UCHealth: How to deal with heavy menses
Heavy periods may be more common than then you think: They affect more than 20% of women in their mid-30s and up. But they don’t have to be endured.
“It can interrupt your life — some women won’t go out during their cycles, they miss work, girls may miss school and stay home,” said Dr. Laurie LeBleu Vaszily, an obstetrician and gynecologist with UCHealth Women’s Care Clinic in Steamboat Springs and Craig. “Sometimes women will get anxiety about their period coming.”
What does ‘heavy menses’ mean?
If your period is heavy enough to interrupt your life — whether it means you’re sleeping on towels, changing your tampon or pad every hour, feeling worried about traveling or exercising, or leaking through clothing — then it’s likely too heavy.
Menstruation, in which a woman sheds the lining of the uterus, is also referred to a period, menses or a cycle. Typically, women lose between two to three tablespoons of blood during one period. The formal definition of heavy menses is having a flow of more than double that — or about two shot glasses — during one cycle. But that can be difficult to measure, and different individuals are impacted in different ways.
“What bothers you may not bother someone else,” LeBleu Vaszily said. “Even if you feel a slight hindrance or annoyance, talk to your doctor. It may be something as simple as a polyp that can be removed, and then hopefully you wouldn’t need further treatment.”
When can heavy menses first strike?
Heavy menses are more likely to begin when women are in their mid-30s and older. “At that point, we’re looking at one in every four or five women being impacted by it,” LeBleu Vaszily said.
When girls start their periods, they may experience heavy cycles for several months at first. Usually that resolves with time, but sometimes, heavy periods at younger ages can signal an issue such as a bleeding disorder.
Any time your periods change significantly or interrupt your regular life, LeBleu Vaszily recommends talking with your health provider.
“Your period can be the first sign that something else is going on. Changes can suggest hormonal or structural problems,” LeBleu Vaszily said. “I always recommend women talk to their health providers at their annual exams and share, ‘Here’s what my periods are doing — is this normal?±’”
Since heavy menses may be caused by various issues, LeBleu Vaszily likes to complete a full history, physical exam, bloodwork and sometimes an ultrasound of the uterus when examining a patient.
Different treatments are available depending on the cause. For instance, birth control pills can help address a hormonal issue, while removing a polyp or fibroid can help if the issue is structural.
Endometrial ablation, an outpatient procedure that cauterizes the lining of the uterus to stop or lessen periods, may also help. Often, dietary and lifestyle changes may also make an impact. A more aggressive option is a hysterectomy, in which the uterus is surgically removed, but in many cases, more conservative treatment may work.
“Having heavy periods doesn’t mean you have to be on hormones or get a hysterectomy,” LeBleu Vaszily said. “Sometimes that is ultimately what is needed if you want relief from symptoms, but there are more conservative options we can try in the beginning. Frequently, there’s something simple that can help.”
Keep in mind that treatments are always changing. For instance, various types of birth control pills are now available with different strengths and formulations. There are also hormonal IUDs, as well a medication taken only at certain times of the cycle.
Sometimes, women don’t realize just how much their period impacts them until they’ve received treatment.
“After I had an endometrial ablation, I wished I had done it five years earlier,” LeBleu Vaszily said. “I hadn’t realized how much my own cycles affected my life.”
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