Heavy Periods Specialist

What is considered heavy bleeding?

Normal menstrual flow lasts about 2-4 days. It produces a total blood loss of 30 – 80 ml (about 2 – 8 tablespoons) and occurs normally every 21-28 days. The amount of blood lost should be completely manageable with the typical hygiene products found on today’s drug store shelves. Keep track of the number of pads or tampons used over time so that the amount of bleeding can be determined. If one is getting up to change feminine products every half hour, or so, that is definitely considered abnormal.

What is considered heavy bleeding?

Medically, heavy periods (or menorrhagia) are defined as those that involve passage of more than three ounces of blood; in a normal period, about an ounce of blood is expelled. Practically speaking, since most women don't have a way to measure their blood flow, heavy periods are defined as those that require the use of tampons and pads at the same time; involve passing clots; require frequent changing of protection – for instance, every couple of hours; or last longer than seven days. Other symptoms include the need to wake during the night to change protection, fatigue, and anemia in more severe cases.

What are the causes of heavy bleeding?

There are many potential causes of menorrhagia, including:

• hormonal imbalances, most typically occurring in adolescence and during menopause
• benign tumors called fibroids, which occur most commonly during the childbearing years
• miscarriage
• ectopic pregnancy
• problems with IUDs
• use of blood thinners
• pelvic inflammatory disease
• cervical, ovarian or uterine cancer
• diseases of the liver, kidneys or thyroid or platelet disorders, all of which can cause issues with normal clotting
• adenomyosis, a condition that occurs when the uterine lining glands become embedded in the uterine wall; this occurs most commonly in middle-aged women who have been pregnant multiple times

How is heavy bleeding treated?

The treatment you'll receive will depend on the cause of your bleeding and may include:

• Medication to reduce the loss of blood and manage cramping and discomfort
• Hormone therapy to regulate your cycle or correct hormonal imbalances
• Surgery to remedy fibroids, treat the lining of the uterus or target the uterus entirely

You may also be prescribed an iron supplement to avoid anemia until your bleeding is controlled.

When Should I Contact My Santa Monica OB/GYN?

It is highly recommended to talk to contact your healthcare provider if you have signs of needing to use double sanitary protection or changing during the night, periods that have been heavy or prolonged for 3+ cycles or bleeding that includes large blood clots. Look for patterns and begin journaling when your symptoms started, when they ended and what attempts have been made to help alleviate them. If you are experiencing symptoms of heavy bleeding, please do not delay getting an exam just because you are bleeding. Immediately contact Dr. Tristan Bickman if:

• You are pregnant;
• There is any unexplained bleeding between periods;
• There is any bleeding after menopause; or
• Abnormal bleeding is accompanied by other symptoms, such as pain, fatigue, dizziness.