A couple heavy flow days at the beginning of your period is normal. We’ve all leaked through a tampon or noticed a couple blood clots on our pads at the end of the day. But if you change your sheets in the morning because you bleed through your tampon or pad at night, avoid wearing light-colored clothing during your cycle or cram your purse full of tampons, you could have chronic heavy periods.

What’s considered a “heavy period”?

You might be surprised to learn that about one in five women experience menorrhagia, the medical term for heavy periods. Because each woman’s period is unique, it can be tricky to know if what you think is “normal” for your cycle is actually excessive bleeding. In fact, half of women who experience menorrhagia don’t realize they have it.

While the best way to know if your heavy periods are chronic is to talk to a doctor, you can keep an eye out for some common symptoms of menorrhagia.

According to the American College of Obstetricians and Gynecologists, any of the following is considered a symptom of heavy bleeding:

  • Bleeding for more than seven days
  • Blood soaks through one or more tampons or pads every hour
  • You need to change your pad or tampon during the night
  • You need to double up on protection to keep from leaking
  • The blood clots in your flow are the size of a quarter or larger

Why do I have heavy bleeding during my periods?

There are many different causes of menorrhagia, most of them treatable. Since everyone is different, seeing the doctor is the only way to know what’s causing your heavy periods. The most common causes of heavy periods include:

  • Life changes – Our bodies are sensitive to change. Even stress can cause abnormal periods. Knowing this, it shouldn’t come as a surprise that big life changes may affect your cycle. It’s common to experience heavy period flow after pregnancy or childbirth, or during the time your body transitions to menopause (perimenopause).
  • Changes to your medications or birth control – Heavy periods are a side effect of some medications, especially blood thinners. Even changes to your birth control can affect the length of your menstrual cycle and how much you bleed. For example, using a copper or hormonal IUD (intrauterine device) can cause heavier periods for 3 to 6 months after insertion. Talk to your doctor if you notice changes to your period after starting a medication or birth control.
  • Hormone imbalance – Too much or too little estrogen and progesterone can cause menorrhagia. Some women experience high levels of estrogen and low levels of progesterone. This can cause the uterine lining to thicken. When a thick uterine lining sheds during menstruation, women might experience heavier blood flows and larger blood clots.
  • Uterine fibroids – Fibroids are small, non-cancerous growths inside the uterus. They range in size from a grain of sand to a large mass that can affect the size of your uterus. If your doctor finds fibroids in your uterus, they might recommend removing them to treat your heavy periods.
  • Endometriosis – Endometriosis is a painful condition that causes abnormal growth of the uterine lining and forms uterine polyps. It can cause short period cycles and heavy, painful periods as your body sheds the thickened uterine lining. About one in ten women in the United States has endometriosis.

How can I stop heavy periods?

If you’ve heard that the only options for treating heavy periods are hormone therapy or surgery, that’s not true! Just like there are many causes of menorrhagia, there are many treatment options available. We’re often able to manage heavy periods with treatments ranging from diet changes to prescription medication.

  • Diet changes – Sometimes, food is the best medicine. Getting more iron in your diet can help reduce heavy bleeding and prevent anemia caused by blood loss. Try eating iron-rich foods like meat, seafood, beans, nuts, seeds and leafy green vegetables. Eating foods with lots of vitamin C like oranges, bell peppers and broccoli can help your body absorb the extra iron in your diet. Also, do your best to avoid foods with processed sugar, trans-fats and starchy carbs. These foods can make menorrhagia symptoms worse.
  • Try over the counter (OTC) medicines – Common medicines like ibuprofen or aspirin can reduce pain caused by menorrhagia and lighten your period. These medicines, sometimes called non-steroidal anti-inflammatory drugs (NSAIDS), can reduce the amount of prostaglandin – a hormone that causes pain and heavy bleeding – in your uterine lining. The best time to take OTC medicines to alleviate menorrhagia is during your period.
  • Birth control – Pills, patches, hormonal IUDs and other forms of hormonal birth control can work to regulate your periods as well. Hormonal birth control can thin the uterine lining, which reduces the amount of blood and tissue you lose during your menstrual cycle. Birth control can also be used to regulate the length of your cycle, alleviate painful cramps or even let you skip your period all together.
  • Hormone treatments – Your doctor might recommend hormone therapy to treat heavy periods caused by an imbalance of hormones. Hormone treatments, like progesterone pills, can be used as fast-acting methods for stopping heavy bleeding. They can also be used regularly to thin the uterine lining and help keep your hormones balanced on a daily basis. Hormones are also used to treat conditions like endometriosis that cause pain and excessive bleeding.
  • Prescription NSAIDs – These medicines are similar to non-steroidal anti-inflammatory drugs (NSAIDs) you’ll find over the counter, but much stronger and only available from a doctor. Prescription medication, like naproxen and tranexamic acid, can thin the uterine lining and may help reduce heavy bleeding.

Menorrhagia can usually be managed with medication and lifestyle changes. In some cases, heavy periods caused by fibroids, growths or endometriosis might be best treated with surgery. The best way to know which treatment options will work best for you is to talk to a doctor.

When should I see a doctor for heavy periods?

Many women have come to accept heavy bleeding as a normal part of their cycle. This helps explain why over half of women with menorrhagia don’t know they have it, or know that heavy periods are treatable. If left untreated, heavy periods can cause other health concerns like anemia, a red blood cell condition that makes it difficult for your organs to get the oxygen they need.

If your period affects your daily life by causing you to miss work or school, cancel social activities or plan your day around bathroom breaks, you might have menorrhagia. Heavy bleeding can cause other physical symptoms that can make you dread getting your period like extreme fatigue, very painful cramps, lightheadedness, anxiety and depression.

We recommend making an appointment with one of our women’s health doctors if you experience any of the above symptoms. A doctor will be able to diagnose what’s causing your heavy periods and recommend treatment options. If you’re not sure whether your period is normal, just ask!

Our women’s health doctors at HealthPartners and Park Nicollet are here to answer your questions. We’ll help you put an end to planning your life around heavy periods.