How to manage a heavy period (menstrual menorrhagia)?

Woman with stomach pain is holding her aching belly

Why's my period so heavy? Is having heavy periods normal? How can I tell if my heavy period bleeding is abnormal? What is menorrhagia? These are common questions to ask when you’re experiencing a heavy period flow. Menorrhagia is a disorder that often goes unnoticed by women. Learn about its symptoms and treatment options.

No one likes worrying about whether or not they’re going to leak through their tampon or have to change their tampon every hour, but for many women with heavier periods and heavy menstrual cycles, it’s just what happens during their cycle every month. In rare cases, bleeding too much during your period can be a cause for concern, so it’s best to check with your doctor to rule out any of those. While there’s no such thing as a ‘normal’ period (everyone’s body is different and will have a different menstrual bleeding experience), you can gauge whether your heavier or longer periods are a cause for concern, or if you’re just built to bleed a little more every month.

Table of content:

What is menorrhagia (heavy period)?

Menorrhagia is the official medical name for long or heavy periods. There is also a specific term for heavy or long bleeding between periods: metrorrhagia. Menorrhagia is a disorder in which menstruation occurs with much heavier bleeding than normal. In addition, it usually lasts longer than normal (more than 5 days). Menorrhagia symptoms occurs during normal menstrual days - that is, the menstrual cycle follows the same schedule and does not change puzzlingly. This makes it even more difficult to distinguish and identify the problem.

The main symptom of menorrhagia is very heavy bleeding. A woman who suffers from it has to constantly change her sanitary pads or heavy period tampons during her periods.

What qualifies as heavy menstrual bleeding?

Studies suggest the average person loses around 85 grams of blood per menstrual cycle, which is about two shot glasses worth (six tablespoons), but there’s a wide range since every woman is different. You might be a little taken aback when you bleed through a super absorbency tampon every few hours, but keep in mind that Super tampons for heavy flow are designed to hold 9-12g. If you’re concerned that you’re bleeding through tampons quicker than you think you should, it may be time to see a doctor about your heavy menstrual bleeding.

Having a heavy period flow isn’t necessarily a bad thing if that’s your body’s baseline. It’s very normal to need super plus tampons for heavy flow during your heaviest days, and then switching to regular and light as your period comes to an end. Tampax offers the full range of absorbencies from Light to Super Plus to give you ultimate protection on your heaviest days and smooth removal on your lightest.

Heavy first period

It’s not typical, but it’s perfectly normal to have a heavy first period. So, if you get your first period and it isn’t super light, don’t panic. If you’re worried about a heavy first period, talk to your mum and maybe think about scheduling an appointment to see your doctor to discuss your concerns.

Whenever heavy bleeding occurs during puberty, it is important to visit a gynaecologist who will take a thorough history and order the necessary tests to assess the hormonal profile. It is important to rule out thyroid disease and coagulation disorders

What are the symptoms of menorrhagia (heavy period)?

To find out if you have heavier periods and menorrhagia, ask yourself the following about your period:

  • Does your period last longer than seven days?
  • Is your period so heavy that you have to change your pad or tampon every one to two hours?
  • Do you often also get spotting between periods?
  • Have you always had a heavy period flow or did it start suddenly?

A tendency to heavy periods can, on the one hand, be a physiological, i.e. natural, feature of the female body and, on the other, indicate the presence of various abnormalities or diseases.

Some women simply lose more blood during their period and this does not necessarily indicate anything worrying. However, it is always worth checking, as these could be menorrhagia symptoms. If only to rule out possible ailments and have peace of mind.

If so, you may need to see a doctor to figure out what’s behind your heavy period. Your doctor can help you rule out or investigate any serious potential health concerns or bleeding disorders.

How do you know if you have heavy period?

A normal period flow lasts no more than 7 days (on average 4-6 days) and the average blood loss is 30-80 ml. A loss of more than 80 ml indicates heavy menstrual bleeding. In practice, it is often difficult to know how much 80 ml of blood is. It is therefore worth keeping an eye on the number of pads or tampons used.

One sanitary pad absorbs approximately 5 ml of blood, so it is assumed that the use of more than 20 sanitary pads during a period can be indicative of heavy bleeding. One tampon, on the other hand, absorbs approximately 3 ml of blood. i.e. the use of more than 30 tampons during the entire period may be a sign that you are having a heavy period flow. However, this is still a low-precision measure, as women change pads and tampons frequently for reasons of hygiene and their comfort. Another way to estimate whether bleeding is excessive is to perform a haemoglobin test before and immediately after the period. If, after the period, the haemoglobin is significantly lower than before it, and even more so if it indicates anaemia, it is possible to speak of excessive bleeding.

What causes heavy periods?

Every month, the lining of your uterus sheds during your menstrual cycle. This process relies on hormones like oestrogen and progesterone to be balanced and working in tandem in order to make sure every month flows smoothly. Whether it’s due to a hormonal imbalance, or another underlying condition, some people experience heavier periods each month than others. While this can be annoying, it’s rarely bad enough for you to have to worry about blood loss or anything serious.

Ironically, while hormonal contraceptives may help heavy periods, non-hormonal contraceptive methods like the copper IUD might actually make your periods heavier and your cramps more painful.

In many cases it is difficult to find the exact cause of menorrhagia symptoms. However, some of the most common causes of heavy periods are:

  • Hormonal changes - in many women, hormonal imbalances cause excessive development of the endometrium, the mucous membrane lining the uterus. When this membrane falls away, menstrual bleeding is very intense.
  • Polycystic ovary syndrome - this is one of the factors causing the hormonal imbalance we mentioned.
  • Polyps - small, benign tumours of the uterus that cause bleeding to be more intense or prolonged.
  • Copper IUD - this is a method of contraception that is usually called a coil. One of the side effects can be menorrhagia symptoms.
  • Uterine cancer or cervical cancer - this is one of the most serious reasons for heavy periods, but fortunately it is not so common. It is linked to the papilloma virus.

Other menorrhagia causes:

  • uterine myomas,
  • inflammation of the ovaries,
  • ovarian cysts,
  • endometriosis,
  • thyroid diseases,
  • infections and infestations, including sexually transmitted diseases,
  • blood disorders, including clotting disorders,
  • anatomical defects in the structure of the female reproductive tract,
  • permanent stress, neuroses and depression,
  • miscarriages,
  • ectopic pregnancies,
  • non-ovulatory cycles,
  • liver disorders,
  • kidney disorders,
  • diabetes mellitus,
  • hypertension,
  • other systemic disease.

Going to see a doctor can also rule out uterine fibroids or growths, cancer, bleeding disorders, inflammation, thyroid conditions, or liver or kidney disease. Certain blood-thinning medications may also impact your period and cause a heavier menstrual cycle.

How is heavy period diagnosed?

Excessive menstrual bleeding may be accompanied by:

  • noticeable blood clots,
  • increased weakness and a tendency to get tired quickly,
  • prolonged menstruation, even lasting more than 7 days,
  • frequent need to change hygiene products, every 1-2 hours,
  • severe menstrual pain in the lower abdomen and sacrum.

In addition you may notice:

  • paleness and dryness of the skin and mucous membranes,
  • weakened hair and nails,
  • headaches,
  • problems with concentration,
  • increased heart rate,
  • shortness of breath.

Not all the symptoms listed need to be on the list for you to decide to consult a doctor.

Even if you have doubts, there is nothing stopping you from making an appointment, especially as heavy periods can indicate the presence of various disorders or diseases in the body.

How to manage heavy periods?

How to stop heavy periods? Going on certain forms of hormonal contraceptives may help with your heavy menstrual cycle, as these balance your hormones out more - it is one of the heavy period treatment methods. Your doctor may also recommend iron supplements or other treatments. If you find you’re bleeding through tampons really quickly, just trying a higher absorbency tampon may also help. Tampax offers Super and Super Plus tampons that may be a better fit for your flow.

How to manage a heavy period? If the cause of a heavy period bleeding is not a specific medical condition, your heavy periods treatment by means of various dietary supplements, e.g. herbal-based, can be resorted to. Non-steroidal anti-inflammatory drugs (NSAIDs) can also be used to alleviate the symptoms of a too heavy period bleeding.

However, if a more serious illness is at the root of the heavy periods, the doctor will decide on the most appropriate menorrhagia treatment method after a thorough diagnosis.

In some cases, other, slightly more complicated surgical procedures are also carried out. If the need arises, do not hesitate to ask your doctor to explain the details.

What’s the best tampon protection for people with heavy periods?

You might be reassured to know that tampons come in industry standard absorbency ranges, with Super and Super Plus tampons for heavy flow and offering the highest absorbency (9-12g, and 12-15g, respectively). You’re likely already doing this, but go for the most heavy-duty tampon you can find and change it as often as needed for your flow. There are different types of tampons available on the market.

How long should a tampon last? If the tampon is placed correctly and changed regularly (every 3-6 hours), it provides reliable protection during menstruation.

You may find that you need to start off with Super Plus absorbency for a few days, and then eventually go down to Super, and then Regular as your period ends. If you use tampons, adding a pad or pantyliner for extra protection never hurts, and the peace of mind knowing there’s an extra barrier between you and your underwear, should you bleed through your tampon, is worth it.

Check what size tampon you need.

When should I go to the doctor or hospital for heavy bleeding?

If you notice your heavy period bleeding matches the symptoms above, it’s not a bad idea to go get it checked out. If you ever feel physically weak from the loss of blood, then it’s definitely time to call your doctor or visit your local urgent care clinic, as blood loss from your period is pretty rare, and therefore something you’ll need to have looked at as soon as possible, then start menorrhagia treatment. A volume of 30-50 ml of blood is considered normal blood loss during menstruation. Any more heavy menstruation with clots, haemorrhage during the period (blood loss can be determined by at least increased use of hygiene products) is an indication to visit the doctor. Symptoms cannot be ignored and must be started as soon as possible heavy periods treatment.

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