Heavy Periods vs. Normal Flow: When to See a Doctor

What Is Considered a Heavy Period?

A heavy period is more than an inconvenience; it meets certain clinical benchmarks.

Red Flags for Heavy Periods	Why They Matter
Soaking through pads or tampons every hour for several consecutive hours	Suggests blood loss greater than ~80 mL per cycle (twice the typical upper limit)
Passing blood clots, the size of a quarter or larger	Indicates rapid bleeding that can be difficult to control
Bleeding for more than seven days	Extended shedding of the lining of the uterus can cause anemia
Needing double protection (pad + tampon) or waking at night to change protection	Disrupts sleep and affects your quality of life
Symptoms of anemia — fatigue, dizziness, or feeling short of breath	Blood loss depletes iron levels over time

If you regularly see any of the above, you are likely experiencing heavy periods and should discuss them with your provider.

Common Causes of Heavy Periods

1. Hormone Imbalances
   Estrogen and progesterone regulate how thick the uterine lining grows each cycle. When these hormones fluctuate—during puberty, perimenopause, or thyroid disorders—the lining can overgrow, leading to heavier shedding.
2. Uterine Fibroids
   Noncancerous growths inside the uterus can distort its shape and increase surface area, resulting in heavier bleeding.
3. Adenomyosis
   Endometrial tissue infiltrates the uterine muscle (adenomyosis) which can cause pain and heavy flow.
4. Bleeding Disorders
   Conditions like von Willebrand disease, platelet dysfunction, or clotting-factor deficiencies prevent normal blood clotting, making periods significantly heavier.
5. Intrauterine Device (IUD)
   A non-hormonal copper intrauterine device can cause heavier, longer periods for some individuals, especially in the first year of use. (Hormonal IUDs, by contrast, often lighten flow.)
6. Pregnancy Complications
   Miscarriage or ectopic pregnancy may present as unusually heavy bleeding. Prompt medical assessment is crucial.
7. Medications and Supplements
   Blood thinners, certain anti-inflammatories, and even high doses of fish oil can increase menstrual flow.
8. A lesion or polyp inside the uterus.
9. Pre-Cancer or Cancer of the uterine lining.

Treatment Options for Heavy Periods

Your plan will depend on the underlying cause, fertility goals, and symptom severity:

Treatment	How It Works	Ideal For
Birth control pills or hormonal patches/rings	Regulate hormones and reduce lining buildup	Irregular cycles, hormonally driven bleeding
Hormonal IUD (levonorgestrel-releasing)	Thins uterine lining locally; can cut flow up to 90 %	Long-term reversible control, desire for lighter cycles
Tranexamic acid tablets	Helps blood clot in the uterus	Heavy flow without hormonal therapy
NSAIDs (e.g., ibuprofen)	Reduce prostaglandins to lighten flow ~20 – 40 %	Painful, crampy heavy bleeding
Iron supplements	Replenish iron stores and treat anemia	Fatigue, low ferritin on blood test
Endometrial ablation	Destroys the lining of the uterus using heat, cold, or radiofrequency	Completed childbearing, uterine cavity <10 cm, no large fibroids
Myomectomy or hysterectomy	Removes fibroids or the uterus entirely	Large uterine fibroids, failed medical therapy

Lifestyle strategies—exercise, stress management, and anti-inflammatory diets—can also modulate hormone balance and ease symptoms.

When Heavy Periods Might Be a Sign of a Health Condition

While most cases relate to benign causes, heavy menstrual bleeding can occasionally signal:

• Bleeding disorders such as von Willebrand disease (often diagnosed via specialized blood test).
• Thyroid dysfunction—both hypo- and hyperthyroidism can destabilize hormonal feedback.
• Polycystic Ovary Syndrome (PCOS), leading to irregular ovulation and heavy breakthrough bleeding.
• Endometrial hyperplasia or uterine cancer especially after age 45 or when accompanied by bleeding between periods.
• Anemia from chronic blood loss—look for low hemoglobin, low ferritin, and symptoms like feeling short of breath after minimal exertion.

Prompt evaluation ensures early treatment and better outcomes.

Preventing and Managing Complications from Heavy Periods

1. Track your cycle. Use a period-tracking app or calendar. Record days of bleeding, number of pads or tampons used, and any clots.
2. Boost iron. Eat iron-rich foods—lean beef, lentils, dark leafy greens—or take iron supplements if your provider confirms low iron levels.
3. Stay hydrated. Adequate fluids offset blood-volume drops.
4. Plan ahead. Keep extra pads or tampons and wear dark clothing during heavy days.
5. Address pain. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) started the day before flow begins can reduce cramps and blood loss.
6. Mind medications. Tell your doctor about any blood thinners or herbal supplements that may promote bleeding.
7. Consider hormonal support. A well-timed course of birth control pills or a progestin IUD can regulate flow.
8. Re-evaluate contraception. If a copper IUD is worsening bleeding, discuss switching to a hormonal device.
9. Schedule follow-up. Repeat labs to ensure iron levels have improved and adjust therapy as needed.

When to Seek Medical Help for Heavy Periods

Consult a Women’s Health Arizona provider promptly if you:

• Soak through tampons every hour for more than two hours.
• Pass clots the size of a quarter or larger.
• Feel lightheaded, fatigued, or short of breath.
• Bleed longer than one week per cycle.
• Experience pelvic pressure suggestive of uterine fibroids.
• Have known bleeding disorders (e.g., von Willebrand disease) and any increase in bleeding.
• Are perimenopausal or post-menopausal and notice fresh bleeding.
• Are trying to conceive yet struggle with heavy periods, which may hinder implantation or signal hormonal instability.

Heavy bleeding that disrupts work, sleep, intimacy, or exercise affects your quality of life—and you deserve relief.

The Importance of Regular Gynecological Check-ups

Routine visits allow your clinician to:

• Perform pelvic exams and ultrasounds to detect uterine fibroids or concern for adenomyosis.
• Order a blood test panel (CBC, ferritin, thyroid) to pinpoint anemia or hormonal causes.
• Discuss screening for clotting disorders, including von Willebrand disease.
• Tailor contraception or hormone therapy (e.g., birth control pills, IUD).
• Monitor response to interventions like endometrial ablation or iron therapy.
• Screen for cancers of the reproductive tract when indicated.

Early detection of imbalances keeps minor issues from escalating into chronic anemia, infertility, or surgical emergencies.

Contact Women’s Health Arizona Today!

If heavy periods are draining your energy, limiting activities, or causing worrisome symptoms, our compassionate team can help. Women’s Health Arizona offers comprehensive evaluation—ultrasound, blood test diagnostics, and individualized treatment ranging from lifestyle guidance and birth control pills to in-office endometrial ablation. We also provide minimally invasive surgery for uterine fibroids and other structural causes.

Don’t let heavy menstrual bleeding dictate your life. Call us or request an appointment online to restore balance, protect your iron levels, and reclaim the freedom to enjoy every phase of your menstrual cycle.