Heavy Periods: Symptoms, Diagnosis, Causes & Treamtent

Heavy periods are used to describe excessive menstrual bleeding that lasts for more than seven days, bleeding with several clots, or bleeding that requires a tampon or pad change more than every two hours. This symptoms can be accompanied by symptoms like vaginal pain, abdominal swelling and fatigue.

Heavy periods, which are medically referred called menorrhagia, can be dangerous as it can lead to iron losses and anemia. Heavy periods can also be a sign of a more serious condition, like cancer. 

If you notice heavy periods, you should consult a gynecologist to identify the  underlying cause of the bleeding and initiate treatment.

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Main symptoms

The main symptoms of heavy periods are:

  • Abnormal and abundant blood loss, requiring a pad or tampon change more than every 2 hours
  • Periods that lasts more than 7 days
  • Vaginal pain
  • Presence of clots during menstruation
  • Abdominal swelling
  • Easy fatigue
  • Possible fever

Excessive bleeding during periods can also reduce hemoglobin and iron levels in the blood, which can lead to symptoms of anemia, like dizziness, paleness, headache, hair loss and lack of appetite. 

Confirming a diagnosis

Heavy periods should be diagnosed by a gynecologist, who will assess the signs and symptoms the patient presents with.

To identify the cause of heavy periods, the doctor may order lab tests that look at progesterone, estrogen and LH levels, a complete blood count and a urinalysis. The doctor may also order an abdominal or transvaginal ultrasound to visualize reproductive organs.

Common causes

The main causes of menstrual bleeding are:

  • Abnormalities in the uterus, such as fibroids, polyps, adenomyosis and cancer
  • Abnormalities in blood clotting
  • Hormonal problems, such as hypothyroidism or hyperthyroidism or lack of ovulation
  • Infection in the uterus, urinary tract or bladder
  • Use of oral contraceptives
  • Pregnancy or miscarriage

Although heavy periods can affect  any woman, it is more common in women who are obese, who are entering menopause or who have a family history of heavy bleeding to experience this symptom.

When it is not possible to identify the cause of excessive bleeding, it may be considered to be dysfunctional uterine bleeding. This condition does not have a specific cause, but is associated with uncontrolled growth of the uterine lining, causing bleeding and increasing the risk for endometrial cancer.

Treatment options

Treatment for heavy periods depends on the cause of the excessive bleeding.

If it is related to abnormal hormone levels, the doctor may prescribe medications to stop menstrual bleeding, such as oral contraceptives. The doctor may also prescribe iron and folic acid supplements, as well as the the insertion of an IUD.

If the heavy bleeding is a result of an infection, the doctor may prescribe antibiotics.

In more serious cases, such as uterine fibroids or cancer, hysterectomy surgery may be indicated to remove part or all of the uterus.