Experiencing heavy or prolonged menstrual bleeding—the medical term is menorrhagia—can be alarming and nerve-wracking. While this is a common experience, heavy menstrual bleeding does warrant a visit to your doctor, preferably your gynecologist.
Experiencing Bleeding?
The easiest way to know if you are experiencing heavy menstrual bleeding is to take note of how often you are soaking through a pad or tampon. If your period is heavy enough to require changing a pad or tampon every hour for several hours, or if you have a vaginal bleeding that lasts more than a full week, you are experiencing heavy menstrual bleeding. Besides these two, other signs of heavy menstrual bleeding include: Wearing more than one pad at a time in order to control the bleeding Having to change your tampon or pad in the middle of the night If your menstrual blood contains clots that are the size of a quarter or bigger
How Is Bleeding Diagnosed?
Diagnosing the cause of heavy menstrual bleeding can be a bit of a tedious process, so it's best to be prepared. Before your appointment, try to jot down your period pattern in the last few months. For instance, how many days did you bleed each month? How many pads or tampons do you go through on the days of your heaviest menstrual flow? In addition, it's a good idea to make a list of all your medications, including hormonal birth control, any hormone therapy, and any vitamins or over-the-counter supplements. In figuring out why you are bleeding heavily, do not be surprised if your doctor orders a series of tests, in addition to performing a pelvic exam. These tests may include: a pregnancy test (if premenopausal) blood tests (for example, a complete blood count, iron levels, and thyroid hormone) an ultrasound of your pelvis Your doctor may also perform a procedure in the office called a hysteroscopy in order to visualize the inside of your uterus. She may also take a sample of your uterine tissue, called an endometrial biopsy, depending on your age and your individual symptoms.
What Causes Bleeding?
There are a number of different causes for heavy menstrual bleeding—some benign (non-cancerous) like fibroids, and some more serious like cancer of the uterus or cervix. Other causes are not structural but have to do with hormone changes or bleeding problems within your body.
Ovulatory Dysfunction
Ovulatory dysfunction during adolescence or perimenopause is the most common cause of heavy menstrual bleeding. During this time, a woman may ovulate (release an egg) irregularly, which means not every month or not at all. This leads to thickening of the uterine lining and heavy periods. Ovulatory dysfunction can also occur with certain medical conditions like hypothyroidism, polycystic ovarian syndrome, and premature ovarian failure. Treating the underlying problem (for example, an underactive thyroid) is critical to restoring normal ovulation and normalizing a woman's periods. If irregular ovulation is part of the body's normal response (for example, puberty or perimenopause), birth control methods or hormone therapy, respectively, can usually ease up the bleeding.
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