When Is Heavy Menstrual Bleeding Cause for Concern?

If your monthly period usually lasts longer than seven days — or if you need to change your pad, tampon, or menstrual cup every hour to keep up with a relentless flow for the duration of your period — you may be experiencing heavy menstrual bleeding. 

Heavy menstrual bleeding is a common problem that prompts one in three women to seek expert care at some point. Why? Heavy periods aren’t simply bothersome; they can trigger painful cramps, make you miss work, diminish your energy, and foster anxiety. And anytime heavy menstrual bleeding affects your daily life, it’s not normal.

At Panhandle Obstetrics and Gynecology in Amarillo, Texas, our team of women’s wellness experts can get to the bottom of abnormally heavy periods and provide treatment solutions that deliver much-needed relief. Here’s why very heavy menstrual bleeding should always be investigated. 

What’s abnormal menstrual bleeding? 

A normal female menstrual cycle lasts 24-38 days. During this reproductive cycle, your uterus sheds its lining and you experience a “period” of bleeding. Normal uterine bleeding, including both light and heavy flows, lasts 2-7 days. 

 Uterine bleeding that doesn’t fit the definition of a normal menstrual cycle — or occurs outside of your regular period — is regarded as abnormal. This includes:

• Light bleeding (spotting) between periods
• Bleeding following sexual intercourse
• A very short cycle with two monthly periods
• A long cycle with less than one monthly period
• Irregular monthly periods that vary greatly 
• Periods that trigger severe menstrual pain
• Any post-menopausal uterine bleeding 

One of the most diagnosed forms of abnormal uterine bleeding is heavy menstrual periods, formerly known as menorrhagia. Among women who menstruate, at least one in four (27%) — and as many as one in two (54%) — experience abnormally heavy periods. 

When your heavy flow is too heavy 

Given that a normal period can include moments or even days of heavy menstrual flow, it’s important to understand exactly what constitutes abnormally heavy menstrual bleeding.

A heavy period is specifically defined as menstrual bleeding that saturates a feminine hygiene product every hour for several hours in a row, and/or a period that continues longer than seven days. With a heavy period, you may: 

• Find that you need to change your pad or tampon during the night
• Pass quarter-sized blood clots (or larger) in your menstrual flow
• Need to wear two pads (or a pad and a tampon) to contain your flow

A very heavy menstrual flow can mean staying home until your period is over — missing work and avoiding activities you’d otherwise like to partake in — or only leaving the house with extra period products and fresh clothes. 

Heavy periods require investigation 

Most women experience abnormal periods at various times in their lives. Just as periods are more likely to be irregular or heavy when they first begin in adolescence, they tend to become less regular, and sometimes much heavier than normal, during perimenopause. 

When heavy menstrual bleeding is a consistent occurrence at any other time in life, it may be the result of a gynecological concern, a medical condition, or even increased stress. 

Heavy menstrual bleeding can stem from: 

Hormonal imbalances 

A reproductive hormonal imbalance — whether caused by excess weight, thyroid disease, anovulation, polycystic ovary syndrome (PCOS), or something else — can prompt irregular ovulation and heavy periods. 

Benign gynecological growths

The endometrial implants that occur with endometriosis are a leading cause of heavy menstrual bleeding, but other benign (noncancerous) growths, including uterine fibroids as well as endometrial, uterine, and cervical polyps, can cause heavy periods too.

Taking certain medications

Sometimes, heavy periods are a result of taking medication like blood thinners, aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs). Certain hormonal contraceptives can also cause abnormally heavy periods during the first few months of use.

A chronic bleeding disorder

Up to 10% of women with abnormal heavy menstrual bleeding have a bleeding disorder, like von Willebrand disease (VWD), that interferes with the normal blood clotting process. 

Sexually transmitted diseases (STDs)

Sometimes, very heavy periods are an indication of an underlying sexual infection like gonorrhea, chlamydia, vaginitis, trichomoniasis, or pelvic inflammatory disease (PID). 

Cancer and precancerous growths

Less commonly, abnormally heavy menstruation can be a warning sign of cervical, uterine, ovarian, or vaginal cancer. It can also stem from a precancerous condition like endometrial hyperplasia. 

We can help normalize your periods

The bottom line? Heavy menstrual bleeding is never normal. Even if it doesn’t stem from a serious hormonal imbalance or a life-threatening condition like cancer, heavy bleeding can point to a minor to moderate health problem that requires care. 

No matter what our evaluation reveals about the underlying cause of your heavy periods, we have an effective treatment protocol that can alleviate the problem and help restore a better quality of life. To learn more, call 806-359-5468 to schedule a visit at Panhandle Obstetrics and Gynecology today.