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Heavy Periods

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What are heavy periods?

Heavy periods are menstrual periods that are characterized by excessively heavy or prolonged blood loss. This condition is also called menorrhagia.

Menstrual periods vary from woman to woman. Most women have a normal period approximately every 28 days, and each period typically lasts from four to seven days. The amount of blood lost during a menstrual period ranges from 20 to 80 milliliters (mL). Blood loss of more than 80 mL may be considered a heavy period. A possible indication of heavy periods is soaking through a feminine hygiene product (pad or tampon) every hour for as long as three hours straight. Nearly one-third of women experience menorrhagia during adolescence or adulthood.

Heavy periods may occur for various reasons, including abnormal blood clotting, a disorder of the uterus, anovulation, or hormonal imbalances. For instance, endometrial hyperplasia occurs when there is excessive growth of the cells that line the uterus. This condition may result from disruption of the two hormones (estrogen and progesterone) that control menstrual periods.

Heavy periods can happen at different ages and stages of life. For instance, young women in the first few years of their menstrual periods may experience heavy periods. Women of childbearing age may have heavy periods because of gynecologic disorders, such as fibroids or polyps, or from complications of hormone-releasing contraceptive devices. Women who are nearing menopause may have irregular periods, including heavy bleeding during menstruation (menorrhagia). Heavy periods may be related to the use of blood-thinning medications, a thyroid imbalance, a uterine infection, or cancer of the uterus.

Seek immediate medical care (call 911) if you, or someone you are with, are pregnant and experience vaginal bleeding. If you are not pregnant, your health care provider will determine the cause of your heavy periods through a pelvic exam and other tests. If your heavy periods are persistent or cause you concern, seek prompt medical care.

What other symptoms might occur with heavy periods?

Heavy periods may accompany other symptoms, which vary depending on the underlying disease, disorder or condition.

Common symptoms that may occur along with heavy periods

Heavy periods may accompany other symptoms including:

  • Abdominal pain or cramping
  • Bleeding or spotting between periods
  • Missed menstrual periods
  • Pain during sexual intercourse

Other symptoms that may occur along with heavy periods

Heavy periods may accompany symptoms related to other body systems including:

  • Bloody or pink-colored urine (hematuria)
  • Fatigue
  • General ill feeling
  • Irritability and mood changes
  • Malaise or lethargy

Serious symptoms that might indicate a life-threatening condition

In some cases, heavy periods may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, are pregnant and experiencing vaginal bleeding.

What causes heavy periods?

Heavy periods may occur for various reasons, including abnormal blood clotting, a disorder of the uterus, anovulation, or hormonal imbalances.

Women of childbearing age may have heavy periods because of fibroids, polyps, or complications from hormone-releasing contraceptive devices. Women who are nearing menopause may have irregular periods that include heavy bleeding during menstruation (menorrhagia). Heavy periods may be related to certain medications, a uterine infection, or cancer of the uterus.

Gynecologic causes of heavy periods

Heavy periods may be caused by gynecologic disorders including:

  • Adenomyosis (presence of uterine lining tissue in the muscle wall of the uterus)

  • Anovulation

  • Cyst (benign sac that contains fluid, air, or other materials)

  • Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)

  • Endometrial hyperplasia

  • Endometriosis (presence of uterine-lining tissue outside of the uterus)

  • Uterine fibroids or noncancerous tumors of the uterus

  • Uterine polyps or masses in the endometrium

Other causes of heavy periods

Heavy periods can also be caused by hormonal imbalances and other conditions including:

  • Bleeding disorders such as von Willebrand’s disease

  • Changes in levels of estrogen or progesterone

  • Complications from hormone-releasing contraceptives (birth control pills, patch or injection; intrauterine devices)

  • Hyperthyroidism (overactive thyroid)

  • Medications such as blood-thinning (anticoagulant) medications

Serious or life-threatening causes of heavy periods

In some cases, heavy periods may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These conditions include:

  • Cancers

  • Ectopic pregnancy (life-threatening pregnancy growing outside the uterus)

  • Pelvic inflammatory disease (infection of the internal genital organs)

Questions for diagnosing the cause of heavy periods

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your heavy periods including:

  • Are you pregnant?

  • When did you first notice your heavy periods?

  • Have you always experienced heavy periods?

  • How often do you have to change your pad or tampon?

  • Do you have any other symptoms, such as severe fatigue or vaginal discharge?

  • Are you currently using oral contraceptives or using any hormone-releasing contraceptive device?

  • What other medications are you taking?

What are the potential complications of heavy periods?

Some variation in menstrual periods may be normal. The causes and complications of heavy periods can vary depending on a woman's age and her stage in life. Because heavy periods can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Anemia (low red blood cell count)

  • Inability to participate normally in activities

  • Severe discomfort or pain

  • Spread of cancer

  • Spread of infection
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 23
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Dysfunctional uterine bleeding (DUB). MedlinePlus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000903.htm
  2. Heavy, prolonged, or irregular periods. UNC Department of Obstetrics & Gynecology. http://www.med.unc.edu/obgyn/Patient_Care/specialty-services/advanced-laparoscopy-pelvic-pain/heavy-...
  3. Committee on Practice Bulletins—Gynecology. Practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol 2012; 120:197.
  4. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.