Heavy periods and all that comes with it.

Experiencing heavy periods has an undeniable impact on your day-to-day life. Anxiety, concern, exhaustion … The mental load is real. 

And understanding the causes behind your heavy periods can feel like navigating a daunting and uncertain path. Truth is, there are many possible causes to this issue, and our bodies change over time. Also, to find out why you bleed heavily during your periods, you need the guidance of a doctor who takes this issue seriously. 

Why is it so hard to explain and get it addressed?

Everyone is different, and context matters also. Depending on where you are in your life (starting to date someone new, trying to conceive), you pay more or less attention to your cycles. 

However,  if you are asking yourself the question “are my periods too heavy”?, our take is – the answer is most likely yes. 

“Normal” periods exist, we all have friends who barely notice their periods, and don’t alter their lifestyle during their periods (note – having too light periods can also be something to monitor). But for some, periods showing up means putting a towel on the bed to protect the bedsheets, using multiple pads and period underwear at once, being constantly scared of leaks, passing clots. etc. 

The good news is? You are not alone. Heavy menstrual bleeding impacts 10% of women worldwide¹. That is potentially 393,000,000 women around the world, who struggle like you do. 

The common recurring patterns includes: 

• The need to change pads, cups or tampons every 1-2 hour because they are soaked
• The need to use two menstrual products simultaneously to manage the bleeding
• The need to change pads or tampons during the night
• You bleed for more than 7-8 days
• You pass blood clots that have the size of a small coin
• Your day-to-day life and mental health are negatively impacted: you have anxiety about how you are going to deal with your heavy bleeding or you need to take time off work or school.

Bleeding exceeding 80ml per period is generally considered heavy. Some of us largely surpass this, indicating the terms heavy menstrual bleeding apply to a large spectrum. 

Understanding heavy menstrual bleeding. 

In most cases, heavy menstrual bleeding is caused by conditions that cannot really be cured, just managed. And their origins remain unclear. Tricky, isn’t it?
Even if some of the conditions causing heavy periods can be linked to fertility issues, women with heavy periods have been able to have babies (thankfully), and they manage to operate somewhat normally to the eye of society. We have developed a way to deal with it, all of us, silently. But it is important to finally break this silence and put words on this issue, for women today and tomorrow.

Several conditions contribute to heavy periods. While they are complex, this is what they mean, in simple words:

• Polycystic ovary syndrome (PCOS): 

It affects about 8 to 13% of reproductive-aged women, according to the WHO². It is a hormonal condition that causes irregular periods or sometimes the absence of periods. Women affected by PCOS show a hormonal imbalance and have small cysts on the ovaries, leading to heavier bleeding when periods do occur. 

• Endometriosis:

It is characterized by tissue similar to uterine lining growing outside the uterus. A common symptom is severe pelvic pain. It is challenging to diagnose, and the cause of endometriosis is still unknown to date. 

• Fibroids:

Fibroids are growths that develop in or around the uterus. This is a common condition, with 2 out of 3 women who develop at least one fibroid in their lifetime³. Fibroids are non-cancerous. They contribute to heavier menstrual bleeding as they themselves require blood to survive, and can prevent the uterus from contracting and managing the blood flow properly. 

• Uterine polyps:

Uterine polyps are growths made of glands and blood vessels which can develop in the uterus. They can be an issue when trying to conceive, and need to be monitored as they can carry a risk of becoming cancerous.

This list is not exhaustive but it gives us enough to understand the most common causes for heavy menstrual bleeding.

How to go about talking to your health practitioner about your heavy periods, so you don’t carry this weight alone.

• Document your cycles. Often, it is easier to start the conversation with documented facts than vague statements. You can use a tracker on your phone or a physical one, to score your periods. Doing this for a timeframe of 3-6 months will most likely give you the most comprehensive picture. 
• Ask your doctor for a transvaginal ultrasound. This will help determine if you have any fibroids, PCOS or polyps.
• Establishing presence of endometriosis is sometimes more complex, and sadly, this can take years to be diagnosed. Endometriosis is something you can live with, but it can highly disrupt your life. Ultrasounds can help with a basic check, but if you have a doubt, it is best to talk to your doctor about the best way to get a definitive answer. 
• There are supplements that can help balance hormonal imbalances. Blood tests are the way to go to find out if you have issues with your hormones. 
• There are medicinal ways to manage heavy bleeding, one being taking a birth control pill – which is a personal decision you need to make. Another one is to take tranexamic acid (not recommended if you have any risk related to blood clots). These are obviously options to be thoroughly discussed with your doctor..

The topic of heavy bleeding during your periods is not black and white. The journey to get it under control is usually complex, but equipped with the right questions, you and your health practitioner (your GP or OBGYN) can get a better understanding of your situation. It is your right to understand your cycle better, and you cannot do it fully on your own. Your doctor needs to be a partner in this, and guide you through your journey. Don’t be afraid to advocate for yourself, and don’t let anyone dismiss your concerns! 

Share your stories in the comments below!

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1. https://www.ncbi.nlm.nih.gov/books/NBK279294/ ↩︎
2. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome ↩︎
3. https://www.nhs.uk/conditions/fibroids/ ↩︎