Your period shouldn’t be a life-changing event. That term should be reserved for getting accepted to university, choosing a career path, marriage… but not your period. But all too often, for women with heavy menstrual bleeding, their period changes their life and directs their decisions for days: what clothes can I wear? Can I go to that party or not? How can I plan my holiday so my period won’t interfere?
How much bleeding is too much?
The UK NHS defines heavy menstrual bleeding as losing more than 60mL of blood during your monthly cycle.
Collecting the blood to get an actual measurement is a little impractical), but it’s also not necessary. More critical than measuring the exact quantity of blood loss is measuring the impact that blood loss has on your life.
- Do you need to change the style or color of your clothing during your period?
- Are you changing your tampon or pad every two hours or more frequently?
- Do you need to wake up to change your tampon or pad in the middle of the night?
- Does your clothing or sheets often get stained?
- Do you need to use two forms of sanitary products together (like a tampon and a pad, or two pads)?
Heavy menstrual bleeding causing you to change around your life can be emotionally draining. That’s in addition to feeling physically drained, which can also be a sign of anemia caused by too much blood loss.
Why is it happening? What’s causing all that blood loss? Most causes of heavy menstrual bleeding don’t pose a medical danger, but they should still be addressed, investigated and treated if they’re interfering with your life.
Causes of heavy menstrual bleeding 1
Fibroids are non-cancerous growths in, or projecting from, the uterine wall. Uterine fibroids can cause heavy menstrual bleeding, pelvic pain or pressure and incontinence (if the fibroid is pushing on internal organs like the bladder). Twenty to forty percent of women will have a fibroid at some point during their reproductive years, although they do not always cause symptoms.
Endometriosis is a condition in which small pieces of the womb lining are found outside the womb, such as in the fallopian tubes, ovaries, bladder or vagina. It causes painful periods and can cause excessive menstrual bleeding. Endometriosis mainly affects girls and women of childbearing age; it’s less common in women who’ve been through the menopause.
Adenomyosis is a condition in which the inner lining of the uterus breaks through the muscle wall, causing cramping, pressure, and may result in heavy periods. The condition can be located throughout the entire uterus or localized in one spot. While it’s not life-threatening, it can be uncomfortable.
Pelvic Inflammatory Disease (PID)
Pelvic inflammatory disease is an infection in either the uterus, fallopian tubes or ovaries. PID can cause pelvic pain and heavy bleeding not only during periods, but also both after sex and in between periods.
Polycystic Ovary Syndrome (PCOS)
Polycystic ovary syndrome is a common condition that involves some combination of irregular ovulation, many underdeveloped follicles in the ovaries, and release of the male hormone, androgen. Periods (especially if they are irregular) can be heavy. Ten to twenty percent of women have PCOS, although many are not symptomatic.
The thyroid produces many of the hormones that are important for the body’s functioning, including the hormones that control your monthly cycle. If your thyroid is not releasing enough hormones, it can affect your period (as well as causing low energy levels and weight gain).
Cervical or endometrial polyps
These non-cancerous growths in the lining of the uterus or cervix can cause heavier bleeding than normal.
Blood clotting disorders (like Von Willebrand disease)
If your body’s ability to clot blood is impaired, blood may flow heavier and faster during your period.
Cancer of the womb can cause heavy menstrual bleeding, although it is relatively rare. The reasons listed above are much more likely to be a cause.
Don’t suffer in silence.
If heavy periods are interfering with your ability to lead a normal life, discuss it with your general practitioner or gynaecologist. Heavy menstrual bleeding is not something you need to suffer from until menopause. You make the choice of taking action now and get your life back.