If you have heavy periods that cramp your style, you may think you’re unlucky, but there may be a real medical reason for heavy flow, long periods, and painful cramps. The medical term for heavy or long menstrual periods is menorrhagia. Periods that are very heavy can also have further medical effects, such as anemia and iron deficiency.
When periods require you to change your pad or tampon hourly for 24 hours, this can obviously disrupt your life. You may also have severe cramps. It’s very hard to get anything done when you spend several days dealing with heavy flow and cramps that are more than a little uncomfortable. You may lose sleep because you have to get up to replace a pad or tampon in the middle of the night. Long periods that last more than a week can really zap your energy and affect your health, and you have every reason to seek treatment for your symptoms.
We encourage women with period symptoms that seem excessive to see their OBGYN to pinpoint the cause. Heavy periods can be caused by a number of conditions, including adenomyosis, fibroids, endometriosis, polyps, hyperplasia, and even uterine cancer. Getting to the root of the cause can lead to more effective treatment.
Adenomyosis is a condition in which the endometrium, or the lining of the uterus, grows into the muscle of the uterus. Because the lining is encased in muscle, this can cause increased cramping as well as heavy, extended bleeding.
Endometriosis is a condition in which the endometrium grows outside of the uterus on structures such as the ovaries, fallopian tubes, outer uterus, and bowel. This can result in painful cramping, pelvic pain, painful intercourse, and even painful bowel movements.
Fibroids are tumors that grow within the uterus. The can be located within the muscle, in the uterine cavity, or on the external surface of the uterus. Fibroids make periods dysfunctional. Making them longer and heavier. They are typically benign.
Endometrial hyperplasia is a condition that thickens the lining of the uterus. Risk factors for hyperplasia include high levels of estrogen that is unopposed by progesterone. This can happen with polycystic ovarian syndrome, obesity, and taking estrogen as a hormone replacement without proper progesterone supplementation.
Small growths called polyps can grow within the lining of the uterus. Like fibroids, they can cause your periods to be long, heavy, and difficult to manage.
Diagnosis & Treatment
To diagnose the cause of your heavy periods, your OBGYN will do an exam and order tests such as a Pap smear, pelvic ultrasound, and blood tests. They may also do a biopsy of the endometrium.
Treatments for these conditions vary from taking birth control pills, placing an IUD, or taking medication to alter hormones and lighten periods. There are also surgical procedures to reduce menstrual flow. Procedures may be required to remove fibroids or polyps or reduce the thickness of the endometrium. Other procedures to treat severe symptoms include endometrial ablation, resection of polyps and fibroids, and hysterectomy. Many of these treatments may affect your ability to bear children, which you will want to discuss with your doctor.
It’s important to treat heavy bleeding, not only to improve your quality of life and reduce the pain and inconvenience but also to avoid other side effects. Anemia can result from losing too much blood during your period. When you have anemia, your body doesn’t produce enough red blood cells. This makes your heart work harder to get oxygen throughout the body. This nutritional deficit can cause paleness and fatigue, too.
If you experience heavy, long periods, we encourage you to discuss your symptoms with your OBGYN. We can work on diagnosing the cause and exploring your treatment options to make your life better.