Excessive menstrual bleeding

If you have periods that are heavy enough to interfere with your everyday life, you may have what's characterized as excessive bleeding. The concept of “excessive menstrual bleeding” may differ for each woman. But if you're changing a pad or tampon every hour or two, that would be considered excessive from a medical standpoint.

In addition to bleeding that's heavier than typical, you also may experience:

  • Blood clots during your period
  • Cramping
  • Bloating
  • Fatigue due to anemia from blood loss

Always let your HonorHealth gynecologist know if there are any sudden changes with your menstrual cycle, such as abnormal bleeding, especially if you're over the age of 35 and/or are obese, both of which put you at a slightly higher risk for developing gynecologic cancers. Although rare, it's important to catch cancer early and to look for pre-cancerous signs.

Note: If you're post-menopausal and begin bleeding, you should make an appointment with your gynecologist to determine the cause and treatment.

What causes excessive menstrual bleeding?

Your gynecologist will consider three main categories when addressing excessive bleeding:

  • Hormone issues: Hormonal changes associated with the beginning stages of menopause or other disorders
  • Medical issues: Including blood disorders, problems with coagulation (clotting), endometriosis, thyroid disorders and polycystic ovarian syndrome
  • Structural issues: Changes in the uterus, possibly fibroids, endometrial polyps or adenomyosis — when endometrial tissue that normally lines the uterus grows into the muscular wall of the uterus

The causes may be different based on your age — whether you just began menstruating or are close to menopause.

How is the cause of excessive bleeding diagnosed?

Your HonorHealth gynecologist will do a full work-up that includes:

  • Blood work to assess your hormone and thyroid levels and general blood counts
  • A pregnancy test to rule out the possibility of a miscarriage or ectopic pregnancy
  • A pelvic exam
  • Possibly a pelvic ultrasound

Depending on the results of your exam and your symptoms, your doctor also may recommend a hysteroscopy to look inside your uterus.

How is excessive bleeding treated?

Treatment depends on the cause and may include: