Maybe Aunt Flo used to come for shorter visits. Maybe she wasn’t always so intense. Maybe you’re experienced in heavier monthly flows, or they are a new part of life to navigate. Does that have to do with lifestyle? Or age? Or something else? Whichever way, we have questions.
We talked to Dr. Heather Bartos, OBGYN and founder of The Me Spot podcast to clarify what could be causing heavier periods. Because, just like all other varying factors that go along with being a woman, there isn’t just one black and white answer. First of all, what exactly is considered “heavy” when it comes to period bleeding?
“Science actually measured this, and the answer is 80 mL, or 5.5 tablespoons— yes, that was someone’s job to determine this,” Dr. Bartos tells us.
Five and a half tablespoons may not seem like a lot of liquid, until it’s our responsibility to think one step ahead of gravity and stop it from making a mess at all costs. This amount could mean having to change your tampon 5-6 times per day (every three hours or less), waking up to stained pajamas or sheets, or expelling large clots.
Heavier periods, Dr. Bartos tells us, are known as “menorrhagia” in the medical world. She explains that when menorrhagia is on the worst end of the spectrum, you’re changing a tampon or pad close to hourly for the first few days of your period—“Think Carrie at the prom.” While we don’t love this image, Dr. Bartos, it does paint a gruesome picture. Here are some things that could possibly be contributing to your hefty flow:
“Sometimes, there are structural issues. Fibroids and polyps can cause heavier periods, especially if they get heavier over time.”
“There can also be hormonal issues, PCOS—even thyroid issues—can cause heavier periods as well. As we begin our reproductive life in our teen years, and as we end it (closer to menopause), heavier periods are more common because of hormonal disruptions.”
Perimenopause is one of these hormonal “disruptions”—in this case, a natural and necessary development. Perimenopause is when we wind down on the reproductive phase of our youth, typically around our 40s, and aren’t ovulating as regularly, which is a clear indication of hormonal changes.
Non-hormonal IUDs and blood thinners can also prevent blood from coagulating, making it come out more runny and more regularly, rather than in smaller, thicker clumps. This will feel heavier and more cumbersome in terms of care and mess-prevention— it’s just as important to pay attention to blood texture and color as it is the volume.
“Other random things that can cause heavier periods are certain gynecological cancers (especially uterine) or bleeding disorders,” Dr. Bartos warns. While these are far less common, if there is a very abnormal amount of blood or even pain, it’s smart to get yourself checked out by a professional, gather some opinions and set out for testing. And, while we can’t be certain yet whether COVID can cause heavier periods, Dr. Bartos tells us that it can cause period disruptions, so stay tuned for more intel on that!
Sometimes heavier periods come with heavier cramping, which could require more downtime before, during, and just after the bleed. Consider dialing down physical activity and only doing restorative workouts, and increase your rest. Heavier periods could also mean a greater risk of iron deficiency, so attuning your diet to make up for lost nutrients is crucial.
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