Menorrhagia: Understanding Heavy Periods

Heavy menstrual bleeding, also known as menorrhagia, can be a distressing condition, that affects many aspects of everyday life. Heavy periods can seem like a mystifying happening. In some cases they aren’t an indication that something is particularly wrong, whereas in others, they are an alert of an underlying issue.

This blog is for anyone feeling like they want to get to the bottom of their heavy period, understand the reason for it, and whether heavy menstruation is an indication of a bigger issue. We hope this can provide you with some necessary insights and enlightenments around heavy bleeding and as always, empower you to center and prioritize your own comfort and health. 

What Is Considered a Heavy Period?

A “normal” period involves around 30-60 milliliters of blood loss, which is roughly two to four tablespoons. Heavy bleeding, however, is defined by the American College of Obstetricians and Gynecologists (ACOG) as losing over 80 milliliters in a menstrual cycle. Indicators of heavy periods include:

• Soaking through one or more pads or tampons every hour for several hours
• Needing to wear more than one pad at a time
• Changing pads or tampons during the night
• Passing large blood clots (as big as a quarter or larger)

Experiencing any of these signs, particularly if they interfere with daily life, could indicate a need for medical attention.

What are the Causes of Heavy Periods?

Heavy periods can stem from a variety of factors, often influenced by age, lifestyle, and underlying health conditions. Here are some common causes:

Hormonal Imbalances: 

Hormonal shifts, especially during puberty and perimenopause, can lead to irregular ovulation and a thicker uterine lining resulting in heavier and prolonged menstrual bleeding. Conditions such as  polycystic ovary syndrome (PCOS) and hypothyroidism, commonly have hormonal imbalances and result in heavier, prolonged menstrual bleeding as well.

Structural Abnormalities in the Uterus: 

Uterine fibroids and polyps, benign growths in the uterus, are known to cause excessive bleeding by preventing the uterine muscles from contracting effectively. Adenomyosis, where endometrial tissue grows into the uterine wall, also leads to heavy bleeding and painful periods.

Blood Disorders: 

Certain bleeding disorders, like von Willebrand disease, affect the blood’s ability to clot, leading to heavier-than-normal periods. These bleeding disorders are often hereditary, so ask others in the family if they have ever been diagnosed with or checked for them.  People taking blood thinners or aspirin might experience heavier bleeding for similar reasons.

Infections and Inflammatory Conditions: 

Pelvic inflammatory disease (PID) and infections in the uterus or fallopian tubes can cause excessive bleeding. Adhesions (bands of scar tissue), which may form from surgeries, infections, or endometriosis, can also contribute to menorrhagia.

Medications and IUDs:

Blood-thinning medications are a common culprit, as are copper intrauterine devices (IUDs), which tend to increase menstrual bleeding in some users.

Cancer

While less common, certain cancers, including endometrial and cervical cancer, can cause heavy bleeding. This is more likely in postmenopausal women or those with significant risk factors.

Complications from Pregnancy

Heavy bleeding can also be associated with pregnancy complications such as miscarriage or ectopic pregnancy, where the embryo implants outside the uterus.

What are the Long Term Impacts of Heavy Periods?

Heavy bleeding can lead to iron-deficiency anemia, a condition where your body lacks enough iron to produce healthy red blood cells. Symptoms of anemia include fatigue, weakness, pale skin, and, in severe cases, shortness of breath and heart palpitations. Treating anemia alongside heavy bleeding is essential to prevent more serious health issues and maintain energy levels.

How Can I Make My Heavy Periods More Comfortable?

There is no denying that heavy periods are going to impact the comfort and ease of the day to day, on both a physical and an emotional level. 

Layer Up on Menstrual Products

Worrying about bleeding through a tampon at work is an unnecessary and taxing anxiety. Whatever your primary menstrual product is, consider using or having on hand a different backup product so you can feel more secure. Using both a menstrual cup and a pad or absorbent period underwear can help you feel more secure. Aisle Menstrual Cups hold up to 30 ml or 6 tampons worth and paired with period underwear (like any of the Aisle Boost products, which hold up to 8 tampons) you are guaranteed to feel stress free about leaks. 

Gentle Movement: 

Incorporating regular and gentle movement into your routine when you are experiencing heavy bleeding is known to reduce pain associated with heavy bleeding, as well as increase dopamine production to give you a well deserved boost. 

Stay Hydrated: 

Staying hydrated helps replenish fluids lost during heavy bleeding.

Prioritize Iron-Rich Foods: 

Iron-rich foods like spinach, beans, red meat, and fortified cereals are essential to replenish iron levels. Pairing these foods with vitamin C sources (like oranges or bell peppers) can boost iron absorption.

Using Topical Pain Relief: 

Topical pain relief such as creams and heat therapy, can help with the pain and discomfort associated with heavy bleeding. Products such as Somedays Cramp Cream and Flaxseed Heatpad, are great natural and alternate options for comfort. 

Use Pain Relief When Necessary: 

There is no need to suffer, even if you are prioritizing natural pain relief. NSAIDs like ibuprofen can reduce both blood flow and cramps, offering a two-fold benefit for comfort.

What are some medical solutions and treatments for Heavy Periods? 

There are numerous ways to manage heavy menstrual bleeding, from medications to lifestyle adjustments and even surgical options. It is important to research and discuss what options may work best for your specific body with informed healthcare professionals:

Medications

• Hormonal Treatments**: Birth control pills, patches, or intrauterine systems (like hormonal IUDs) help regulate hormone levels, reducing menstrual flow and cramps. Hormone therapy may also be recommended to stabilize the uterine lining.

• Gonadotropin-Releasing Hormone (GnRH) Agonists: These medications stop the menstrual cycle temporarily and reduce the size of fibroids, which may alleviate heavy bleeding.

• Tranexamic Acid: This medication helps clot blood, reducing blood loss during periods, used mostly for people with clotting factor diseases like von Willebrand disease Unlike hormonal treatments, it doesn’t alter the menstrual cycle.

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Ibuprofen and similar NSAIDs can help reduce blood flow and alleviate period pain.

Surgical Procedures 

For those with chronic heavy bleeding unresponsive to medications, several surgical options are available:

• Endometrial Ablation: This procedure destroys the uterine lining to reduce or stop bleeding entirely. It’s usually recommended for those who do not plan to have more children.

• Uterine Artery Embolization: This treatment blocks blood flow to fibroids, shrinking them and alleviating bleeding.

• Myomectomy: This surgery removes fibroids, preserving the uterus for those who want to maintain fertility.

• Hysteroscopy and Hysterectomy: Hysteroscopy allows doctors to examine and remove polyps or fibroids, while hysterectomy (removal of the uterus) is a last-resort option for chronic, severe bleeding.

Heavy periods and menstrual bleeding have serious impacts on your daily life as well as your own overall menstrual health. You and your health are worth seeking out relief and support in order to prioritize living your best and most fulfilled experience in your unique and special body. 

Much love.