Is your heavy period normal?

When it comes to getting your period, establishing what’s “normal” is a fine art: every human body is as unique as a snowflake, and your periods are no exception. Even your individual cycles can vary in length and volume, depending on the month. So what causes heavy bleeding on your period, and how much is too much?

Abnormally Heavy Periods

A period usually lasts about 3-5 days, and produces a total of 30-40 ml (6-8 teaspoons) of menstrual blood. Menorrhagia, or heavy menstrual bleeding, is medically defined as passing more than 80ml of menses over the course of a period.

These numbers are probably meaningless to you, unless you use a menstrual cup in which you can see the actual volume; even then, you’re probably not sitting on the toilet measuring out your blood like a goth scientist. More signs of menorrhagia include:

• Large blood clots
• Bleeding through tampons in less than an hour
• Needing to double up on pads and tampons to prevent leaks
• Bleeding for longer than a week
• You’re bleeding so much that you feel like you can’t manage it

Heavy Period Causes

Heavy periods are a common medical complaint, but in more than half of cases, a root cause is not clear. There are many conditions that can present themselves in the form of heavy periods with cramps or a heavy period without cramps. Heavy period bleeding can be a sign of:

• Estrogen and progesterone imbalances: these hormonal imbalances can cause buildup in the uterine lining. This will shed during a period, causing a heavier flow. Common conditions that could be linked with hormone imbalance include polycystic ovary syndrome, insulin resistance, pre-diabetes, thyroid illnesses, and obesity.

• Endometriosis: when uterine tissue grows outside of the uterus and into other parts of the pelvic area, it can cause people with endometriosis to experience very heavy periods and cramping, and possibly clots in their period blood.

• Polyps/ Fibroids: Polyps are overgrowths of the endometrial tissue that lines the uterus and can be malignant, while uterine fibroids are (non-cancerous) growths in the actual muscle and fiber wall of the uterus. Some people are at greater risk for fibroids and polyps, so tell your doctor if your heavy bleeding comes with a family history of fibroids, polyps, or other uterine growths.

• Adenomyosis: when glands from the endometrium become embedded in the walls of the uterus.
• IUDs: both the hormonal and non-hormonal form of this birth control device has a well-known side effect of heavy period bleeding. Heavy bleeding with an IUD is especially common in the first few months after insertion.
• Pregnancy: pregnancy occasionally goes unnoticed before ending in a miscarriage, which can be mistaken for a heavier-than-normal period.
• Cancers of the uterus andcervix: these can cause heavy menstrual bleeding. But before you start panicking that your heavy bleeding = cancer, there are many other symptoms that are more reliable for a cancer diagnosis. Make sure you’re getting regular pap smears to ensure a healthy cervix.
• Postpartum bleeding: heavy bleeding after childbirth is common but it is not the same as getting a period. Postpartum bleeding can be dangerous if excessive and is a sign of a hemorrhage.
• Other bleeding disorders: various diseases can impair the body's ability to coagulate blood, resulting in abnormal periods. People with Von Willebrand Disease, for example, are missing a blood-clotting protein and may have heavy period bleeding.

• Medications: many medications, including birth control, often can contribute to hormone imbalances and heavy bleeding.

• Beginning your period: Teenagers are more prone to heavy flow and irregular periods in the year following their first cycle.

• Perimenopause: the years leading up to menopause (for some that can last up to 10-15 years) is marked by heavy bleeding for many people.

If you have abnormal bleeding, your doctor or health practitioner may search for the cause with blood tests, a pelvic exam, or a hysteroscopy.

Managing Heavy Periods

Making changes in your lifestyle can make heavy bleeding far more manageable. The following adjustments may help make your period more comfortable:

• Nutrition: If heavy bleeding is making you anemic, certain foods, such as dark leafy vegetables, meat, fish, and tofu, can help restore healthy iron levels.
• Exercise: Regular exercise can help shorten your periods, reduce cramps, and lighten your flow by increasing your metabolism. It can also be a serious mood lift and stress-reliever. Don’t sweat how you sweat: if the gym isn’t your place, there are lots of other ways to get moving. Join an kickball league, sneak into the neighbor's yard to take a dip in their pool, or go out to disco night at a roller-rink: voila, you’re exercising!
• Medication for heavy bleeding: hormonal forms of birth control such as the pill or a hormonal IUD can help decrease bleeding and duration. NSAIDs (such as Advil) can also reduce bleeding and cramps.They can also increase bleeding, so ask your doctor if medication options are right for you.
• Menstrual products that help: If you are filling your pads and tampons faster than you can change them, consider switching to a menstrual product that can handle more blood. Menstrual discs and menstrual cups both hold more fluid than tampons and pads- up to five times as much fluid- and can stay in up to 12 hours. Discs and cups can also reduce the cramping that goes with heavy bleeding, and they catch heavy period blood clots more effectively.

Go to thy Doctor

We love Googling “do I have cancer” at 2 AM just as much as the next person, but going to the doctor is truly your best bet for figuring out what, if any, implications there are with your heavy bleeding. While menorrhagia is not per se a sign of an underlying condition, regular checkups with your care practitioner will keep an eye on anything that may be going on in your body or life. Make sure your doctor knows if you have any other conditions or symptoms with your heavy bleeding, and your family history of disease.