Nearly all women will experience menstrual problems at one time or another. Changes in your period are normal over your menstruating years, but it can be hard to know what is normal, and what signifies a problem. Many women are uncomfortable talking about their periods, even when they suspect something is wrong.

Every woman’s period is different, so how do you know if your period is normal or not?

Severe menstrual cramps, irregular periods, heavy bleeding, and missing periods are some of the most common types of problems that women experience throughout their lifetimes. Your menstrual cycle can tell you a lot about your health, and regular periods between puberty and menopause mean your body is working normally. This also means it is important to not ignore problems with your period, because they may indicate more serious issues.

What is Considered a “Normal” Period?

A normal menstrual cycle is between 24 to 38 days, with menstrual bleeding lasting up to eight days. Regular cycles are fairly consistent, meaning that cycle lengths will vary by less than 7-9 days. According to the Centers for Disease Control (CDC), a normal period will release 2-3 tablespoons of menstrual blood.

Menstrual Cycle Irregularities Are Common!

According to the authors of a recent study, abnormal uterine bleeding and heavy menstrual bleeding affect 14-25% of women of reproductive age. Menstrual irregularities can include absent, infrequent, heavy, prolonged, or painful periods.

Most women will experience heavy menstrual bleeding at some point, but if every menstrual cycle is heavy or exceptionally painful, that is not normal. Abnormal Uterine Bleeding (AUB), also known as “menorrhagia,” can be a painful, frustrating, and embarrassing problem. Heavy periods can make everyday activities difficult or impossible.

What is Abnormal Bleeding?

Your period is a deeply personal experience, so it can be hard to know if your period is normal or not. When it comes to bleeding and pain, how much is too much?

Here are a few good reference points for what constitutes an abnormally heavy menstrual cycle:

  • Your period lasts more than 7 days
  • You are passing large clots of blood during your period
  • You need to change your tampons/pads more frequently than once every two hours, or require double protection to stay clean and dry
  • You experience fatigue, tiredness, or shortness of breath during your period, which may be due to anemia

What Is Causing My Period Problems?

There are many causes of abnormal periods. If you are experiencing abnormal bleeding, you should talk to your gynecologist. They may want to screen for conditions like:

  • Ovulation problems, which can affect the length of your cycle and intensity of your flow
  • Uterine fibroids, which can cause heavy, painful periods
  • Endometriosis, which can cause intense pain a few days before the start of your period, pain during intercourse, and problems with infertility
  • Problems related to certain birth control methods, such as the pill or Intrauterine Devices (IUDs), which may cause heavy, long-lasting periods or a total absence of a period
  • Certain bleeding disorders, which may cause abnormally heavy menstrual flow
  • Hormone imbalance
  • Miscarriage, which may cause intense pain and heavy bleeding
  • Ectopic pregnancy, in which an egg becomes fertilized inside of a fallopian tube instead of implanting in the uterine wall
  • Certain types of cancers, like cancer of the uterus or cervix

Next Steps for Painful, Heavy Periods

If you are experiencing heavy bleeding or other menstrual concerns, it’s a good idea to speak with your gynecology provider. Your period can be an indicator of your overall health, so don’t ignore it!

When you schedule an appointment with a gynecological provider, they’ll want to take your medical history and listen to your symptoms. Based on your age, symptoms, and other risk factors, your provider may recommend testing to better understand what’s causing your heavy periods or irregular cycles.

Some Tests Your Provider May Suggest

If you are experiencing heavy periods or abnormal menstrual bleeding, your provider may perform various exams and testing including but not limited to:

  • Pelvic exam to examine your pelvic organs
  • Urine tests to check for infection or other indications
  • Blood work to check for signs of infection, anemia, or other underlying health problems
  • Pelvic or transvaginal ultrasound or other imaging to get a look at what’s going on inside of your body

Conversations with Your Provider

It’s normal if you feel a little nervous about talking to your gynecologist! Here are some questions you may want to ask:

  • What is causing my heavy, painful, or abnormal periods?
  • What are my treatment options?
  • What are the least invasive options for treating my heavy periods?
  • Would hormones be helpful in treating my abnormal menstrual cycle?
  • Should I follow a special diet plan to help with heavy periods?
  • If I need surgery, do you offer minimally invasive surgery options?

Treatment Options

Treatment for heavy periods or abnormal cycles vary depending on the cause. Some treatment options may include over the counter or prescription medications, hormone therapy, IUD, minimally invasive surgical procedures such as Dilation & Curettage (D & C), Global Endometrial Ablation, or hysterectomy.

Talk to your provider to determine which treatment options may be best for you. Talk to your provider about your symptoms and your goals for treating your heavy periods, so they can build a treatment plan that works for you.

Period problems are normal, Elite Women’s Health can help

Untreated heavy or painful periods can stop you from living life to your fullest, and can cause other health concerns such as anemia. Don’t let your health wait; speak to one of our providers about treating your heavy, painful, or irregular periods today.

Elite Women’s Health now has two convenient locations in Fredericksburg and Spotsylvania to serve the Fredericskburg, Spotslyvania, and Stafford communities. We now also offer convenient telemedicine appointments for existing patients for certain types of visits.

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