What is heavy periods?

With heavy menstrual periods, your bleeding may be heavier or last longer than normal. You may pass large blood clots and have to change sanitary pads or tampons often. Or your periods may last longer than 7 days.

Heavy bleeding can be caused by not ovulating regularly. It can also be caused by other problems, such as fibroids (growths that aren't cancer). If you are overweight, you may be more likely to have heavy menstrual periods. But in some cases, there may not be a specific cause for your heavy periods.

Your doctor may recommend hormone treatments to slow or stop your periods. If you have a fibroid, your doctor may recommend surgery or other treatments to remove the growth. Because blood loss from heavy periods can make you very tired and weak (anemic), your doctor may recommend that you take extra iron.

In most cases, heavy menstrual periods can be managed with medicines or hormone treatments. If those treatments don't help, you may need surgery to help control your bleeding.

Medicine options

Your doctor may suggest that you take a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen (such as Advil or Motrin) or naproxen (such as Aleve). Taking an NSAID can reduce bleeding and pain during your period. But NSAIDs usually don't help as much as hormone treatments.

Hormone treatments that may be prescribed include:

• Birth control pills, patch, or ring. These release two hormones, estrogen and progestin. They prevent pregnancy and also can reduce menstrual bleeding and pain.
• Progestin-only birth control, such as mini-pills, implants, and shots. These types of birth control can reduce bleeding and cramping.
• Progestin pills. These are progestin-only pills that help reduce bleeding but do not prevent pregnancy.
• Hormonal IUD. This is a birth control device that your doctor places inside your uterus. It releases a type of progestin that can reduce bleeding and cramping.

Sometimes doctors prescribe a medicine called tranexamic acid (such as Lysteda). It is not a hormone treatment. It reduces bleeding by helping blood to clot.

Surgery options

You may want to think about surgery if medicines don't help or if you have a growth in your uterus. Your choice will depend partly on whether you want to get pregnant in the future. Surgery options include:

• Hysteroscopy. This procedure is done to diagnose heavy periods. But it can also treat some problems at the same time. For example, fibroids or polyps may be removed during this procedure.
• Endometrial ablation. This procedure destroys the endometrium. This reduces or stops uterine bleeding. But it is not an option if you hope to get pregnant.
• Hysterectomy, a surgery to remove the uterus. This may be an option if heavy bleeding can't be controlled or when the cause of bleeding can't be found and treated. It ends your ability to get pregnant.

Your doctor will ask about your menstrual periods and do a pelvic exam. During the exam, your doctor will check for signs of disease, infection, and abnormal growths.

If needed, your doctor may also do one or more tests to find out what's causing heavy periods. These tests may include:

• A fluid sample from your cervix or vagina. This can look for signs of infection.
• A Pap or HPV test. This screens for cervical cancer.
• Blood tests. These can check for anemia, a bleeding disorder, or other problems.
• A pelvic ultrasound. This test can look for any problems in the pelvic area.
• An endometrial biopsy. It can check for abnormal cell changes in the lining of the uterus (endometrium).
• A hysteroscopy. This can check the lining of your uterus to look for the cause of bleeding, such as fibroids.

• Get plenty of rest.
• Keep a record of your periods. Write down when your period begins and ends and how much flow you have. That means counting the number of pads and tampons you use. Note whether they are soaked. Note any other symptoms. Take this record to your doctor appointments.
• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• Try to reach a healthy weight. If you are trying to lose weight, do it slowly with your doctor's advice.
• If you are taking iron pills:
  • Try to take the pills about 1 hour before or 2 hours after meals. But you may need to take iron with some food to avoid an upset stomach.
  • Vitamin C (from food or pills) helps your body absorb iron. Try taking iron pills with a glass of orange juice or other citrus fruit juice.
  • Do not take antacids or drink milk or caffeine drinks (such as coffee, tea, or cola) at the same time or within 2 hours of the time that you take your iron. They can make it hard for your body to absorb the iron.
  • Iron pills may cause stomach problems, such as heartburn, nausea, diarrhea, constipation, and cramps. Be sure to drink plenty of fluids, and include fruits, vegetables, and fiber in your diet each day.
  • If you forget to take an iron pill, do not take a double dose of iron the next time you take a pill.
  • Keep iron pills out of the reach of small children. An overdose of iron can be very dangerous.

When you lose a lot of blood during your period, your iron levels can drop. This can cause anemia. Anemia can make you feel tired and weak.

A number of things can cause heavy periods. These include:

• Irregular ovulation. Normally, one of your ovaries releases an egg during your menstrual cycle. This is called ovulation. If you don't ovulate, this can affect the lining in your uterus and may cause heavy bleeding.
• A growth in the uterus, such as a polyp or fibroid.
• Adenomyosis. This condition occurs when the cells that normally line the uterus grow into the wall of the uterus.
• Some bleeding disorders that prevent blood from clotting properly.
• A copper IUD.
• Certain medicines, such as anticoagulants.

Sometimes a cause can't be found.

In rare cases, heavy periods may be a sign of a serious problem, such as an infection or cancer.

With heavy menstrual periods (also called menorrhagia), your bleeding may be heavier or last longer than normal. You may:

• Pass large blood clots and soak through your pads or tampons often.
• Bleed for more than 7 days.
• Have menstrual cramps.

Heavy periods may disrupt your life. But in most cases, they aren't a sign of a serious problem.

Still, it's a good idea to see your doctor. A doctor can suggest treatments to ease your symptoms and make sure that you don't have a serious condition.