Heavy Menstrual Bleeding: Understanding Common Causes and Your Treatment Options

Menstrual bleeding that lasts longer than seven days or occurs with a heavy flow is called menorrhagia. This relatively common condition affects over 10 million women in the United States every year. While about 50% of women experience heavy menstrual bleeding without a specific medical cause,  it can indicate a serious problem for others.

If your flow produces so much blood that it requires changing your pad or tampon hourly for several hours in a row, you may have menorrhagia. Other signs of the condition include passing blood clots the size of a quarter or larger during your flow, having to wake up to change your pad or tampon at night, and constant cramps during your period. You should seek medical help if you experience any of these symptoms. 

With offices in Bedford Park, Naperville, and Oak Lawn, Illinois, Denise Furlong, MD, and her team at Chicago Center for Women's Health specialize in diagnosing and treating heavy menstrual bleeding. Dr. Furlong can provide treatment to relieve your symptoms and treat any underlying conditions if necessary. 

Heavy periods can interfere with your physical, social, and emotional well-being. Losing more than the normal amount of blood every month can cause anemia, making you feel weak and fatigued. Delaying appropriate diagnosis and treatment can also put you at risk for complications from several types of conditions that cause heavy periods. 

We describe some of the causes of heavy periods below.

Hormonal imbalances

Every month, your uterine tissue, called the endometrium, builds up and then sheds during your period. Estrogen controls cell growth and makes your endometrium thicker, while progesterone regulates how often the cells shed and makes the endometrium thinner. The delicate balance of estrogen and progesterone can be disrupted by conditions such as polycystic ovary syndrome (PCOS), insulin resistance, obesity, thyroid problems, and menopause. 

An imbalance of estrogen and progesterone can result in endometrial hyperplasia. Too much estrogen makes the uterine lining too thick, resulting in a heavier-than-normal flow.

Uterine conditions

Fibroids are noncancerous, muscular tumors that grow inside the uterus, on the uterine wall, or its outer surface. These tumors can cause heavy periods and other complications such as infertility or repeated miscarriages because they can alter the structure of your uterus. 

Endometriosis occurs when uterine tissue grows outside your uterus. This results in deposits of uterine tissue in areas such as your ovaries, fallopian tubes, bowel, rectum, or bladder. Endometriosis can also contribute to heavy periods.

Adenomyosis is a condition in which the endometrial tissue, which lines the uterus, breaks through into the outer, muscular walls of the uterus. The uterine tissue continues to thicken, break down, and bleed with each menstrual cycle, resulting in heavy bleeding and pain during your menstrual cycle. 

Disorders and diseases

Heavy periods can be a warning sign of cancer of the uterus, fallopian tubes, or ovaries. Diseases of the liver, kidney, or thyroid can also cause heavy periods. Investigating the source of your heavy periods allows Dr. Furlong to catch these diseases at the earliest possible stages, improving your chances for better treatment results.

Heavy periods also occur as a symptom of hereditary blood-clotting disorders, such as hemophilia or von Willebrand disease. Both conditions involve a deficiency or lack of an important blood-clotting factor and serious outcomes without treatment.  

You can also experience a heavy period resulting from issues related to pregnancy, such as miscarriage or ectopic pregnancy. Ectopic pregnancy requires immediate medical care to avoid life-threatening complications. 

Medication and birth control

Heavy periods can occur as a side effect from certain prescribed medications, including blood thinners (anticoagulants), anti-inflammatory medications, aspirin, and hormonal medications.

You may also experience heavy periods as a side effect of copper intrauterine devices (IUDs). While bleeding after the first 3-6 months of IUD insertion is common, repeated heavy periods may require that you select another birth control option. 

Don’t delay in coming in to see us about your heavy periods. You can improve your quality of life with an accurate diagnosis and plan for treatment. Schedule an appointment online or call one of our Chicago offices today. 

Medication treatments

Hormonal birth control pills

Endometriosis, fibroids, polycystic ovary syndrome, and issues with ovulation can often cause heavy bleeding. Certain birth control pills can help reduce blood flow, regulate your period, and in some cases, halt the bleeding altogether.

Hormone therapy

Some women experience heavy bleeding during perimenopause. Hormone therapy can help reduce the bleeding.

Nonsteroidal anti-inflammatory drugs

Drugs, such as ibuprofen and naproxen, can help reduce the bleeding and aid in relieving menstrual cramps.

Other medications

With heavy bleeding due to fibroids, gonadotropin-releasing hormone agonists can help by reducing the size of the fibroids. However, the medication can only be used for six months or less, and the fibroids will likely return to their original size.

Tranexamic acid is another option that may be able to reduce bleeding. If heavy bleeding is due to a bleeding disorder, certain medications can help with blood clotting.

Surgical treatments

Endometrial ablation

• This procedure entails destroying a thin layer of the uterus lining to reduce or stop the bleeding.

Fibroid treatments

• A uterine artery embolization blocks the vessels that provide blood flow to the fibroids
• A myomectomy removes the fibroids without removing the uterus
• Hysterectomy involves removing the uterus and thus removing the fibroids

If you’re concerned about irregular bleeding, and for all of your women’s health care needs, schedule a visit to our most convenient location in either Bedford Park, Oak Lawn, or Naperville!