Are Your Heavy Periods Normal?

Periods can be unpredictable, painful and sometimes extremely heavy. Period intensity, duration and regularity can vary not only from one individual to the next, but also from month to month. Periods can be light and easy one month and heavy and unbearable the next. Due to the wide range of expectations for a period, how do you know when a heavy period is normal or cause for concern? Here's a look at period symptoms that are likely reasons to see a doctor.

When a heavy period isn't normal

If you've been dealing with heavy periods, or menorrhagia, for your entire menstrual life, you likely have a pretty firm grasp on what is normal and what isn't for your cycle. But if you're not used to a heavy flow, it could come as quite a shock when it happens.

Occasional heavy periods can be normal, and menorrhagia is common, affecting more than 10 million American women each year, according to the Centers for Disease Control and Prevention (CDC). Fluctuations in period intensity can occur as a result of hormonal changes, often due to birth control and typically are not concerning.

Of course, it's unlikely you'll be able to tell if your hormones are slightly off, so this can be difficult to gauge. Look for these symptoms:

• Heavy bleeding that soaks through pads or tampons every hour
• Bleeding that lasts longer than seven days
• Blood clots larger than a quarter
• Persistent bleeding that requires you to change feminine products during the night
• Consistent pain and cramping in the lower abdomen
• Exhaustion, drowsiness, lack of energy or shortness of breath

While any of the above symptoms can be normal in a cycle, it's important to talk to your doctor if you experience any of them during a heavy period.

Diagnosing heavy periods

Your gynecologist may have an idea of what's afoot based on your medical history, but in most cases, they will need to conduct an exam or test. They may test your blood to check for anemia, to ensure blood is clotting properly and to look for thyroid issues. Additionally, a Pap smear may be done to review cervical cells for cancer or other abnormalities. Other tools your doctor may use to get to the root of the problem include an ultrasound or an endometrial biopsy to collect tissue samples from the uterus to check for abnormal cell growth.

Treatment for heavy periods

Treatment options vary depending on the test results, your lifestyle and fertility plans. Some options include medication such as oral contraceptives, which help regulate your cycle or tranexamic acid, which helps prevent blood loss during periods. Progestin-containing IUDs and the Depo-Provera injection are two other hormonal treatments that work very well to control heavy periods and are commonly used too.

A doctor may suggest further testing, such as a sonohysterography, which uses sound waves to painlessly look inside the uterus to look for any polyps or fibroids in the lining of the uterus

Another treatment option is dilation and curettage (D&C), which involves removing some of the lining of the uterus to help with monthly bleeding. D&C is a temporary fix for heavy periods since the lining can grow back. Generally used for acute bleeding.

Other treatment options fall on the more extreme end, including endometrial ablation or endometrial resection, both of which involve the permanent removal of the lining of the uterus. Another option is a hysterectomy—removing the uterus and cervix. These options, while effective in managing or stopping heavy periods, obviously can prevent pregnancy as well, so they may not be for everyone.

You might find out you have either endometriosis or polycystic ovary syndrome (PCOS). Treatment for these conditions might include birth control, ibuprofen for pain, iron supplements, hormone therapy.

Living with heavy periods

Many people live with heavy periods during their entire reproductive life span and find homeopathic ways to cope with feeling tired or experiencing extreme pain. Unfortunately, for a lot of people who experience heavy periods, there is no simple cure or treatment available.

If you're experiencing heavy periods frequently, it can be helpful, both emotionally and physically, to connect with a support group. Finding like-minded people who are dealing with the same symptoms as you can help you discover new ways to manage your pain, or give you an outlet to simply empathize with individuals who really understand what you're going through.