Most of us experience what we feel is unusually heavy bleeding during our menstrual periods from time to time. Normal menstrual bleeding, usually about two to eight tablespoons, lasts about five days. According to The American College of Obstetricians and Gynecologists, heavy menstruation includes periods that last longer than seven days and bleeding heavy enough to require changing a tampon or pad at least hourly for several hours.
Most often what we think of as abnormal or heavy bleeding is not enough to be diagnosed with a clinical condition called menorrhagia, which the Mayo Clinic describes as prolonged or excessive bleeding and heavy blood loss. The Mount Sinai Medical Center estimates that while nearly 30 percent of women have heavy menstrual periods, only about 10 percent of women have menorrhagia.
Heavy menstrual cycles are normal when a girl first begins menstruating−menarche−or when a woman is in perimenopause−the stage leading up to menopause. These two situations are usually due to an imbalance in the hormones estrogen and progesterone .
Not all heavy periods can be associated with a particular cause but they can also be caused by endometriosis, adenomyosis or uterine fibroids, Certain medications, including anti-inflammatory medications and anticoagulants (to prevent blood clots), can contribute to heavy or prolonged menstrual bleeding.
Women who lose large amounts of blood during a menstrual period can have low levels of iron in the body and may be at risk for anemia. Heavy bleeding and blood clots can cause painful menstrual cramping.
For women who have heavy periods, there are several ways to manage the challenges:
• To treat heavy bleeding due to hormonal imbalances, physicians may prescribe birth control pills to decrease menstrual flow.
• To help manage the discomfort of increased cramping, physicians often prescribe over-the-counter or prescription strength variations of ibuprofen.
• If the abnormal bleeding is caused by fibroids or polyps, often the problem can be solved by having them removed.
• For women who bleed heavily, menstrual cups offer the benefit of longer protection times.