What Causes Heavy Periods?

OBGYN's (like me) see many women on the daily who have problems with abnormal bleeding, the most common problem being heavy or irregular bleeding.

In the United States alone, more than 10 million women who experience abnormal bleeding. For most of us this is no big deal, but sometimes it can cause serious health problems.

Why do some women have heavy periods while others don't?

Let's start with a refresher on our bodies 

Girls are born with a lifetime of eggs. These eggs just sit and wait until puberty. At puberty there is flurry of activity where the brain starts releasing hormones that trigger the ovaries to make estrogen and progesterone. (You may remember this from health class)

Estrogen and progesterone from the ovaries cause the release of an egg, and they tell the uterus to get ready for a pregnancy. The lining starts building up with blood and chemicals just waiting for the fertilized egg. I have seen inside the uterus during this time and the best description I can provide is “fluffy”. That’s right, the lining gets fluffy. This whole process takes about 2 weeks after your last period.

If there is no pregnancy (no sperm that makes it to the released egg), then all the hormones from the brain and the ovaries just shut off. The blood that was built up is not needed and sheds - our female bodies work brilliantly. This is your period.

The cool part is if a pregnancy does occur, the embryo starts producing hormones to keep things going, and because of this, the lining does not shed. Super cool! 

What’s normal & what’s not

Your period will last about 3-7 days. It can come every 25 days, or every 30 days, or even every 35 days. The average is every 28 days. But remember, anywhere between 25-35 days apart is normal.

The amount of bleeding is very important to understand. The average amount of blood lost is 35 mL and can range from 20-80 mL. One tablespoon is 15 mL. So normal bleeding amount is anything less than 5 tablespoons.

Now, don’t freak out, I know a lot of you are thinking “I bleed way more than that”. In the United States, 9-30% of women suffer from too much bleeding.

We can all dream

There are some women in this world who have light periods. They were born this way. They didn't do anything different from you. They aren't on a special diet. They just got lucky. It’s like the woman who has beautiful full hair her entire life. No one knows why this happens, but these women have normal reproductive and fertile lives.

Don’t read this, just glance at it...

The causes are many. This photo is taken from Glass’ Office Gynecology. There are causes and then there are other causes. The chapter goes on and on. The most common are hormonal imbalances (your brain or ovaries just got their signals wrong), endocrine diseases like thyroid problems, tumors in the uterus, and precancerous or cancerous lesions. I know it’s not that simple.

The causes are many. This photo is taken from Glass’ Office Gynecology. There are causes and then there are other causes. The chapter goes on and on. The most common are hormonal imbalances (your brain or ovaries just got their signals wrong), endocrine diseases like thyroid problems, tumors in the uterus, and precancerous or cancerous lesions. I know it’s not that simple.

 

When to be seen

The important part is knowing when to be seen.

1.     If you bleed more than 80 mL (Pop quiz: how many tablespoons is that?)

2.     If your bleeding lasts more than 7 days

3.     Bleeding in between your cycles

4.     If your period comes every 21 days (instead of the normal 25-35 days) or more than 35 days apart

5.     If you don’t get a period for a few months

6.     If you start bleeding after you go through menopause. More specifically, if you start bleeding one year after your last period.

What can I do at home for heavy periods?

I wish I had better information on this topic.

On the internet, I found a variety of options ranging from chiropractic adjustments to placing ice on the abdomen. But, when I looked into the medical literature where studies have proven the benefits of these techniques, I did not find many non-medicinal alternatives.

Chiropractic adjustments and ice can’t hurt. So, if it is working for you or if you want to try it, go for it. 

Diet can definitely help build more blood in your system. Eat foods with iron including fish, poultry, red meats, green leafy vegetables, and lentils. Foods high in beta-carotene are also recommended. These include fruits and vegetables like watermelon, sweet potatoes, carrots, beets, and squash.

NSAIDS, like ibuprofen, which are over the counter have been studied extensively. We’re not sure how they work exactly we have a few theories. But, some studies documented a 50% reduction in blood loss.

If you are going down the route of medical treatments, you should see your doctor. There are a ton of options like birth control pills, the IUD, progesterone pills, etc.