Let’s face it: Aunt Flo is a VIP on the guest list of womanhood. She might be pesky, but her visits remind us of the female body’s beautiful complexity.
Sometimes, though, things can get a bit, well, heavy when she’s in town. Should you be concerned? Read on.
How do I know if I have a heavy period?
It’s important to note that every woman’s “normal” menstrual cycle is different. Most women, according to the Cleveland Clinic, have a 21- to 35-day cycle and bleed anywhere from two to seven days. As the body prepares for potential pregnancy, you can expect premenstrual symptoms (PMS) and hormonal fluctuations.
But because every woman’s period is different, it’s vital to know what’s normal for you. It’s also essential to keep in mind that your period can change each month. Stress, physical activity, and medications can also impact your flow.
The bottom line? Pay attention to your body and what you experience on a regular basis.
Every period may seem like a miserable, heavy one (hello, cramps!). But abnormally heavy bleeding can severely impact your daily tasks. Clinically known as menorrhagia, the Mayo Clinic defines this condition as a period that is abnormally heavy or lasts for more than seven days. Symptoms include soaking through a single pad or tampon every hour for consecutive hours. “During your period, it’s not normal to need a tampon and a pad for more than two to three days,” says A. Nicky Hjort, M.D., OB-GYN at Peninsula Primary Care in California.
Although it’s not uncommon to bleed heavily every now and then, Hjort says that menorrhagia is specifically defined as blood loss of 70 milliliters (12 teaspoons) per cycle. The Mayo Clinic explains that though heavy menstrual bleeding is a common concern among women, “most women don’t experience blood loss severe enough to be defined as menorrhagia.”
In some cases, bleeding might be so heavy that you may use more than one pad or tampon each hour. You may be unable to carry on daily activities due to extreme blood loss. You could also experience anemic symptoms such as fatigue and exhaustion. On top of it all, bleeding can even occur in between periods, Hjort shares. Menorrhagia can be debilitating, tiring, and downright annoying.
What can cause a heavy period?
Humans are routine beings. When you start new habits or get on a new schedule, your body tries to roll with the punches. Your period will also attempt to adjust right there with you.
Your body’s normal hormonal balance can get thrown off, and estrogen and progesterone are the first to take the heat. Normally, these female sex hormones prep the uterus lining (endometrium) for pregnancy. When an imbalance occurs, an excess amount of endometrium is produced, according to the Mayo Clinic. This results in a heavy period. Not cool, we know! Don’t worry—once your body adjusts to the changes, your period should go back to normal.
A shift in weight prompted by lifestyle changes is another way those tweaks can impact the heaviness of your period. “Weight gain is directly proportional to the heaviness of a cycle,” Hjort says. When your body is introduced to newly acquired pounds, your body’s processes—such as your period—can be thrown for a loop. Weight loss can have the opposite impact; it is more likely to cause a lighter or absent period. Because fat cells produce extra estrogen, sudden weight gain increases endometrium production. Your best bet is to seek out healthy weight management—not just for your period but for your body as a whole.
Whether you’re adjusting to a new routine or taking on a big task, life can get pretty darn stressful. Is it bad to feel stressed? Not always. Stress motivates you to stay goal-oriented, learn new responsibilities, and challenge yourself. But when it builds up, stress can also shake up your hormonal balance.
Stress can cause weight gain; when you’re bogged down, you may eat your emotions or become more sedentary. That change in weight can boost estrogen-induced endometrium production, which results in a heavy flow. The International Journal on the Biology of Stress also states that stress can meddle with your cycle via the hormone prostaglandin. It’s worth noting that prostaglandin happens to be responsible for your period-related cramps and digestive issues, too.
If you’ve been feeling burned out, try to take a breather, and seek healthy ways to deal with stress until the craziness tapers off.
Let’s backtrack to hormonal imbalances. Hormones seem to rule our body, don’t they? When it comes to heavy periods, a potential culprit is an imbalance of thyroid hormones (TH). Produced by the thyroid gland, these hormones help regulate the menstrual cycle. When levels are too low, a condition known as hypothyroidism develops. This is characterized by heavier, more frequent periods paired with painful cramps. These symptoms are the opposite of hyperthyroidism, characterized by an overactive thyroid and high TH levels, which causes lighter missed periods.
Because women are five to eight times more likely than men to develop a thyroid disorder, according to Thyroid.org, it’s vital to keep tabs on your thyroid gland function. Do this by getting a complete blood work at your next doctor visit.
Polyps are growths on organs, and they are often not cancerous. The types of polyps that can impact your period are cervical and endometrial, which grow on the cervix and the uterus, respectively. “They are almost always benign,” Hjort assures. Cervical polyps are quite common, typically found in women who have had children and are over the age of 20. Endometrial polyps, which are also common, are typically found in women ages 40 to 50 and who are obese or overweight, according to Cleveland Clinic. The National Library of Medicine states that symptoms of both include unusually heavy, frequent menstrual bleeding.
While the exact cause of polyp growth is unknown, both kinds are associated with an increased level of estrogen. Your gynecologist can determine if you have polyps during a pelvic exam. She may prescribe an ultrasound and removal, if necessary. “They can easily be removed in the office,” Hjort says.
Pelvic Inflammatory Disease
The female reproductive organs make up a delicate yet robust part of our body. When infected, the regularity of your period and how much blood is produced is affected.
Pelvic inflammatory disease is an infection of the reproductive organs, including the uterus and the ovaries. Symptoms of PID include bleeding between periods, heavy bleeding, abdominal pain, fever, and strange discharge.
Luckily, PID is preventable. The risk of PID increases if you have an untreated sexually transmitted disease—because STDs are common, PIDs due to STDs are also quite common, which stresses the importance of getting checked if you suspect you have an STD. According to the Centers for Disease Control and Prevention, additional risk factors for PID include having sex with more than one partner, using an intrauterine device for birth control, and douching. And if the PID isn’t treated? Potential complications include infertility, scarred reproductive organs, and long-term pelvic pain.
Cervical and endometrial polyps that are reoccurring and unmonitored pose the risk of turning into cancer. This risk is increased if they are accompanied by obesity or other hormonal issues. However, while cervical polyps are common, cervical cancer is rare thanks to its highly preventable nature, as the CDC states. Endometrial cancer, one of the top ten cancers in the U.S., is also highly curable, according to Cancer.gov. A major symptom of these cancers is heavy, prolonged periods with bleeding between each period.
While the idea of cancer sounds scary, know that cervical cancer is the second most preventable disease in women. Thanks to the increased use of Pap smears, abnormal cervical cells can be spotted before they become cancerous. Because human papillomavirus is the most common cause of such abnormalities, it’s not a bad idea to make sure an HPV test is included with your Pap smear. Don’t hesitate to request both at your next gynecologist visit; it’s worth it.
As for endometrial cancer? “Also known as uterine cancer, this is usually present with unpredictable and heavy menstrual bleeding,” Hjort states. This disease can be assessed during a pelvic exam for changes in size and shape of the uterus. A Pap smear can provide further insight but does not necessarily diagnose it. According to the National Cancer Institute, this type of cancer makes up 3.3 percent of all new cancer cases each year. Again, staying on top of your OB-GYN appointments can decrease your risk for both conditions.
For most women, menopause starts in their early fifties. Perimenopause—or the time before menopause begins—can occur when women are as young as 30 or 40. Whereas most women associate menopause with little to no periods, intervals of menorrhagia can occur during this life-changing phase—we can thank the wonky hormonal dances that our bodies go through for that. Because menopause signifies the ending of a woman’s reproductive period, these bouts of heavy bleeding will eventually subside.
While these can all be reasons, nothing beats a trip to a gynecologist you trust. If your periods are heavier than normal for you, or if you’re concerned that you have menorrhagia, no amount of web sleuthing is better than a visit to an M.D.