Heavy bleeding during a menstrual period, also referred to by the medical term menorrhagia, affects a staggering number of women around the world each year. According to a Harvard University study, about ten percent of women experience menorrhagia, making it a relatively common condition.
Notably, while there are various causes for menorrhagia, about one third of women who are living with uterine fibroids report suffering from intense, heavy periods. If you’re experiencing heavy bleeding, you may be wondering about the link between the condition and menorrhagia, and whether your intense periods mean that you have fibroids.
In this blog, we’ll answer some of the most common questions around periods and fibroids, including what actually constitutes heavy bleeding, the biological causes behind menorrhagia, and how fibroids can affect the duration and intensity of menstruation.
How do I know if my bleeding is unusually heavy?
Heavy menstrual bleeding is characterized by an excessive and prolonged menstrual flow that can interfere with a woman’s quality of life. Although the exact definition of heavy bleeding may vary from woman to woman, medical professionals have established guidelines to help identify menorrhagia.
Duration and Volume
Menorrhagia is typically defined as abnormally intense menstrual bleeding that lasts longer than seven days or requires changing a tampon or pad every hour for several consecutive hours. Additionally, passing blood clots larger than the size of a quarter may also be an indication of the condition.
Periods so heavy that your physical health is affected are not normal, and a sign that you’re experiencing menorrhagia. It’s important to note that excessive blood loss during menstruation can lead to iron-deficiency anaemia.
If you experience symptoms such as fatigue, weakness, pale skin, or shortness of breath in conjunction with heavy bleeding, it is essential to seek medical attention.
Impact on Daily Life
Menstrual flow that hampers routine activities, such as work, school, or social engagements, due to its intensity or the constant need for changing menstrual products, is typically defined as heavy bleeding.
This could look like a flow so unmanageable that you can’t engage in normal activities and need to stay at home during your period. Waking up to find your menstrual flow has soaked through bedding or clothing despite using appropriate overnight protection may be a sign of menorrhagia.
While periods are nobody’s favourite time of the month, bleeding that disturbs your everyday life or impacts your well-being should be considered unusually heavy. If you’re experiencing a menstrual flow that prevents you from going to school or work, sees you needing to constantly change menstrual products, and are suffering ill effects on your health such as anaemia, you should see a clinician.
What causes heavy bleeding?
While some causes of heavy bleeding are unrelated to chronic conditions, others can be indicative of underlying health issues. Common causes of menorrhagia include:
Hormonal fluctuations play a significant role in regulating the menstrual cycle. Imbalances in oestrogen and progesterone levels can disrupt the normal shedding of the uterine lining, leading to heavy bleeding. Hormonal imbalances may occur due to factors such as polycystic ovary syndrome (PCOS), thyroid disorders, or the perimenopausal and menopausal transition.
Certain bleeding disorders, such as von Willebrand disease and platelet dysfunction disorders, may lead to heavy menstrual bleeding. These conditions affect the body’s ability to form blood clots properly, resulting in excessive bleeding during menstruation.
Medications and Medical Treatments
Some medications, such as anticoagulants, nonsteroidal anti-inflammatory drugs (NSAIDs), and hormonal therapies, can contribute to heavy bleeding. Additionally, specific medical treatments, such as non-hormonal intrauterine devices (IUDs) or certain cancer treatments, may cause menorrhagia as a side effect.
Here’s why fibroids can cause heavy bleeding
One of the most common causes of menorrhagia is uterine fibroids. While the exact biological mechanism by which fibroids trigger heavy bleeding is not fully understood, there are several factors believed to be at play:
Increased Surface Area of the Endometrium
Fibroids can distort the uterine cavity, altering its normal structure. This results in an increased surface area of the endometrium, which is the lining of the uterus that sheds during menstruation. The larger surface can lead to heavier bleeding during menstrual periods.
Disrupted Uterine Contractions
The uterine muscle’s ability to contract effectively may be affected by fibroids. The enlarged size and altered location of fibroids within the uterine cavity can disrupt the natural rhythmic contractions of the uterus, preventing the muscle from effectively constricting the blood vessels. This may trigger prolonged bleeding and heavier menstrual flow.
Proximity to the Endometrium
Some fibroids develop within the inner lining of the uterus or protrude into the uterine cavity. Their location close to or inside of the endometrium can directly impact the normal shedding process. Particular types of fibroids may cause irregular and excessive growth of the endometrium, which results in heavy menstrual bleeding.
Increased Blood Supply
Fibroids require a robust blood supply to sustain their growth. In response to the presence of fibroids, the body increases blood flow to the uterus. This increased blood supply is thought to contribute to menorrhagia.
I have a super heavy period. Does that definitely mean I have fibroids?
The short answer to this question is no. As we covered earlier, there are a number of medical conditions and treatments that can cause menorrhagia. For many women, the cause of their heavy periods is uterine fibroids, but experiencing intense periods does not definitely indicate the presence of the condition.
In order to receive help for managing your heavy bleeding, as well as for scans that can determine if you have uterine fibroids, you should visit a clinician. A doctor can provide you with the right guidance for treating fibroids, should you have them, and for managing your heavy periods and improving your overall quality of life while living with menorrhagia.