Why Is My Period So Heavy?

Periods differ for every woman - we all experience different side effects, premenstrual symptoms, and flows. Heavy periods can often be a normal part of a healthy cycle, but understanding the difference between a heavy flow and an abnormal amount of blood loss can help you know when to seek support.

What Is Heavy Menstrual Bleeding?

Menorrhagia Meaning and How It’s Diagnosed

Let’s first break down what’s considered heavy periods. 

Heavy menstrual bleeding, or abnormal uterine bleeding (AUB), with “menorrhagia” being an outdated term, is defined as menstruation that’s too heavy for regular period protection and has an impact on your daily routine. This might mean you find yourself changing your pad or tampon after 1-2 hours, using both pads and tampons together, or frequently bleeding through your clothes.

Your periods may also make daily life difficult, affecting your ability to work, attend school, or exercise. While it may seem alarming, heavy periods affect approximately 1 in 3 menstruating people worldwide. It can often be little cause for concern, but seeking support may help make your periods more manageable and receive medical support if needed.

Signs You're Losing Too Much Blood During Your Period

In every cycle, you may lose anywhere between 20-80 ml of blood, which works out to roughly 1-5 tablespoons. Anything within this bracket is considered a “normal” flow. An abnormally heavy flow may exceed 5 tbsp of blood lost during your period.

It can be hard to measure your flow in this way, but try to notice if you’re often changing your protection on an hourly basis, or layering different forms of protection to prevent leaking. Periods can be uncomfortable, but a regular flow shouldn’t be a major disruption to everyday life.

“But why is my period so heavy?”

What Causes Heavy Periods?

Hormonal Imbalances

Estrogen/progesterone imbalance

Estrogen and progesterone hormones fluctuate in a pattern that dictates the proper functioning of your cycle, but sometimes they may become irregular. These hormones control the monthly rebuilding of your uterine lining (endometrium). 

When these hormones are out of balance, the lining can become too thick, and when shed, it may lead to a heavier period. Hormonal imbalances can be caused by many factors, including certain health conditions or lifestyle choices.

PCOS

PCOS is a common condition that affects your ovaries, leading to hormonal imbalances, inflamed and enlarged ovaries, and irregular periods. While there’s no known cure, it can be made more manageable with proper support.

PCOS supplements are one option that can help ease your symptoms. Our PCOS supplements are designed to help bring balance to your hormones, which can, in turn, improve the symptoms that PCOS often brings.

Anovulation

Ovulation is a key part of your cycle, but sometimes an egg isn’t released, which is known as anovulation. Anovulation can cause imbalances in typical progesterone production, leading to further imbalances and heavy periods.

Thyroid Issues

Thyroid issues, such as hypothyroidism, may cause heavier periods, as low thyroid hormone levels impact estrogen and progesterone balance, leading to an excessively thick uterine lining, as mentioned above. Thyroid symptoms include fatigue, weight gain, constipation, and brain fog.

Structural Conditions in the Uterus

Fibroids

Fibroids are a type of growth that can develop in and around the uterus. Many women with fibroids won’t experience any symptoms, but those who do may notice discomfort in the lower back or abdominal areas, pain during sex, as well as potentially heavy painful periods.

Polyps

Small growths found on the uterine lining, polyps can not only lead to heavier or longer periods, but also potential bleeding between your monthly cycle, as well as during menopause.

These types of growths in your body may sound alarming, but be assured that fibroids and polyps are not cancerous.

Adenomyosis

Adenomyosis affects the growth of your uterine lining, causing it to grow into the uterus’ wall itself, typically affecting more women aged 30+. Adenomyosis can cause some uncomfortable symptoms, such as debilitating period pain and heavy bleeding, as well as pelvic pain and painful sex.

Underlying Health Conditions

von Willebrand disease

Von Willebrand disease is a hereditary condition affecting your blood’s ability to properly clot, meaning you bleed more easily or excessively when injured. You may also experience frequent nosebleeds, and women may notice heavier periods. 

Liver or kidney disease

The proper functioning of certain organs can have a knock-on effect for your cycle. Liver or kidney disease, for example, can both lead to a disruption of estrogen, other ovarian hormones - potentially leading to irregular or a period heavier than usual.

Obesity

Maintaining a healthy weight helps protect and promote the proper functioning of your hormone levels. Medical research has found a link between obesity and heavy periods, as excess body fat triggers higher estrogen production, leading to a thickened uterine lining and heavy menstrual bleeding.

Infections or Pregnancy-Related Causes

STIs (e.g. chlamydia, trichomoniasis)

Sexually transmitted infections, or STIs, can affect your reproductive organs. Certain STIs may also trigger heavier periods, particularly chlamydia and trichomoniasis. If you’re sexually active, it’s important to have regular checks to ensure you’re protecting yourself from potential infection.

Pelvic inflammatory disease

Also known as PID, pelvic inflammatory disease (PID) is an infection that affects your reproductive organs. Sometimes there are no notable symptoms, but common symptoms include pelvic pain, heavy or painful periods, and unusual vaginal discharge.

Pregnancy complications (e.g. miscarriage, ectopic pregnancy)

Sometimes, certain pregnancy complications may present themselves as a heavy period. A miscarriage, defined as the loss of a pregnancy during the first 20 weeks, often begins with bleeding, along with potential stomach cramps. 

An ectopic pregnancy occurs when a fertilized egg is implanted outside of the womb, commonly in the fallopian tubes, and can trigger heavy vaginal bleeding or one-sided stomach pain. These pregnancies are unfortunately unable to progress and are usually removed through medical intervention. 

Medications and Birth Control

IUDs (esp. copper)

IUDs, a form of contraception, are known for causing heavy bleeding, particularly those made with copper. If you feel this may be the case, speak with your doctor to explore your options and discuss potential birth control alternatives that may be more comfortable for you. 

Anticoagulants

Anticoagulants, or blood thinners, are prescribed to those prone to blood clots to combat the risk of stroke or heart attack. However, they can also cause excessive bleeding, such as prolonged nosebleeds, blood in your urine, or, for women, heavier periods.

Tamoxifen or HRT

Medications such as Tamoxifen and HRT (hormone replacement therapy) both affect estrogen levels. As increased estrogen thickens your uterine lining, you may experience a heavier period when this lining begins to shed.

Why Is My Period Heavier Than Usual?

When to Track and Talk to Your Doctor

Sometimes, a heavy flow can be a normal part of your menstrual cycle, but there may be a point where you want to talk with your doctor.

Tracking period symptoms can help you notice any abnormalities and sudden changes, as well as patterns that may point to a potential concern. Here’s a mini checklist you could try using to notice if your period is heavier than usual:

• Are you noticing heavy real period blood on pad within an hour of changing?

• Are you passing blood clots larger than a quarter?

• Do you feel unusually fatigued during your period?

• Does your period cause you to regularly skip work, school, or other activities?

Many women believe that it’s normal to suffer with your periods, and to experience the signs above - and while some discomfort is natural, your period shouldn’t severely affect your daily life. 

Remember, you don’t have to wait until it’s unbearable to seek help.

Risk Factors for Heavy Menstrual Bleeding

Certain demographics of women may be more likely to experience a heavier flow. These demographics include:

• Teens who have just begun their periods

• Women in their 40s, or those experiencing perimenopause

• Women with a family history of fibroids or certain clotting disorders

• Women with thyroid or bleeding disorders

• Women who are obese

If you’re looking for some support with your periods, our Hormone Health Clinic for Fertility offers 1-on-1 support for women with unexplained heavy periods, fertility concerns, PCOS, and more, helping you identify potential issues and explore potential support and treatment available.

Complications of Heavy Periods

Sometimes, heavy periods can lead to additional complications. 

Iron deficiency anemia can be triggered by excessive blood loss, leading to symptoms such as fatigue, brain fog, and feelings of breathlessness. Sometimes, heavy periods may also take a toll on your fertility health, especially if they’re linked to certain reproductive disorders.

Heavy menstrual bleeding can also have an impact in other ways. The psychological toil of living with such heavy bleeding every month can become a lot to bear. For some women, it can become a great source of anxiety and lead them to withdraw from society. These feelings are just as important as medical implications to seek support with.

How Heavy Periods Are Diagnosed

Your doctor may need to perform certain tests to achieve a proper diagnosis for your heavy periods. Knowing what to expect during these appointments can help make them less daunting.

It can also help to track your period symptoms beforehand to give some background to your doctor before they begin. Using hormone trackers and apps are a popular method for many women. 

If this interests you, try our Mira App and Monitor, a handy tool for tracking cycle patterns, key hormones such as LH, FSH, E3G, PdG, giving insight into cycle phases and abnormal bleeding patterns. Our Panorama Lab Test is another option that offers a deeper lab panel to explore hidden hormonal, thyroid, or fertility concerns.

You may need to do a physical and pelvic exam at your check up. Other common tests for heavy periods include blood work, ultrasounds, biopsies, PAP smears, or potentially a hysteroscopy - a test that allows your doctor to see into your uterus by inserting a thin, lighted instrument.

How to Treat Heavy Menstrual Bleeding?

The treatment you may need can depend on your diagnosis, but also your medical history, tolerance to certain treatments, any plans to have children, as well as your personal choices too.

First-Line Treatments

• NSAIDs (e.g., ibuprofen) - anti-inflammatory medications are an accessible and easy way to alleviate symptoms, potentially reducing heavy periods and painful menstrual cramps.

• Hormonal birth control - if you’re not currently TTC, hormonal birth control can help manage your flow and symptoms and is a popular option for many women.

• Tranexamic acid - only needs to be taken during your period, and can help reduce your menstrual flow.

• Iron supplements - if you’re anemic, taking iron supplements should alleviate many symptoms anemia can bring, including abnormally heavy periods.

Surgical or Procedural Options

• IUDs (Mirena) - this type of birth control releases a type of progestin that thins your uterine lining, reducing the amount of blood lost during your period.

• Endometrial ablation - this is a medical procedure that safely destroys your uterine lining. This can drastically reduce your flow, but is not recommended for women who wish to one day have children.

• Myomectomy, polypectomy - removing your polyps or fibroids will eliminate the root cause of your heavy periods, and should make your flow much more manageable.

• Hysterectomy - when all else fails, a hysterectomy involves the partial or total removal of the uterus. This will end your periods, as well as your ability to get pregnant, so may only be recommended if you don’t plan to ever conceive, or as a last resort.

Treatment Options for Heavy Menstrual Bleeding: Comparison Chart

Living With Heavy Periods

Living with heavy periods can be physically and emotionally draining, but tracking your cycle can help you identify patterns and better communicate with your doctor. Before appointments, make a note of your flow levels and how your daily life is impacted to advocate clearly for your needs. 

Choosing the right menstrual products, like high-absorbency pads or menstrual cups, can offer better comfort and protection. The emotional toll is real, so prioritize self-care and speak up for yourself in medical settings. Natural supports like Mira Fertility Tea may also help restore hormonal balance and promote uterine health, adding a calming, holistic layer to your routine.

Sudden Gush of Blood During Period: What It Means

You may notice a sudden gush of blood during your period. This can often be caused by hormone surges, or if you have fibroids. It may also be a sign of miscarriage.

This sudden gush is common during your period, and isn’t always a sign of something severe. That being said, it shouldn’t be ignored, so be sure to check in with your doctor if you experience this - or call them immediately if it seems excessive.

Conclusion

Periods can be complex and highly individual for each woman, and can change throughout the course of a woman’s reproductive life.

Heavy periods can be a normal part of your cycle, but if they become debilitating or concerning in some way, it’s important to reach out and seek help. There remains significant social stigma surrounding periods across the world, but understanding when to talk to your doctor and voice your concerns can help you live in harmony with your periods and enjoy life to the full.

Frequently Asked Questions 

Why is my period so heavy on the second day?

It’s common for periods to be at their heaviest on day 2, as this is when the shedding of your uterine lining is at its most intense due to hormonal triggers - compared to day 1, when the process is just beginning.

What causes big blood clots during your menstrual period?

If you’re wondering, “Why is my period so heavy this month with clots?” it can be helpful to know what blood clots are.

Blood clots form when menstrual blood collects for long enough in your uterus to coagulate and clot together. While heavy periods with clots are pretty normal, it can be worth checking with your doctor if they’re unusually large.

Why do I have no period cramps but an extremely heavy flow?

If you have a very heavy flow but no cramps, it may mean your uterine lining is shedding efficiently without the need for strong contractions. It may also be due to certain conditions or imbalances that increase bleeding - so consider consulting your doctor with any concerns.