An Overview of Heavy Menstrual Bleeding
An Overview of Heavy Menstrual Bleeding
Experiencing heavy or prolonged menstrual bleeding—the medical term is menorrhagia—can be alarming and nerve-wracking. While this is a common experience, heavy menstrual bleeding does warrant a visit to your doctor, preferably your gynecologist.
The easiest way to know if you are experiencing heavy menstrual bleeding is to take note of how often you are soaking through a pad or tampon.
If your period is heavy enough to require changing a pad or tampon every hour for several hours, or if you have vaginal bleeding that lasts more than a full week, you are experiencing heavy menstrual bleeding.
Besides these two, other signs of heavy menstrual bleeding include:
- Wearing more than one pad at a time in order to control the bleeding
- Having to change your tampon or pad in the middle of the night
Causes
There are a number of different causes of heavy menstrual bleeding—some benign (non-cancerous) like fibroids, and some more serious like cancer of the uterus or cervix. Other reasons are not structural but have to do with hormone changes or bleeding problems within your body.
Ovulatory Dysfunction
Ovulatory dysfunction during adolescence or perimenopause is the most common reason for heavy menstrual bleeding. During this time, ovulation (releasing an egg) can be irregular, which means not every month or not at all. This leads to thickening of the uterine lining and heavy periods.
Uterine Fibroids
Fibroids are generally benign (non-cancerous) growths that develop from the muscle of the uterus. They are most often seen at ages from 30 to 49 years.
While there are several types of bleeding disorders, the most common type in women is von Willebrand disease (VWD). Treatments for von Willebrand disease involve the release of stored clotting factors in the blood or, in extreme cases, replacing the clotting factor with an intravenous treatment or with a prescribed nasal spray.
Other bleeding problems like having a low platelet count (platelets are involved in the clotting process and are produced in the bone marrow) or being on a blood thinner like Coumadin (warfarin sodium) can also be the culprit behind heavy menstrual bleeding.
Diagnosing the reason for heavy menstrual bleeding can be a bit of a protracted process, so it’s best to be prepared. Before your appointment, try to jot down your period pattern in the last few months.
For instance, how many days did you bleed each month? How many pads or tampons do you go through on the days of your heaviest menstrual flow?
In addition, it’s a good idea to make a list of all your medications, including hormonal birth control, hormone therapy, and any vitamins or over-the-counter supplements.