It is called many things in our society — Aunt Flo, the Crimson Tide, Mother Nature’s Gift — but it’s more commonly known as your period. For many, these few days out of the month are nothing more than a tolerable nuisance. But many other women, however, experience heavy menstrual flow that can be debilitating and affect a woman’s quality of life.
One-third of visits to the gynecologist are due to abnormal bleeding of some kind, and more than 70 percent of gynecology consultations in the years leading up to menopause and the years following menopause are due to abnormal bleeding.
From an obstetrician-gynecologist, here’s what women should know about heavy menstrual flow and the next steps in treatment.
What’s causing my heavy flow?
Before we can know the best way to target heavy bleeding, it is crucial to understand its cause. The cause of heavy menstrual bleeding often varies depending on which phase of life that we are in; the common causes of heavy periods for a 21-year-old will be quite different from the common causes of bleeding for a 41-year-old.
The most common causes include some of the following:
Structural abnormalities within the uterus
These types of structural abnormalities consist of fibroids, polyps or irregularities in the muscle of the uterus that can cause bleeding in between periods, severe cramping, increased need to urinate, constipation and pelvic pressure.
Bleeding disorders can range in type and can sometimes be genetic. Have you had heavy periods since your period first started? Did your mom suffer from heavy periods too? Are you having any other unusual symptoms since these heavy periods began?
One of the most common bleeding disorders associated with heavy bleeding is Von Willebrand’s disease. Women with this condition often present to their doctors in their teens complaining of heavy periods since their periods first started. Because this is a genetic disorder, a woman with Von Willebrand’s may also find that her family members experience excessive bleeding as well.
Are you suddenly experiencing heavy bleeding in the years leading up to menopause? Do you suffer from several days of heavy bleeding followed by weeks or months of no period at all?
Estrogen and progesterone are both present throughout a woman’s menstrual cycle and the two must remain in perfect balance to have regular cyclic periods.
Estrogen and progesterone are both present throughout a woman’s menstrual cycle and the two must remain in perfect balance to have regular cyclic periods. In the perimenopausal period, or the time before menopause, there are fluctuations of these hormones. When these hormones are out of sync with one another, irregular and heavy periods can occur.
Such hormonal imbalances can also be seen in the reproductive years with women who suffer from conditions such as polycystic ovary syndrome (PCOS). In this condition, irregular intervals between periods are commonly seen. However, some women with PCOS also experience several days or weeks of bleeding when they do actually have a period.
Pre-cancerous and cancerous causes
This is typically not the most common cause of heavy bleeding, but certainly, one that must not be ruled out if it is at all a concern.
Sudden, heavy bleeding in the years leading up to menopause can be a symptom of precancerous or cancerous cells within the uterus. This is why speaking to your gynecologist about these symptoms is key.
If you’ve already gone through menopause and are experiencing heavy bleeding again, or if you have a family history of uterine or colon cancer, take a break from reading this and contact your friendly neighborhood gynecologist to discuss your symptoms.
Treatments for heavy period bleeding
The treatment options for heavy bleeding are as diverse as the causes of heavy periods themselves. What treatment method is right for you depends on the cause of the bleeding and what stage of life you are in. This is where it is helpful to talk through the options with your OB/GYN.
For many women, hormonal treatments such as oral contraceptive pills or progesterone IUDs provide significant relief from both heavy bleeding and the cramping associated with bleeding.
What treatment method is right for you depends on the cause of the bleeding and what stage of life you are in. This is where it is helpful to talk through the options with your OB/GYN.
For women suffering from fibroids, treatment options include removal of the fibroids, a procedure called uterine artery embolization to decrease blood supply to the fibroids and therefore shrink these benign tumors, and hysterectomy, a procedure to remove the uterus. Hysterectomies are more often than not minimally invasive procedures and most women will be back at home in less than 24 hours following surgery.
For women in whom cancerous or precancerous causes of heavy periods have been ruled out but who prefer not to have a hysterectomy, ablation (or “burning”) of the uterine lining is a highly effective procedure with hardly any downtime. Most women will have a significant reduction of heavy periods, and a subset of these women will stop having periods altogether.
Periods are a healthy part of a woman’s reproductive years, and they should not be debilitating. Talk to your gynecologist to determine what is causing your heavy periods and which treatment option is best for you.
Don’t have an OB/GYN? Find one at Baylor Scott & White Health.