What can I do about heavy periods?

Many women suffer from heavy periods (menorrhagia). Having heavy periods often makes you more likely to experience period pain, fainting, nausea and diarrhoea during your period. Therefore, if you do have heavy periods, you may want to try to treat them, fortunately there are various options available that can help reduce your flow and the uncomfortable symptoms associated with heavy periods.

What are heavy periods?

The definition of a heavy period can vary from woman to woman, but the approximate threshold is about 80ml (16 teaspoons) of blood over one period. That can be a difficult thing to estimate, so the general guidelines to evaluate if you have heavy periods are:

You have to change sanitary products every 1-2 hours
You pass blood clots over 2.5cm in diameter
You often bleed through to your clothes
You need to use both tampons and sanitary towels
You need to wake up at night to change your sanitary products
You bleed for over seven days

You do not have to meet all of those criteria. Meeting just one suggests that you have heavy periods.

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What causes heavy periods?

There are many causes of heavy periods, but they are usually related to increased thickness of the lining of the womb (endometrium) or blood disorders i.e. anaemia or clotting disorders that may lead to excessive bleeding. Several other medical conditions can also result in heavy periods including:

Endometriosis - endometrial tissue exists outside the womb, as well as inside the womb
Fibroids or Polyps - small growths in and around the womb
Pelvic inflammatory disease (PID) - infection of the womb, fallopian tubes or ovaries
Polycystic ovary syndrome (PCOS) - Ovaries that work in an abnormal way, causing irregular and heavy periods.
Various clotting disorders and hormonal diseases can also contribute to heavy periods.

What is the connection between period pain and heavy periods?

The lining of the womb contains chemicals called prostaglandins. As the endometrium breaks down during your period, these prostaglandins are released. This sudden influx in prostaglandins can cause period pains, fainting, nausea, diarrhoea and other uncomfortable symptoms. People who have heavy periods, often have a thicker endometrium, which means that there would usually be more prostaglandins contained within it. Treatments for heavy periods and period pains typically involve reducing the endometrium's thickness with hormonal medications such as the contraceptive pill or treating inflammation and pain caused by the prostaglandins with ibuprofen and other non-steroidal anti-inflammatories. These treatments can be really beneficial to treat period pains.

What can I do about heavy periods?

If you have heavy periods that interfere with your life in any way, you should consider speaking to your doctor. First, they might to do a blood test, to check for anything that could contribute to your condition. Iron-deficiency anaemia is a common cause of heavy periods, especially in younger women and vegan or vegetarian women. If there is an underlying cause of your heavy periods, the doctor may treat the cause, which can indirectly treat your heavy periods. Alternatively, treatments such as anti-inflammatories, the contraceptive pill or an intrauterine system (IUS) may be offered as a first option. Surgical interventions, such as removing the lining of the womb, removing fibroids, or a hysterectomy, may be used in severe cases.