is a great option for women who are young and who wish to get pregnant in future.

Hysterectomy

Hysterectomy is a process where the uterus itself has to be removed out from the body. ^{[21] [22]}

After this procedure, you will no longer have periods and you will not be able to get pregnant. 

HOW TO MANAGE HEAVY PERIODS WITH DIET?

Needless to say, diet plays an extraordinary role in treating any abnormalities or dysfunctions of the body. If your diet is on point, everything comes on track.

If you have heavy periods, I want you to make these three simple dietary tweaks.

Boost your intake of omega 3

In large doses, omega 3 has blood-thinning effects. If you regularly have thick, heavy periods and blood clots, an omega 3 rich diet may help to thin your period blood. ^[22]

You can achieve this naturally, through dietary changes, or you may like to try some supplements.

Foods rich in omega 3 include

• Fish and other seafood
• Nuts and seeds
• Walnuts
• Chia seeds
• Soybeans
• Avocados

Try vitamin E supplements

Vitamin E supplements commenced just prior to commencing menstruation and taken until your period stops have been found to reduce menstrual blood flow in some women.

It is not a guaranteed solution, but there is some evidence to show that it works for some women. ^{[23] [24]}

Before taking any supplements, speak to your doctor or dietician because supplements are usually concentrated forms of nutrients, so you want to ensure that you are getting the right dose for your personal needs.

You can also take vitamin E from foods that include

• Avocados
• Peanut and peanut butter
• Sunflower seeds
• Pumpkin
• Red bell pepper
• Almonds

Take adequate iron

Iron is a key nutrient in blood, so when we bleed, we lose iron stores.

If you are bleeding a lot, it is obvious to become iron deficient. ^[25]

Although taking more iron is not going to reduce your periods but it is going to give you back your energy.

Iron carries oxygen around in our blood, taking its cells all over our body, so when our iron stores are low, one of the first symptoms is exhaustion.

By boosting your iron levels again, you will have the energy to deal with everything else.

Foods rich in iron include

• Fish
• Green leafy vegetables such as spinach
• Dry fruits such as raisins and apricots
• Peas
• Beans

WHEN TO SEE A DOCTOR?

Due to a lack of knowledge and awareness, some women think that heavy bleeding during periods are normal and are part of their normal cycle. That’s why many women don’t even know that they have menorrhagia.

If this is left untreated it can lead to several health complications which can make you dread getting your period.

If at all you realize that your period flow is not normal and it is affecting your daily routine then probably you should see a doctor.

If during your periods you are unable to step out of the house because you are unable to manage the flow, definitely go for a doctor’s visit.

If your heavy periods are accompanied by painful cramps then again it calls for a doctor’s visit.

Your doctor can ask you to go for

• Thyroid test
• Iron deficiency test 
• Ultrasound
• Pelvic examination
• Internal examination
• They may ask you about your detailed menstrual history.

CONCLUSION

Periods are an inseparable part of a woman’s life.

Nature has designed our body in such a way that we are capable of bringing a new life into this world.

Well, why I am saying all this is because I think that periods are natural and nature did not intend to give us sufferings. 

Anything which is natural does not give us sufferings.

Heavy periods are not normal and if you are having one, the body is probably saying that something is wrong.

Pay attention to it and take the necessary steps to treat it.

I hope this will help you to have a hassle-free period in your future.

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