Heavy periods (The Basics)

Written by the doctors and editors at UpToDate

What causes heavy periods? — That depends on your body and individual situation. There might be nothing wrong with you at all. Things that cause heavy periods include:

  • One of your ovaries not releasing an egg during one or more months
  • Growths in the uterus called “fibroids”
  • A bleeding disorder that prevents your blood from clotting normally
  • Side effects of some medicines, such as some types of birth control or blood thinners
  • A problem with your thyroid (a gland that makes hormones)

How much bleeding is normal when I have my period? — During a normal period, bleeding lasts between 3 and 7 days. Most women lose between 2 and 3 tablespoons of blood during that time. Losing more than 5 tablespoons of blood during a period can be a sign of a problem. Blood loss is hard to measure with a spoon. But you can look for other signs that your periods are too heavy, such as:

  • Having to change a pad or tampon every 1 or 2 hours
  • Passing large lumps of blood, called clots

Is my bleeding an emergency? — See your doctor or go to the emergency room right away if you soak through 4 or more pads or tampons in 2 hours. Any bleeding is an emergency if you are pregnant.

Should I see a doctor or nurse? — Call your doctor or nurse if you:

  • Are pregnant or think you may be pregnant
  • Have a period that lasts for more than 7 days
  • Soak through a pad or tampon every 1 or 2 hours, and this happens every time you have a period
  • Need to use both pads and tampons at the same time because you are bleeding so much
  • Need to change your pad or tampon during the night
  • Pass clots that are bigger than 1 inch wide
  • Bleed in between periods.
  • Have irregular periods that happen more or less often than once a month
  • Have pain and bad cramps in your lower belly before or while you are bleeding
  • Are having trouble getting pregnant
  • Have any of symptoms listed above and are low in iron. Signs of being low in iron include:
    • Feeling weak
    • Feeling very tired
    • Having headaches
    • Having trouble breathing when you exercise
    • Feeling your heart beat too fast when you exercise

Are there tests I should have? — Your doctor or nurse will decide which tests you should have based on your age, symptoms, and individual situation. There are lots of tests, but you may not need any.

Here are the most common tests doctors use to find the cause of heavy periods:

  • Blood tests – Blood tests can check if you are pregnant, or have hormonal changes, a bleeding disorder, low iron levels, or other problems.
  • Endometrial biopsy – For this test, the doctor will take a sample of tissue from inside your uterus. The sample can be viewed under a microscope to look for problems.
  • Pelvic ultrasound – This test uses sound waves to make a picture of your uterus, ovaries, and vagina. The pictures can show if you have fibroids or other growths.
  • Hysteroscopy – For this test, the doctor will use a small instrument to look inside your uterus.

How are heavy periods treated? — That depends on what is causing your heavy periods and whether you want to get pregnant soon zoloft pill. You may not need treatment. If you do, treatments might include:

  • Birth control methods that use hormones. These make your period lighter or stop your periods completely. They come as:
    • Pills
    • Skin patches
    • A ring that you put inside your vagina
    • Shots that you get every 3 months
    • An intrauterine device (IUD), a plastic device that your doctor inserts into your uterus.
  • Medicines that thicken blood and slow bleeding
  • Medicines that reduce swelling, such as ibuprofen (sold as Motrin® and Advil®) or mefenamic acid (sold as Ponstel®)
  • Medicines that contain a hormone called “progestin.” These are taken for a week or so every few months.
  • Medicines that make the ovaries stop working for a short time
  • Surgery to remove fibroids or other growths

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