Every woman’s period is different, some lasting only a few days with a light flow, others last a week with a heavier flow. But each person normally has a relatively similar flow each month and it is hard to know whether you have what is considered to be heavy menstrual bleeding, or menorrhagia.
What is a Typical Period?
During a typical period a woman loses approximately 6 to 8 teaspoons, or 35 ml., of blood, although yours may be a little lighter or heavier than this. To be considered menorrhagia, doctors look for blood loss of about 80 ml.
Determining if Your Period is Heavy
But because we do not really have any way of actually measuring our blood flow it is normally impossible to know whether our period is “typical.”
You can somewhat measure your flow by how many and how often you change your tampon or pad. According to Epigee.org, 1 normally soaked regular tampon holds approximately 5 ml. of blood and super or maxi pads hold about 10 ml. Using these amounts as a guideline, you can measure your flow by the number of tampons or pads you need throughout your period.
Additional signs include:
- Needing to change your tampon or pad hourly or you need to use a tampon and a pad together for more than a few hours
- If you notice large or heavy clots
- Having periods that last for more than one week
- Excessive tiredness or lethargy during your period, which can be a sign of anemia from losing too much blood
- You have bleeding more than once a month
- The amount of bleeding or pain from cramping interferes with your daily life or causes you to miss school or work
- Your period begins without warning and is like a “faucet turning on”
Younger girls frequently have heavier periods due to changes in hormonal levels but this normally levels off as she matures. This may occur again when a woman reaches the years shortly before menopause, as hormonal levels again fluctuate from month to month.
What to Do if You Have Heavy Periods
You may want to start by keeping a log of your menstrual flow for a few months. Keep track of how often you change your tampon or pad, how many you use during your period and how long it lasts. Write down whether you have cramps and how many days the cramps or other symptoms, such as headaches lasts. Use the list in the previous section to write down information that would help your doctor determine if you have menorrhagia.
Once you have tracked a few months, make an appointment with your gynecologist. He (or she) will probably request a blood test to check your hormonal and iron levels. In addition, you will probably have a pelvic examination and may have a hysteroscopy. This procedure involves using a telescope to view the lining of the womb to make sure there are no abnormalities. This is normally done without general anesthesia. If you are over 40, your doctor may also request an ultrasound or a biopsy of the lining of the womb to make sure there are no abnormalities in the cells.
Your doctor will look for underlying conditions which may be causing your heavy periods, such as fibroids, endometriosis, pelvic inflammatory disease and polyps on the lining of the womb.
Treatment of Menorrhagia
While treatment for menorrhagia is often not medically necessary, many women do want treatment to help alleviate the uncomfortableness and the pain from cramping.
Some of the common treatments include:
- Birth control pills to help regulate hormones
- Non-hormonal medications such as tranexamic acid which can reduce blood loss by up to one half
- Anti-inflammatory drugs can reduce flow by approximately one third
- The hormonal IUD (Mirena) usually reduces menstrual flow and cramping
For extreme cases, surgical options include using laser or heat treatments to destroy the lining of the womb or a complete hysterectomy, removing the womb, can be performed.
In addition to treatments specifically for heavy bleeding, you may need to be treated for secondary problems, such as being given iron supplements for anemia.
"Dysfunctional Uterine Bleeding (DUB), Updated 2011, July 25, David Zieve, M.D., Susan Storck, M.D., MedlinePlus
“Heavy Periods,” Date Unknown, Staff Writer, Epigee
“Heavy Periods (Menorrhagia),” Updated 2005, Dr. Erik Fangel Poulsen, NetDoctor