What is
heavy menstrual bleeding?
What is
heavy menstrual bleeding?
In order to understand what heavy menstrual bleeding (HMB) is, it helps to understand what a normal period is. Getting to know your cycle will help when it comes time to talk to your doctor.
Let's start at the beginning:
Just what is a “normal” period, anyway?
Everyone is different, which can make it hard to know what “normal” even means. But there is an average, or range of typical characteristics. For example, a “normal” period (or menstrual flow) may:
Occur every 28 days on average
Last for
4 to 5 days
Result in a total blood loss of 35 mL to 40 mL
A normal period
may result in a blood loss of 35 mL to 40 mL (2 to 3 tablespoons)
a heavy period,
which may result in a blood loss of 80 mL (5 to 6 tablespoons) or more.
What is a “heavy” period, exactly?
According to the objective standard for measuring HMB, women with HMB may lose 80 mL of blood (5 to 6 tablespoons) or more during their period and may have bleeding that lasts longer than 7 days.
While common, HMB is not a normal or typical event. It can interfere with your work life, social plans, or daily activities.
Your period may be heavy if you:
- Soak through 1 or more pads or tampons every hour for several hours in a row
- Need to wear more than 1 pad at a time to control your bleeding
- Need to change pads or tampons during the night
- Have periods with blood clots that are the size of a quarter or larger
- Have periods that last more than 7 days
- Have a heavy flow that keeps you from doing the things that you would normally do
- Have constant pain in the lower part of the stomach during your period
- Feel tired, lack energy, or experience shortness of breath
Talk to your doctor to learn more and see if you may have heavy menstrual bleeding.
In order to understand what you are experiencing, your doctor may run some tests, including:
A blood test to check for anemia, thyroid problems, or blood clotting issues
A Pap test to determine if you have an infection, inflammation, or
cell changes
An endometrial biopsy to examine tissue from the lining of your uterus
An ultrasound to see how your blood vessels, tissues, and reproductive organs are working
Why do some women experience heavy periods?
Heavy periods are one of the most common problems that women share with their doctors. Several conditions may cause heavy periods, or HMB; however, there are many times in which heavy bleeding does not have a known cause.
Some of the possible causes include:
- Uterine-related problems
- Hormone-related problems
- Other illnesses or disorders
Some women who have heavy periods have no evidence of any physical abnormality and their doctors are unable to find the cause. If there is no gynecological problem, and other causes are ruled out, you may be a candidate for hormonal treatment. Talk to your doctor to see what treatment options are available.
