What Are My Options for Heavy Menstrual Bleeding?

While up to 30% of women experience abnormal bleeding during menstruation, that doesn’t mean that heavy bleeding is normal or that you should have to put up with it. In fact, heavy bleeding puts you at risk for anemia. It may also severely affect your quality of life and even how much restorative rest you get at night during your period.

A normal, healthy period lasts anywhere from 2-7 days and occurs regularly on a cycle of about 21-35 days.If you bleed longer than 7 days or bleed more frequently than every 21 days, you’re considered to have abnormally heavy bleeding. 

Other signs of heavy bleeding include:

• Wearing more than one tampon or pad at a time
• Changing pads or tampons every hour for several consecutive hours
• Passing blood clots larger than a quarter
• Getting up frequently at night to change tampons or pads

Heavy bleeding puts you at risk for insomnia, which can lead to daytime fatigue and brain fog. Fatigue puts you at increased risk for accidents. Heavy bleeding and the causes behind it may also lead to pelvic pain.

At Elite Gynecology, our expert gynecologists diagnose and treat heavy bleeding at our offices in Murray Hill (Midtown East) in Manhattan, New York City, and in Forest Hills, New York. Molly McBride, MD, and Tamara Guichard, MD, want your periods to be normal and comfortable so you stay safe and healthy. 

If you have heavy bleeding, our gynecologist conducts a thorough exam and testing to determine why. Following are some of the most common reasons why you’re bleeding heavily and the kinds of treatments that are available.

Endometriosis or adenomyosis

Your uterine lining, the endometrium, is the tissue that becomes rich with blood and nutrients in preparation for a fertilized egg. If your egg isn’t fertilized, your body discards the top blood-filled layer of endometrium through your vagina.

If you have endometriosis or adenomyosis, though, your endometrium grows either outside the uterus or inside the uterine muscles, respectively. Your periods are longer and heavier as your body attempts to expel the aberrant tissue. 

Depending on your situation, you may respond to hormonal birth control that stops or lessens your periods. An intrauterine device could also work. 

Sometimes simply taking an anti-inflammatory medication before your period can reduce pain, inflammation, and bleeding. However, in extreme cases you may need a surgical hysterectomy (removing your uterus).

Uterine fibroids 

Fibroids are benign growths made up of uterine muscle cells and connective tissue. Fibroids can be extremely tiny, but can grow so large that they distend your uterus.

When you have fibroids, the extra surface area in your uterus creates a greater mass of endometrium. When you menstruate, therefore, you may pass large amounts of blood and blood clots. Extremely large fibroids may even make it difficult to become or stay pregnant.

If you want to preserve you fertility, we might recommend a short course of hormonal contraceptives, such as the birth control pill, to normalize your period. We might also recommend surgical removal of fibroids, a procedure called a myomectomy.

If you’re not interested in becoming pregnant however, we offer a nonsurgical procedure called uterine fibroid embolization (UFE). With UFE, we inject pellets into the uterine arteries that supply your blood to your fibroids. Without nourishing blood, the fibroids shrink.

We may recommend UFE as an alternative to hysterectomy. About 9 in 10 women get relief with UFE alone and don’t have to go on to hysterectomy. 

Hormonal imbalances

Perimenopause— the time when you transition from fertility to menopause, may come with unpleasant symptoms — including heavy bleeding. To normalize your periods and help alleviate discomfort, such as dry vagina or insomnia, we may recommend hormone replacement therapy (HRT).

We offer a variety of HRT options, including topical creams and gels, oral therapy, and skin patches. Depending on your needs, you may only receive short-term therapy. For instance, for prolonged periods, a short course of oral progesterone may get you back on track.

You can menstruate normally and comfortably again with the correct diagnosis and treatment for your heavy bleeding, fibroids, or pelvic pain. Contact our team at the office nearest you by phone or click to request an appointment day and time.